#docblr

[tmedic]

Last day as university student... :) !

After passing practical and oral exam today, I became a MD! ❤️👩‍⚕️

Despite of being stressed and under pressure, the practical rounds (which I had at internal medicine ICU) turned out beyond my expectations!❤️(.. btw shifts at ICU where those shifts I appreciate the most.. It was the best way to see spectrum of diseases and gain theoretical knowledge and practical experience.. !) The oral part of finals also went well, so after ,,nerve-racking" day we finally know, that everyone today has passed and this is our last day as -students. 😊!

Also a HUGE THANKS! goes to the studyblr community ! You guys are amazing!❤️❤️ Inspiring others to study, motivating them, giving tips and tricks, helpful advices, printables, pdfs, links, and maaany more... !!!! Please never let this community die out!!!!❤️:)

[zigcarnivorous]

This week, the Associated Press reported rather matter of factly that Israeli Prime Minister Benjamin Netanyahu “is examining a plan to seal off humanitarian aid to northern Gaza in an attempt to starve out Hamas militants, a plan that, if implemented, could trap without food or water hundreds of thousands of Palestinians unwilling or unable to leave their homes.”

Any Palestinians remaining in northern Gaza – a large area including Gaza City – “would be considered combatants – meaning military regulations would allow troops to kill them – and denied food, water, medicine and fuel.”

But that intensified genocide-by-starvation plan is already well underway. On Saturday, the United Nations World Food Programme said that no food aid has entered northern Gaza since 1 October.

“People have run out of ways to cope, food systems have collapsed, and the risk of famine is real,” Antoine Renard, WFP country director for Palestine, said.

In reality, Palestinians in northern Gaza, particularly children, have been starving to death for months as the direct result of Israel’s declared policy of cutting off all life-sustaining supplies to the territory.

Yet while Israel is open about its intentions, it could not carry out this mass-murder by starvation without the aid and support of the United States – which still purports to be working towards getting more aid into Gaza.

Following the news brief from Nora Barrows-Friedman, we’ll speak about the situation with Laila Al-Arian.

An Emmy and Peabody award-winning journalist, Laila is executive producer of Al Jazeera’s flagship documentary series Fault Lines. A recent episode, “Starving Gaza,” documents how the United States government has been knowingly covering up for Israel as it deliberately starves Palestinians to death. You can watch it here: • How Israel’s man-made ...

This is a segment from The Electronic Intifada's day 376 livestream. Ali Abunimah, Nora Barrows-Friedman, Jon Elmer and Asa Winstanley were joined by EI contributor Abubaker Abed live from the Gaza Strip, and award winning journalist Laila Al-Arian. You can watch the entire broadcast here:

[unhingedselfships]

How do I know if I need a tetanus shot? Asking for a friend 😂

[medicslacks]

Am now the Orthopod on the other side of that initial conversation lol. And if a Resp F1 called me now, the conversation would go pretty much exactly the same 😂😭

The policy in hospitals I’ve worked in is that Osteomyelitis goes to the medics for abx- usually they’ll get IVs in hospital so you can check they’re responding/ are no longer septic, then carry on for however long it takes until you can sort out a PICC line and send them home for ongoing IV abx in the community till they’ve had 6 weeks, then 4-6 weeks further of PO.

Surgeons only get involved if something needs debriding or draining. If the foot is attached to a diabetic, Vascular. If not, Ortho.

I’ve been told by quite a few Medics over the years that since Surgeons are doctors too, we should be able to manage medical problems in our patients. Fair. But the other side of that is that if they only have medical problems, why are they under Surgery in the first place? The most common argument I hear back as an Orthopod is with regards to conservatively managed fractures which need physio and pain control so often end up under Medics.

Well if the management of the pain isn’t surgical fixation, then they need medicine? Surgeons are going to give them Paracetamol, Morphine, Codeine, Gabapentin, Diazepam and Diclofenac. No laxative or PPI.

I promise you Betty with her L4 fragility fracture and no peripheral neurological symptoms is going to do better and get home much faster under Medics.

It seemed really unfair to me as a Medical F1 that surgery wouldn’t take seemingly “obvious” surgical problems, but now I realise every surgical bed that is taken by a patient who just needs medical management is a patient waiting longer at home or in hospital for actual surgery.

I cannot tell you the number of times I have had patients cry to me about how much pain they are in when I’ve had to call and cancel them the night before their scheduled surgery because I’ve been told there are no beds to bring them into, we already have 5 DTAs in ED and that patient is at home “stable”. Or because we have too many major traumas or NoFs, the Trauma List is full… so the trimalleolar ankle fracture is going to have to roll for the 6th day in a row… can I go tell her she can eat?

Referrals Are A Pain In The Foot...

ORTHO: “Has he been seen by a Tissue Viability Nurse?”

“No. We figured since this is likely osteomyelitis, he should be referred to Ortho directly.”

“Well we need them to see it first and then refer to us.”

“Okay.”

TVN: “It’s probably osteomyelitis. Please order an MRI to confirm and then refer back to Ortho.”

ORTHO: “Oh, you didn’t mention he has diabetes. Are his BMs stable?”

“They were fluctuating between 17 and 32 when he was first admitted, but he was reviewed by the Diabetic Specialty Nurse and they’re now under control.”

“Okay that’s good. But since it’s related to his diabetes, he’s not suitable for Orthopaedics anymore. You need to refer him to the Surgical Reg.”

SURGERY: “Sorry I only take referrals for general surgery. You need to refer him specifically to the Vascular surgeons.”

VASCULAR: “Have you sent a written referral?”

“Well I tried but they said I needed to call you first to let you know we need to refer somebody to you or else you won’t know to check the referrals box.”

