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she’s spitting facts! take care of yourself or evil can’t prosper!
2020, a summary
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when i was depressed those “reasons not to kill yourself” lists never helped.. maybe they do for some people but for me they actually made me feel worse. it was like….here’s a reminder that there are all these things other people find joy in that you can’t. with a sprinkle of guilt because “your family/friends will miss you.”
what i needed to hear, and so what i’ll tell any of you reading this who are in the same situation, was: a lot of people recover from mental illness and go on to live full lives. it’s quite likely that with treatment, a time will come when you won’t want to die anymore and you’ll find joy in everyday life. yes, you. stay alive for that possibility.
Coming full circle
In the midst of this coronavirus pandemic, as our positive cases continue to climb (and our unresulted tests do too), I had a patient today come in for something unrelated.
He’s an older gentleman, in his 80s. He had some abnormal lab tests last week - a double-digit bilirubin, and a quadruple-digit alk phos - for which his cardiologist stopped his amiodarone. He saw his PCP today who saw the labs, looked at his newly yellow skin, heard his complaints of fatigue and poor appetite (but no pain), and had him directly admitted to the hospital - to me.
For those med students reading, he sounds like a textbook case - pancreatic cancer.
For me, he sounds like my mom. She was admitted to the hospital for back & abdominal pain and weight loss. Her GI doctor called me, a state away in my last year of med school, and told me to come to the hospital. I get there, 3 trains and a taxi ride later, and see the hospitalist has left her number. I call from my phone, and with the poor reception in the hospital, all I can make out is “pancreatic malignancy.” My mom is sitting on the bed, a foot away, and I don’t know if she knows this yet. So I ask, “Is that what you think this is?” and hear a definitive “yes.”
I hang up the phone, and turn to my mom, and ask her, just like I was taught in med school, “What have you been told about what’s going on?”
She tells me, “They think it’s something with my pancreas, it might just be inflammation.”
I tell her, “Mom, they think it’s cancer.”
She cries. I cry. Neither of us stops crying for quite a while. Her first question for the oncologist is, “Will I make it to her match day and graduation?”
They tell her yes.
They were 50% right.
Between all the chemo, the nausea and vomiting and diarrhea, the begging her to eat, the intolerable side effects, the second line chemo, the failure of the second line chemo, and finally, finally the decision to do home hospice - and all the horrors we dealt with therein - I still think the most awful part was having to tell my own mother that she had cancer, because none of the doctors who saw her were willing to do so.
And now, almost two years later, I look at the man in front of me. He knows he’s doing poorly - he described the last two weeks as “a steep decline, like a ski slope.”
I ask him, “What have you been told about what’s going on?”
He tells me, “My doctor thinks it’s something with my liver or my pancreas. Some kind of rubin?” - I smile, say, “Bilirubin” - “Yeah, that’s it! Anyhow something with that so he wanted more tests. I don’t know if it’s my liver, or if it’s cancer, or what.”
A small part of the knot in my chest unwinds. I explain, the best I can, about how there’s something blocking the flow of bilirubin, which is why it backed up. “It could be a stone from your gallbladder, but usually you’d have pain then; that’s why we’re worried it might be cancer, maybe in the pancreas, blocking the bilirubin and causing these symptoms. That’s why we want to get this CT scan, to see what’s going on, and it can show us if there’s a cancer.”
He nods - he has an excellent primary care doctor, and he wasn’t blindsided by the news. He starts to ask a question, then stops himself, and says, “I’ll wait til we have more answers. Thank you.”
He’s here alone. We have a 0 visitor policy because of the Covid19 pandemic. I’m wearing a mask, hiding half my face, because I’m worried I’m asymptomatic but infected and don’t want to spread it to any of my patients.
But at least I told him the truth. I didn’t keep him in the dark, or dance around the diagnosis.
I’ll see him in the morning. We’ll have some answers then. And he’ll have more questions, and I’ll give him all the answers I can. I can’t do anything else.
Thank you for sharing this – so well-written.
