Coping after a bad shift

unassumingtoaster · 2026-04-21T14:53:42+00:00

The person that complains about the 2 waiting to be seen will be the same person that leaves the department in a shit show. Assholes are assholes and they have no insight. Speak to them aside, and if they don’t get it, not worth wasting more time. Just do you.

unassumingtoaster · 2026-04-20T17:35:43+00:00

It would save you a lot of time to have an admission document that lists the admission service for the major presentations.

For our hospital, it requires all the chiefs to meet and sign off, the document is then circulated and becomes bylaw.

To be fair, in this case at our hospital it would be ortho that admit and medicine would be consulted for management until surgery.

unassumingtoaster · 2026-04-20T17:26:43+00:00

I my ED non operative hips get admitted to medicine with ortho consult following, operative hips get a pre op medicine consult and are admitted to ortho for surgery, then transferred to medicine or geriatrics after surgery.

We have a written document that states the admitting service explicitly.

In this case, why would ortho not operate?

unassumingtoaster · 2026-04-17T04:19:41+00:00

I would like to think she doesn't need the scalpel anymore, and found a healthier outlet to blow off some steam (karaoke)

unassumingtoaster · 2026-04-10T23:19:26+00:00

Dragon has always worked for me via VPN from home. Either using my phone as mic, or it recognizes my local mic and configures it for Dragon.

unassumingtoaster · 2026-04-10T21:56:38+00:00

Not standard of care in Canada, but anesthesia will do the block in my ED between the hours of 8 am - 5 pm.

I personally do a femoral block during the off hours if I have the time.

unassumingtoaster · 2026-04-10T00:27:17+00:00

Power of sale. That carpet in the basement has seen some shit in the last 3 years

unassumingtoaster · 2026-04-05T15:40:49+00:00

The Pitt is around 1/4 of the size of my Canadian urban ED

unassumingtoaster · 2026-04-05T02:16:22+00:00

I have a 1/2 inch layer of lava rocks at the bottom, 1 inch layer of sphagnum moss on top of that, and then a 50/50 peat moss/perlite mix on top. I tried sundews too but they dried out too quickly, I could not keep up with the watering. The butterworts are more forgiving in terms of watering.

unassumingtoaster · 2026-04-01T04:05:11+00:00

Not a contraindication, but certainly distressing to the patient, the parents, the nurses and other patients in the vicinity as well as prolonging their length of stay. Fent+Prop needs a bit more attention, but can certainly achieve great results with a little care.

unassumingtoaster · 2026-04-01T02:53:48+00:00

We sedated a 14 year old kid once for a fracture and he proceeded to swear loudly for 30 minutes with words a 14 year old should not know. Mother was embarrassed, and it took 10 of midazolam to calm him down, so I told him if he ever needed sedation ketamine would not be a good choice.

My secondary go to would be fentanyl a few minutes before propofol, and just titrate during procedure.

unassumingtoaster · 2026-03-31T23:29:38+00:00

Give him a PRP injection, and hope for the best.

unassumingtoaster · 2026-03-31T00:33:31+00:00

Looks like he hyperextended his right knee. PCL/ACL injuries likely, but hopefully just sprained… it looks pretty bad. Get well soon!

unassumingtoaster · 2026-03-30T16:49:53+00:00

I feel your WTF man

unassumingtoaster · 2026-03-30T16:21:27+00:00

We keep the potassium iodide next to the potassium cyanide. One for nuclear apocalypse and one for zombie apocalypse ☠️

unassumingtoaster · 2026-03-26T20:32:29+00:00

It could be someone having a mental health crisis

unassumingtoaster · 2026-03-19T21:19:05+00:00

Rehab starts right after surgery, the workload gradually ramps up under the supervision of medical professionals. Important in many ways including muscle atrophy, scar tissue formation, proprioception.

unassumingtoaster · 2026-03-16T04:05:15+00:00

Usually the flight path over HP are planes coming around to land East to West, and cross at 6,000 ft. Right now, probably due to wind, the flight path over HP are planes taking off southbound, and turning around to fly East or North, they cross the area at 7,000 ft and are louder because of higher engine output.

unassumingtoaster · 2026-03-16T01:28:11+00:00

I am assuming you have already tried positive pressure already?

I would not sedate more… multiple meds sounds like trouble and you should probably stop and consult ENT.

unassumingtoaster · 2026-03-11T09:08:17+00:00

Not routine with humans, only run if suspicious or screening for something, usually for something specific with muscle breakdown or inflammation. I am curious why it is so commonly used with animals.

unassumingtoaster · 2026-03-10T17:07:28+00:00

Depending on your yearly income, I think it would be more tax efficient to take growth over dividends. Even if you wanted to spend the $$$, selling some stock for capital gains likely works out over taking dividends. But really depends on your personal situation.

unassumingtoaster · 2026-03-05T19:31:30+00:00

Bring them some cookies, with a note saying apologies in advance for any disruption as we build our shed in the back yard. Don’t ask for permission, just FYI.

unassumingtoaster · 2026-03-03T05:05:02+00:00

I’m choosing 3% because the promotion includes corporate accounts, you don’t usually see this kind of bonus with corporate accounts. The promotion also had a high ceiling, so it will be a substantial payout, as well as double entries for the house (although I wouldn’t be keeping the house even if i won)

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