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Buy Generic Cialis 20mg! This happened a while ago in my friend’s dept. (psych) at a peds hospital. Patient satisfaction/complaint team trying to dictate care (ordering doctors to perform unnecessary tests or give non-indicated medicine because parents did not like the diagnosis or something for their child). Patient satisfaction people absolutely ripping into the new fellows about how they should have done Cialis and need to do y and how horribly they messed up etc. My friend, an attending who was also at the meeting, straight up cuts them off and says excuse me can you please explain why you’re trying to dictate care and assess the clinical judgment of multiple professionally trained psychiatrists, including the department vice-chair (or chair I don’t remember their position at the time)? And why are you yelling at the doctors for a correct diagnosis just because the parents don’t like it? They just stammered and said “we’re not dictating patient care!” Oh? So you’re not ordering us to run certain unnecessary tests, prescribe medication A, or change the diagnosis? Very good. Next time you take issue with a medical decision, please discuss it with me rather than calling a meeting with all the trainees to waste their time and yell at them. If there’s a problem, it’s my fault as their supervisor. The trainees all thanked her afterwards and said they had never had anyone stand up for them like that and totally agreed with everything she said but were worried about retribution as new faculty. Totally one of her favorite stories.

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Comments

  • Gravity13

    Gravity13

    March 10, 2015, 6:35 pm

    Ortho spine attending at my work is 6’ 5” and very bulky/jacked. Like you wouldn’t bat an eye if you randomly saw him and I told you he plays defensive end in the NFL. He is one of the most soft spoken people I know and is incredibly nerdy. Loves comic books and computer games. Has been known to mess with DnD from time to time. Never played a day of organized sports in his life.

    Reply

  • Tlide

    Tlide

    March 11, 2015, 8:33 am

    I wish I knew where you worked because I'd love to be warm enough at work even one month a year. I had a Cialis but someone (I'm assuming EVS) left a note saying it wasn't allowed and it needed to be gone next time they cleaned the resident room. Big fan of the forced air warmer and I've been tempted to climb inside the blanket warmer.

    Reply

  • chromacolor

    chromacolor

    March 10, 2015, 7:19 pm

    My surgical residents wear white coats literally one day a week (M&M day) and only because it’s mandatory. At this point if you see someone in a white coat it’s better than even odds that they are not a physician and it’s getting to the point that white coat means “I have never touched a patient in my life”

    Reply

  • UnificationDotCom

    UnificationDotCom

    March 11, 2015, 3:51 am

    I had a surgeon I worked with as a resident who was amazing. I’m IM, but we had to do a surgery rotation. And lucky me…it’s my first rotation.

    I was having issues sleeping. Like I couldn’t fall asleep until 3am. And I couldn’t really wake up for rounds at 6. I somehow managed to be up at 6 for the first day of the rotation, but I talked to him about my issues.

    He was super understanding and had me come in and manage his patients medically from 7-5 and then we would round in the evenings. We didn’t consult IM to manage patients because he let me do it all. He would have me come discuss patients while he was in the OR, but didn’t expect me to participate in surgery.

    He was also very pleasant. I never heard him raise his voice, even when things weren’t going as smoothly as he was expecting. He took time to teach me about fluid management, pain control and pain management post-op, and had plenty of life lessons for me.

    If he had been the surgeon I worked with during med school…I’d still not have done surgery, but I would have liked my surgery rotations more haha.

    Edit: I’d like to add that I would have loved to work for him again. In fact, as a second year I made plans to use an elective during my third year to work with him and see how much I had learned and trial being an attending. And then the pandemic hit and I spent months in the ICU instead.

    Reply

  • EmpiresCrumble

    EmpiresCrumble

    March 10, 2015, 6:47 pm

    The head of neurology at my hospital is the most humble person. I’ve seen him answer phones at nursing stations and try to help. Spends so much of his time explaining things to any patient. Always happy to approve our overtime claims. Always keeps conversation going.