“Okay, do the referral and we’ll come and see him.”

“Thank you so much.”

WARD CLERK: “Oh good you’re back from lunch. I have a message for you. The Vascular Registrar called about your patient- he won’t see him until you get the MRI and confirm that it’s osteomyelitis.”

“……….”

RADIOLOGY: “Hi would it be possible to get this MRI Foot done some time today to confirm or rule out osteomyelitis?”

“Has he been seen by Orthopaedics or the Vascular team to confirm that it’s likely osteomyelitis?”

“Ortho says it’s not their problem since it’s related to his diabetes and Vascular won’t do anything until we get the MRI.”

“Is he unwell?”

“Well… we’ve had to do an MCA and DoLS on him because he’s delirious from the sepsis which we suspect is from osteomyelitis due to his diabetic foot ulcer.”

“Okay. We’ll try and get it done today.”

MRI FOOT WAS NOT DONE UNTIL TWO DAYS LATER WHEN PATIENT WAS NO LONGER DELIRIOUS AS PATIENT REPEATEDLY REFUSED TO BE TAKEN DOWNSTAIRS FOR MRI SCAN. 

ENDO: “He has an infected diabetic foot ulcer. The MRI showed it wasn’t osteomyelitis but we still think the infection might have caused his sepsis. We’ve investigated other possible causes and haven’t found any. He is no longer septic and has full capacity again.”

“Are his respiratory symptoms under control?”

“He never had any.”

“So what’s he doing on the Respiratory ward?”

“I don’t know. I think maybe he coughed once in A&E. Would you be able to come and review his foot and suggest further management?”

“Has he been seen by the Diabetic Specialty Nurse?”

“Yes.”

“Tissue Viability Nurse?”

“Yes.”

“Has he been seen by Orthopaedics or Vascular?”

“No they both said he’s not suitable for them.”

“Okay. Well since he’s better and his BMs are under control, we don’t really need to see him anymore. Just refer him to the Diabetic Foot team and they’ll discuss him at the MDT.”

[seriousacademic]

I'M A DOCTORAL CANDIDATE NOW!!!!!!!!!!!!!!!

[judas-officially]

i have this really fun and not inconvenient at all power where when I can unwillingly fall asleep at any given moment literally until outside stimuli awakens and disturbs me such as a loud noise or something touching me it’s really great actually yea what the fuck is this called

[psychokangaroo]

CARTILAGE HELIX PIERCING! WHERE MY TATTED AND PIERCES DOC/MED STUDENRS AT?????

[medicinasanguis]

Let’s start my first day of work!

[tmedic]

ICU & ED simulation training -challenging but great experience!💪

[medicslacks]

Accurate description of the Night Registrar On Call at morning handover :)

She smelled like hand sanitizer, pure and reminiscent of a hospital.  Her lips were like marble, cold and smooth.  Her eyes were like a stop light, you wanted them to be green but they were red and occasionally yellow.

[medicslacks]

Just took a year out of medicine to work as COO for a start up.

On reflection, the way we behave and are treated as doctors working in the NHS is utterly bizarre. Guys, it’s really not normal to be made to feel like a naughty child or to be spoken to like you’re an idiot when you’re very obviously not. Especially not at work.

I’ve recently been thinking back on several incidents that upset me throughout my FY training and they were all incidents that I just would not tolerate now and can’t believe the audacity of the people who made me feel that way. I repeat… at work.

I’m not entirely sure why despite so many difficulties for doctors being directly related to communication and conflict resolution, they just kind of stop teaching these skills to us as soon as we’re thrown into the field of medicine. We’re expected to just pick it up, but I’d argue these skills are just as important for our clinical practice as our clinical knowledge and so should be formally taught.

When your only reference point is being treated like a stupid, misbehaving child by everyone- you start to think that’s normal. And it’s just not. What you say and how you respond is a learnable skill but you have to first be given the opportunity to realise that the way you’re being treated or spoken to is objectively unacceptable. And then learn how to confront it while remembering the person you’re speaking to is also… at work.

I am both optimistic and cautious to be taking this change in attitude, expectation and behaviour back into surgical training from August. Like I said, the NHS is a weird world to work in when you’ve taken a step back for a while and the ground rules are a bit different. The potential benefits to my own well-being and career happiness is so significant though I think I’ll take the risk and let you guys know how it goes.

[seriousacademic]

quick personal/school update:

Y'all. I've officially formed my Dissertation Committee (with some absolute rock stars) AND I just sent my chair the draft of my first 3 chapters (the dissertation proposal)!!!

With any luck, I'll be a doctoral candidate in just over a month!

I still have tons to continue working on in the meantime, but I had to share the good news with someone. :)

[shadeswift99]

I have now been reminded that The Docblr is a thing that exists

[medlabscience]

What an awesome graphic! Really demonstrates the interval changes.

Hyperkalaemia ECG changes in 15 seconds. 

High levels of potassium destabilise the cardiac membrane causing arrhythmia’s which lead to cardiac arrest. This can be a real life-saving opportunity if you can catch and treat it!

I made this as an experiment while learning a bit more about After Effects to animate my medical illustration. Hope it’s useful!

[nettka]

Heyyy.

Asking all #docblrs/#studyblrs.. how many hours of sleep does a person need to be able to study?

[docinlimbo]

Scuba Steve: Where do you go to school?

Me: Oh I’m long done with school.

Steve: Okay so where did you go to school.

Me: I did undergrad in *state name* and graduate school in Poland.

Steve: Cool what’s you degree in?

Me: Medicine

Steve: What do you do with that?

Me: Well I’m a doctor.

Steve: Wait, what...no way, how old are you?!?!?

The one time I slipped and told someone the truth about what I do- they don’t believe me anyways!!! 😂