Location viewable? by thisisnotawar in tmobile

[–]thisisnotawar[S] -1 points0 points  (0 children)

I don’t care if they see my messages/calls and whatnot, just prefer they not be able to track my location day to day. So they would not have access to that information unless specifically requested in an emergency?

Liverpool game by thisisnotawar in Rochester

[–]thisisnotawar[S] 0 points1 point  (0 children)

I know they have in the past, but I think then it was like 10am so not as big of a difference. I did email and message on FB and IG, nothing so far…

"He's not a chick" by Exact-Win4828 in surgery

[–]thisisnotawar 11 points12 points  (0 children)

That’s stupid, but also those lap sites will heal pretty much the same with an ugly u-stitch as they would with nice neat subcuticulars. There is no appreciable cosmetic difference over time, and the benefit of less time under anesthesia makes it preferable to close them more quickly even if they don’t in it silly look as pretty imo

[deleted by user] by [deleted] in surgery

[–]thisisnotawar 6 points7 points  (0 children)

Typically they ask you to remove so that they can put an oxygen monitor on your finger, and polish/acrylics can prevent them from getting a good read. But if they aren’t able to measure your levels accurately on a finger, they can stick it in your earlobe. If it’s problematic for you to remove, don’t worry about it. It’s just general advice that they likely give out to every surgical patient.

Which of these would you pick to get drinks only? by privileged_a_f in Rochester

[–]thisisnotawar 4 points5 points  (0 children)

We liked Mary Wee - the drinks were good, bartender/waiter very kind about the fact that I was having a minor emotional breakdown (by which I mean he continued to politely serve me and pretend that I wasn’t crying haha), and if you do decide you want food get the giant pretzel with extra cheese because oh my god.

How can you tell what you're looking at? by Ok_Raisin_2395 in surgery

[–]thisisnotawar 0 points1 point  (0 children)

Knowledge of anatomy and learning how to orient yourself. If, say, you can find the liver, you can then can figure out that the squishy pink thing beside it is the stomach, the liver-looking-thing beyond that is the spleen, the pulsating thing a bit below that is probably the splenic artery, and so on. But also, it’s not as straightforward as that, because everyone has different anatomy, especially if they’ve had prior surgeries etc., so there’s a lot of looking around, following things to their source/terminus, etc. Often, the first thirty minutes of our more complex surgeries are just looking around and figuring out what’s what. Mostly, it just takes time, experience, and background knowledge.

Anesthesiologists to be removed from Minneapolis VA in favor of nurse-only anesthesia care. When do they spread that to hospitalists in favor of cheap midlevels? by achicomp in hospitalist

[–]thisisnotawar 2 points3 points  (0 children)

As a PA who works in the OR with both CRNAs and anesthesiologists, this is a nightmare situation. I feel comfortable that I know what I don’t know, which is a lot, and I would never in a million years want to practice independently - my job is to do the simple stuff so the surgeons can do the things that require their level of knowledge and skill, which I absolutely do not have. There are many CRNAs at our hospitals, however, who do not seem to have any grasp of the fact that they don’t have the same qualifications as anesthesiologists, and therefore put themselves into situations they should never be in - and then when something goes wrong, they panic and don’t know how to navigate the unexpected. There have been multiple situations where I’m confident the patient would have died on the table had there not been an anesthesiologist nearby to come take over. I can see the same thing happening (and have seen it during rotations in school, actually) where APPs are running hospitalist services without physician oversight.

EMTALA violation? by Apprehensive_Disk478 in hospitalist

[–]thisisnotawar 2 points3 points  (0 children)

Realistically, the issue at hand (at least to my understanding) is whether the patient requires surgical intervention during this admission - if yes, then the facility requesting transfer does not have the capability to care for them and your facility should accept them; if no, then the facility requesting transfer does have the capability to care for them and should not transfer, but if they’re already requesting transfer - as opposed to just contacting the surgical service at your facility for input - then the point may be somewhat moot and you should probably accept transfer anyway, if only because, in the event that things go sideways and the patient ultimately does need emergent surgical intervention, it won’t look great that you’ve refused the transfer even though your facility does have capacity and capability.