    Reply

  • Gedrah

    Gedrah

    March 11, 2015, 12:00 am

    I performed an intubation on a 2 year old who had aspirated a kernel. The whole case landed in a province-wide M&M because of events leading up to the intubation. The chief of peds ICU at another hospital in another city was unkind about the fact that just an RT had intubated as opposed to anesthesia. Anesthesia told her that if she considered anesthesia airway experts, his expert opinion was that RT does a great job of intubating.

    Reply

  • marblelion

    marblelion

    March 10, 2015, 11:07 am

    I work in a rural facility too. Face similar challenges but we do keep vents. Our RTs generally are the first to try intubation before our ER docs do, especially for codes on the floor. Anesthesia at night is usually 30 mins away minimum and during the day they’re tied up in surgery. Thank god for our RTs!

    Reply

  • Snorple

    Snorple

    March 10, 2015, 8:13 pm

    Just kind of depends on the situation. A lot of times RT makes it to the code before the doctor does, at night we only have the one doctor in the building and it’s the ER doctor, so if multiple codes arrive (god forbid) or if he’s tied up in the ER someone else needs to be able to intubate so RT does. We don’t have anesthesia in house except during the week days and they are pretty much tied to the OR (admin felt it was fine to only have one anesthesia provider currently). So RT does a lot of intubations, usually in the ER they’re waiting at the ready, so the docs just let them take over that part, and they just run the code. Tbh, I didn’t know other places did it differently.

    Reply

  • megatom0

    megatom0

    March 10, 2015, 6:47 am

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  • mredd

    mredd

    March 11, 2015, 1:58 am

    I haven’t seen any association between appendicitis and COVID. Given the community prevalence right now I don’t think it is an enormous coincidence that seven randomly selected children would have current/recent infections. We did have a likely intussusception with COVID gastroenteritis some months ago but it spontaneously reduced.

    Reply

  • corby10

    corby10

    March 11, 2015, 5:50 am

    I know it’s a hot comment lately to say “if you have URI symptoms, assume it’s Covid”. But does anyone saying that have kids in daycare? Fuuuuck they have URI symptoms 24/7 365. I could’ve sworn our whole family had Covid twice this month. All negative via antigen and confirmed with pcr. We are doing a ridiculous amount of home tests bc I swear like every other day it’s something else.

    Reply

  • backpackwayne

    backpackwayne

    March 10, 2015, 10:51 pm

    This patient referenced ACTIV6, which is sponsored by Duke and Vanderbilt. Their study is a double blinded RCT studying several drugs vs. placebo. The Ivermectin dose is weight based (from the trial page, it's a "pre-specified number of tablets for 3 consecutive days based on their weight for a daily dose of approximately 300-400 µg/kg."). My answer was that a RCT is to study whether a drug is safe and effective and participants must meet inclusion/exclusion criteria and have the approval of the IRB to participate. Obviously, just because a drug is part of a RCT doesn't mean it's appropriate for it to be prescribed outside of the RCT but that doesn't convince people that we shouldn't be giving them the trial dose of Ivermectin when others could get it from these prestigious medical centers specifically for covid.

    Reply

  • Gravity13

    Gravity13

    March 10, 2015, 6:48 am

    I’m not prescribing it and made that clear but the trial mails you your meds so I guess some people enroll and get it (not that they’ll know at the time since they could be getting placebo!). It’s even more ridiculous because they have no clue what other cocktail of drugs these patients may be taking or whether they’re even taking the study drugs.

    Reply

  • sonicon

    sonicon

    March 11, 2015, 9:10 am

    From nursing here so sorry if it’s not helpful. My hospital in the Midwest has completely stopped giving baracitinib. Everyone and their brother gets actemra, but no ones told me why, and I’ve asked. It was maybe 50/50, then one week it vanished without a trace. Maybe my institution picked a preference idk.

    Reply

  • Chaoticmass

    Chaoticmass

    March 10, 2015, 2:21 pm

    Generally I've found that taping the mask (this works with surgical masks too) to the bridge of my nose from the outside keeps it from sliding up and down my nose, which is the major source of irritation. Also keeps it from slipping down and breaking the seal; my nose bridge doesn't like to keep it up there naturally. This only works with soft n95s, obviously.

    Reply

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