Careless

You're an interesting species. An interesting mix. You're capable of such beautiful dreams, and such horrible nightmares. You feel so lost, so cut off, so alone, only you're not. See, in all our searching, the only thing we've found that makes the emptiness bearable, is each other.

[copingnurse-deactivated20240217]

To all the nurses, doctors, patient care assistants, EMTs, and other supportive staff taking care of the Orlando victims right now...

We love you. We are thinking of you. We are proud of you. Thank you for doing your best. We know this is so difficult right now. Thank you.

[itsgoooooofytime]

Is there anything this girl can’t do? Perfection! 

[medicine-and-coffee-deactivated]

Hahah Dj-Phosphotase…

[micdotcom]

[itsgoooooofytime]

Trump is also bff with Putin.

[surrealmeds]

Are you “I’m fine”ing me??

So I do this group for health professionals where we talk about self care and struggles at work. When I asked if their colleagues ever checked in on how things were going, they all said yes. However, their response was always “I’m fine.” All they can think about is getting home and drinking, or of jumping off a building - but “I’m fine”. “How are you doing?” and then being emotionally available for their colleagues. 

The irony that they are not emotionally available for themselves was not lost on them. They will give emotionally for everyone but not for themselves. 

We dreamed of creating work places that offer space and safety to let us say we’re not OK. Places where we are able to say “that was a really hard shift, can we talk about it?” Where no one is ridiculed for showing emotions or appearing vulnerable. Where as part of our regular feedback in training and from supervisors includes a review of our self care. 

When I left the group, enjoying how well it went, I noticed a colleague pretending that he wasn’t crying. He has been having quite a bit going on at home with a sick parent and a jerky daughter. I asked if he was ok, and he said, automatically, I’m fine. 

I tilted my head and said “Are you I’m fineing me?” (What is it about a head tilt that gets the truth out of people??)

“Yes”

“Do you want to talk about it?”

“Yes please”

15 minutes later, he feels heard and safe, I’m not burdened. Certainly not as much as I would be if he needed to take time off in the future for stress/addiction/post MI. Easy peasy lemon squeezy. 

This is a culture we can create folks. Any other ways you can think of making it happen?

[cranquis]

Reminder to self: Check up on my colleagues’ stress levels more often, especially during flu season.

[itsgoooooofytime]

You killed me with the #lasixforthesoul

[itsgoooooofytime]

Let me start off saying this: I love steak, I love most red meat, I love pork, chicken, fish, seafood, and eggs. But currently I'm day 3 of my transition to a plant based diet. So far pretty good! I can't wait to start cooking and baking vegetarian/ vegan breakfasts and desserts.

[tenaflyviper]

[itsgoooooofytime]

Evolution

[itsgoooooofytime]

I feel so anxious…augh..this overwhelming sense of dread. Wtf is happening.

[oliveramy]

Cuddle with pup?

[itsgoooooofytime]

I'm not at home :( I'm in school until Thursday!

[itsgoooooofytime]

I feel so anxious...augh..this overwhelming sense of dread. Wtf is happening.

[anneboleyns]

favorite fictional ladies | ravenna (snow white and the huntsman) “I will give this wretched world the queen it deserves.”

[mrbeniciodeltoro]

We’ll be waiting for you when you get back. A little older, a little wiser, but happy to see you. Do not go gentle into that good night. Old age should burn and rave at close of day. Rage, rage against the dying of the light. Though wise men at their end know dark is right, because their words had forked no lightning they do not go gentle into that good night. Rage, rage against the dying of the light.

[itsgoooooofytime]

Hi. It's been a while.

[itsgoooooofytime]

The Signs as Cardiac Rhythms

Aries: Normal Sinus Rhythm

Taurus: Ventricular fibrillation

Gemini: Ventricular tachycardia

Cancer: Atrial flutter

Leo: Torsades des Pointes

Virgo: Asystole

Libra: Junctional tachycardia

Scorpio: Wandering Atrial Pacemaker

Sagittarius: Sinus arrest

Capricorn: Bradycardia

Aquarius: 3rd degree AV block

Pisces: Atrial fibrillation

[changemeupbro]

And its not fun being used. Always being the one who helps people escape, but never the one receiving anything back.

rr (via breathemyhigh)

Lawd Jesus help

[micdotcom]

After Darsh’s photo was used in an Islamophobic “joke,” the internet rallied around him in love and respect. His response on MSNBC is the definition of poise and rising above the hate.

[micdotcom]

“Silence in the face of prejudice is an act of hate.”

[thevelvetgoldmine]

[itsgoooooofytime]

All these kids looking like my grandma

[unnecessary-observations-deacti]

This one night on MICU: 22 vials of 50 mg/10ml IV diazepam, 9 vials of 65mg/ml IV phenobarb

The pt got a total of 1100 mg of IV diazepam and 585 mg of IV phenobarb over the course of 8 hours… just doing room air.

Got a pt that was in bad ETOH withdrawal. Not intubated. We use a protocol at my hospital that’s based on RASS Scores. More effective than CIWA in severe DT. 

This study explains how these pts reduce their risk for intubation using this protocol. This pt did not need to be intubated by the end of the night.

[caringintensely]

Earned your $.

[medicine-and-compassion-blog]

Was the patient trying to quit drinking or were they there for another reason?  I’ve heard some doctors prescribe alcohol if the patient happens to be there for another reason and isn’t planning on quitting.  I have no personal experience with this.   

[unnecessary-observations-deacti]

@medicine-and-compassion: the pt’s primary admission diagnosis was liver failure, who was also encephalopathic and had an upper GIB. Ethanol is an older practice for DT management and I can immediately think of 3 reasons why it is strongly recommended against:

1. the pt should remain NPO d/t high risk of aspiration and I have never heard of an MD who would order ethanol rectally… yikes

2. Benzodiazepines are recommended for their influence on GABA receptors and have been found to be superior in lowering chances of recurrent withdrawal or seizures

3. the use of ethanol is also difficult to dose to a therapeutic level and has high metabolic costs in pts who are critically ill

but on that note… I think I will have a beer tonight :D

[caringintensely]

I have heard of ethanol IV drips for the DTs, but I think that was long ago. Benzos do the job just fine, if they let you give enough of them.

[freshrn]

Mind. Blown.