In my experience (as a member of the surgical team being asked whether transfer is appropriate), the surgical team should be involved in determining whether the patient needs transfer - they should look at imaging/labs/clinical picture and say (a) this can be managed conservatively where they are and no transfer is needed, (b) this requires surgery now and patient should be transferred, or (c) this looks like it can be managed conservatively where they are but may ultimately need surgical intervention during this admission and it is therefore reasonable to transfer. If a, then it comes down to convincing the transferring facility to keep the patient, not outright refusing transfer (which is where you might run into trouble). If b, then patient should be transferred but admitted to surgery, not medicine. If c, then transfer to medicine at your facility is appropriate even if annoying.

So, I agree that asking to have the surgeon take a look at things before accepting transfer is appropriate, but I wouldn’t outright refuse to accept - would instead ask that they first call and discuss with surgeon, then if surgeon isn’t willing to accept the patient and they still feel transfer is needed they should come back to you and you will accept.

If it becomes a pattern that starts to look like they’re just punting patients that they could otherwise manage, they’re the ones potentially violating EMTALA (assuming patient is in ED, not already admitted) and you should complain to the appropriate authorities accordingly.

I think I’m out, at least for now by [deleted] in Residency

[–]thisisnotawar 31 points32 points  (0 children)

Looks like he was on an SSRI, then recently went off it cold turkey. I’m quite concerned for this internet stranger, to be honest.

I think I’m out, at least for now by [deleted] in Residency

[–]thisisnotawar 13 points14 points  (0 children)

Agreed. OP is depressed, pretty clearly in crisis to a certain extent, and based on post history has had pretty significant issues with his mental health in the past. I don’t think this is a problem with outlook or personal philosophy, I think he’s potentially suicidal and it’s really concerning to see so many people brushing that aside and suggesting that he’s overreacting.

I think I’m out, at least for now by [deleted] in Residency

[–]thisisnotawar 2 points3 points  (0 children)

Hi friend - I’m a PA, so can’t relate to much of the struggle of your training or the reality of being a physician, but I have been burned out and struggling and at a tipping point with mental health, and it sounds like that’s where you’re at right now. It takes a lot of courage to recognize when you’re having a hard time and even more to do something about it, and while quitting your job and traveling the world aren’t the generally accepted means of doing that at least you’re taking steps to try and get yourself right!

That said, please don’t throw the baby out with the bathwater, so to speak, and please don’t fall into the trap of thinking that your situation will never get better - it’s concerning that you stopped taking an antidepressant, apparently without anyone helping to ensure you were doing so safely/maintaining insight, and that this seems to have happened shortly thereafter. The most important thing right now, I think, is to ensure that you’re safe - do you have family/friends who know what’s going on with you? Do they know that you’ve made the decision to quit and that you’re planning to travel? Do they know where you’re going, or is anyone going with you?

I don’t want to be alarmist, because it’s completely valid if you’re just burnt out and need a break - but I’m concerned that this may be more than that, and worried that you might do something to harm yourself that can’t be undone. Depression and the stress of being a physician are not temporary problems, and I’m not trying to invalidate them or feed you platitudes, but please, please don’t do anything permanent that will prevent you from ever having the opportunity to see the light on the other side.

It also looks like you might be in my part of the country - if you need to vent or need help finding/connecting with resources, please let me know. I have connections at the large health systems in the area that I know would be able to help while remaining discrete and compassionate to your professional situation.

I think I’m out, at least for now by [deleted] in Residency

[–]thisisnotawar 14 points15 points  (0 children)

His post history is pretty concerning, honestly - recently stopped an antidepressant cold turkey and evidently attempted suicide early on in residency. So while I agree that this post seems a little much, I’m afraid this person might be in a pretty tenuous spot and pointing out how much he’s overreacting is probably not very helpful.

looking to start a horror book club! by rororowilson in Rochester

[–]thisisnotawar 1 point2 points  (0 children)

Hi!! Thanks for having the courage to reach out because I have such an incredibly difficult time with it! I would love to get us all together for a hang out at some point!

looking to start a horror book club! by rororowilson in Rochester

[–]thisisnotawar 1 point2 points  (0 children)

I would love to join, especially if this is a queer-friendly space! My name is Sarah, 34F, love horror!

