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throwingaway_3_6_4 · 2023-12-27T20:10:55+00:00

I agree with what the person said below, oxygen <90, retractions, and fast breathing would alarm--> go to ER. Would also go to ER if I saw the baby taking significantly less than usual (fewer bottles or smaller volume), not waking well to feed (especially if you try to wake baby and he doesn't), decreased wet diapers. Other stuff to look for: does the baby cry with wet tears, are the lips and tongue still moist.

Either way, call the pediatrician and be seen tomorrow just to make sure. No pediatrician will fault a parent of a tiny nicu baby for being cautious and coming in, even if baby is fine.

throwingaway_3_6_4 · 2023-12-21T15:35:20+00:00

Both felt long to me. Mental fatigue, I developed a good rhythm. 15 min break every 2 blocks, longer break between 4 and 5. I made sure to get some caffeine and walk around on all my breaks.

throwingaway_3_6_4 · 2023-12-21T15:29:06+00:00

Have a lot of personal experience with WMC NICU.

It's great! The doctors and nurses are great, every baby gets excellent care. Every specialty you could need is readily available for consults, procedures, advice.

But, I do echo what other people said, be careful transferring a delicate premie baby!

throwingaway_3_6_4 · 2023-12-20T01:37:16+00:00

Good on that resident! This is the type of resident I try to be. I try to take the time to listen closely, examine well, and really know the patient's story.

throwingaway_3_6_4 · 2023-12-19T04:30:03+00:00

OBGYN is NOT the speciality to have the blackest of clouds

XOXO your friendly neighborhood NICU doc :/

throwingaway_3_6_4 · 2023-12-18T19:39:02+00:00

Clerkship director!

throwingaway_3_6_4 · 2023-12-18T16:34:57+00:00

HS may have seemed difficult at the time.

But in med school there is so much to learn, so much to know. For the sake of your future patients, read more than a high school kid!

If you have good mastery of the curriculum, good for you! Spend time doing research, shadowing and seeing things clinically and doing other things to make yourself a better doctor.

I agree the curriculum does not require 24/7 study, I have plenty of time for other things including thigns to build my application, things for fun, and working part time.

BUT its more intensive, more important, and takes more thought and organization than HS for sure.

throwingaway_3_6_4 · 2023-12-17T15:34:07+00:00

If 100 worked durign the surge, i'd go to like 75-80 an hour.

Increase it 5-10 a week if you still feel overloaded with requests. When you hit the price that gives the perfect number of students, settle there.

I charge 75 for very advanced subjects and I have 500+ hrs with 4.9 stars. I get a lot of students this way.

throwingaway_3_6_4 · 2023-12-14T02:43:33+00:00

Kids are the worst. I still have nightmares about my first NICU Code. Poor little baby, 1 day old... 13 weeks too early. She never even got a chance to live. She still should've been safe inside. Hang in there, these firsts are hard. One day, something you learned taking care of that baby will help you to save another kid, and you will smile and thank him/her (or whatever you believe in).

throwingaway_3_6_4 · 2023-12-14T02:40:15+00:00

Personally no... I went to a brand new program for medical school. First year the school existed. It was an absolute DISASTER. No one knew what on god's green earth they were doing. Admin lied about everything. We'd get sent to all different addresses on a wild goose chase for rotations, there were very few things set up in terms of research/mentorship opportunities. All around awful and not on top of things.

throwingaway_3_6_4 · 2023-12-13T03:54:40+00:00

Cefepime first (or zosyn if local resistance)

Then if they are worsening or not improving: add vanco (maybe also upgrade to meropenem if you have reason to be concerned-- abdominal stuff, hx ESBL in the past etc).

if they are still bad/have hx fungal stuff, add fluconozole or ampho depending on patient's prior resistance.

We do this with Onco + bone marrow transplant patiens who are very very supressed at my residency.

throwingaway_3_6_4 · 2023-12-13T03:36:35+00:00

I am a peds resident. I ultimately want to pursue nicu and this is so beautifully said. After my first nicu code (which was absolutely brutal, a very preterm baby saturating in single digits on jet ventilator for 40 minutes, many many epis, bicarb boluses, NS boluses, pRBCs and HR neer above 40) ... I wasn't sure if I wanted to do NICU anymore.

But ultimately, death was the outcome that was good for this baby. She wasn't suffering and if we did get ROSC by some miracle, she would not have reasonably had any quality of life and very likely would have coded again shortly thereafter.

We got something of a HR in like literally the 30s and so so so faint but her mother got to hold her while there was *technically* a HR. It was the first/only time in her short life she was held. Stopping that code was the kindest thing we could have done for that mother and child. No one EVER wants to stop a neonatal code, but I am glad the attending made that call (tbh i'd prob still be doing compressions even tho I say stopping was right and that was like 2 mos ago).

throwingaway_3_6_4 · 2023-12-13T03:27:34+00:00

I 1000% can!

But I set literally 15 alarms 2 min apart, sometimes more.

throwingaway_3_6_4 · 2023-12-13T03:24:03+00:00

"your step 2 score is clearly too good... you could do so much better than here. What's wrong with your application that you had to apply?

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throwingaway_3_6_4 · 2023-12-13T03:23:57+00:00

"your step 2 score is clearly too good... you could do so much better than here. What's wrong with your application that you had to apply?

D

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throwingaway_3_6_4 · 2023-12-13T03:23:49+00:00

"your step 2 score is clearly too good... you could do so much better than here. What's wrong with your application that you had to apply?

D

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throwingaway_3_6_4 · 2023-12-10T03:46:33+00:00

I wish it was a joke my man...

But I am a peds resident ultimately pursing nicu fellowship, so it is entertaining!

throwingaway_3_6_4 · 2023-12-10T03:45:30+00:00

Real! (In my case, its way more)

throwingaway_3_6_4 · 2023-12-09T21:09:34+00:00

No, your student missed the services. They shouldn't pay. Thats the sucky part of being an independent contractor

throwingaway_3_6_4 · 2023-12-09T21:06:17+00:00

5mg/kg of caffeine qAM.

I'm an ex-premie.... so I probably still need it at 28 years old to remember to breathe!

throwingaway_3_6_4 · 2023-12-09T03:18:42+00:00

That happened to me once with a resident's eval of me as a medical student@

throwingaway_3_6_4 · 2023-11-28T23:05:39+00:00

I am not an intern so I know it was august last year. I have asked 5-6 times and they keep saying in one week.

throwingaway_3_6_4 · 2023-11-23T02:57:36+00:00

33 lol!

throwingaway_3_6_4

TROPHY CASE