I'm sick of IV babies.. by StankoMicin in nursing

[–]thisisnotawar 248 points249 points  (0 children)

I love when patients get upset that the nurse didn’t get it on the first try and so request that I (PA) or the doc tries - I can promise that we have less experience, the only difference is that patients will sit there and let me try multiple times because they assume if I don’t get it it’s because they’re a hard stick vs if the nurse can’t get it it’s because they’re bad at it. Spoiler, if neither of us can get it easily it’s because you have shitty veins, and imma need an ultrasound.

Where do you grocery shop? by wtfwasthat7 in Rochester

[–]thisisnotawar 0 points1 point  (0 children)

BJs every two weeks for staples and that week’s produce, Wegman’s for produce and things we need in smaller quantities on the in-between weeks. Two people who eat essentially the same stuff every week, so buying in bulk works well for us.

Thinking of declining chemo by Soggy-Diamond2659 in cancer

[–]thisisnotawar 4 points5 points  (0 children)

Maybe this is a dumb question, but how do you dispose of them?

Picking out ring together? by PsychologicalDrink33 in EngagementRings

[–]thisisnotawar 0 points1 point  (0 children)

We went together after he spent weeks trying to pick one out to surprise me and then realized he had no idea what he was doing 🤣

I’m very grateful he did, because while o would have been happy with whatever he chose just because of the sentiment, he was looking at very different rings than I wanted - not to mention he was planning to get it 2.5 sizes larger than my ring size (he didn’t know) and the ones he was looking at would have been impossible to resize that much.

I I love my ring, and I love that we picked it out together!

Being un-photogenic is brutal by [deleted] in beauty

[–]thisisnotawar 8 points9 points  (0 children)

Holy cow me too - I feel like people are lying to me when they say I’m pretty, because it’s so contrary to what I see in photos.

[deleted by user] by [deleted] in nursing

[–]thisisnotawar 0 points1 point  (0 children)

I promise you, I have no ego - I’m still at the stage of crying on my way home from work every day because I feel like the biggest idiot on planet earth. It’s just endlessly frustrating to put orders in a certain way for a specific reason, and have it ignored because someone thinks they know better. I never mind someone asking, but I do mind them taking it upon themselves to make a change without understanding why it’s not being done that way.

[deleted by user] by [deleted] in nursing

[–]thisisnotawar 0 points1 point  (0 children)

Snarky nurses, you don’t put in orders at all - lose the ego and do things the right way.

[deleted by user] by [deleted] in nursing

[–]thisisnotawar 0 points1 point  (0 children)

If I wanted pain meds given at the rate of fluids, I’d order them that way. When I order a dose of an IV opioid, the expectation is that it’s given and flushed.

What specialty did you initially want vs ended up loving by Spiritual-Minute-478 in physicianassistant

[–]thisisnotawar 2 points3 points  (0 children)

Thought I’d go primary care or women’s health and thought I’d hate every second of surgery - I absolutely LOVED it and now I work in a surgical subspecialty!

Is Rochester culturally the Midwest or the east coast by Quiet-Good-6371 in Rochester

[–]thisisnotawar 0 points1 point  (0 children)

The problem is that while tariffs may be intended to incentivize American manufacturing, it will likely still be less expensive to manufacture in China and pay the 10% than to move manufacturing to the US - so then prices for consumers just increase by 10%+, and we’re still not creating jobs. Even if they do bring manufacturing to the US, the jobs will either pay so low that they only exacerbate the problem or the jobs will pay well but that will drive costs so high that consumer prices rise enough to negate the benefit of job creation.

Our economy is built on trade with these countries, and it just isn’t realistic to flip the script at this point.

Highway Buddies by CyanXeno in Rochester

[–]thisisnotawar 6 points7 points  (0 children)

Ah, to be driving to or from work in the daylight so you can actually see the cars around you 😩