It’s so important for us to remember and use our interpersonal skills during these stressful times.
Some physicians are notorious for coming into the room, saying the big words that laypeople might not know like “hepatic malignancy”, and then walking out. Nurses then get to explain to the patient and their family that what the doc meant was “liver cancer”. It’s incredibly difficult to have to give bad news, but it comes with the job.
Please remember:
This might be the first time a patient and/or family have even been told that cancer (or another condition) is a possibility.
Use words that non-HCPs can understand, and check with the pt/family to ensure they understand what you’ve said; if there’s a language barrier, call for a translator if your facility has.
This might just be another day at work for you, but this might be the worst day of your patient’s life; be respectful of this.
Yes, you’re very busy, but so are most other people who work in the hospital. Stop looking at your watch or checking your phone during discussions with patients and families, because they WILL notice, and it WILL come across as you not caring about their issue.
Absolutely!!
I’ve written here before about avoiding medical jargon. I think it’s important to tell the patients the proper term, because they’ll hear other people use it, and also explain it in a way everyone can understand - for example, “You have a kind of liver cancer which is called hepatocellular carcinoma, or HCC.” I’m not gonna keep calling it hepatocellular carcinoma or HCC to them, but chances are they’ll hear it later (like when someone’s confirming their medical history, going by the diagnoses in the chart, and calls it hepatocellular carcinoma), so I think it’s important to introduce the term so they’ll at least recognize it.
But it is absolutely more important to explain it in lay terms. The average health literacy in the US is at approximately a 5th grade level. You gotta be able to explain it at that level, and add detail and complexity if/when appropriate. Answer their questions. Ask them to explain what you told them (or ask them how they’re going to talk to their family about the diagnosis) to check their understanding. If they can’t explain it back to you, you haven’t done a good job of explaining things to them.
In my third job of f1, I was on a&e. My trust didn’t have f1s out of hours in a&e because we were supernumerary. Instead, I did surgical on calls.
In four months of surgical on calls, four long weekends and 12 nights, I had to tell four patients transferred from other trusts that they’d been moved to us because of cancer.
Once a month, I had to tell a patient I was sorry their previous hospital hadnt told them that. What I meant was, I’m sorry you had to hear this at 11pm, without your family, from someone who has answers to none of your questions.
The times during covid that I’ve seen patients get bad news, we’ve either made a visitor exception or had a family member on speaker phone.
my professor spent our entire seminar whining about how there’s too many girls in our group and not enough boys. he was like “i’m not saying women can’t be good surgeons but we need more men” no, we don’t. men suck. deal with it.
CRY ALL YOU FUCKING WANT YOUR TEARS DON’T MEAN SHIT TO ME. YOUR TEARS MEAN DICK TO ME JUST SO YOU KNOW
Okay so not to be that person who adds on to a post with their own story but my mom is a doctor and when I was eleven she took me to these all-female seminar led by a woman who was the head of a hospital because my mom is an empowered and independent woman who wanted her daughter to be the same way and so there’s like thirty females surgeons in the room, all sitting around his huge circlular confrenece table and talking about their experiences in becoming surgeons
most of them were like “everyone told me I should become a nurse or a pediatrician” and “people assume that I don’t know what I’m doing” you know, your average sexist bs
one of the women’s last name was starboard (yeah I know great name) and she was talking about how even though now she was one of the most accomplished surgeons at the hospital, the male scrub techs (read: guys who didn’t go to fucking medical school) and some of the male doctors call her starbitch in the OR because they (scrub techs mostly, strangely enough) try to suggest different ways to care for the patient and she always tells them no you didn’t go to med school and I did and so they would go out of their way to get the male doctors to treat the patient differently and then she would have to argue with him to prove what she was doing es right but sometimes the male doctor would come and take over the case anyway and this went on for a while
but then the hospital statistics changed bc this woman was literally being prevented from treating her patients bc the men were interfering and so the administrative head heard about this (she was female) and she was like y’all better stop or y’all better start looking for new jobs and then starboard was allowed to work on her patients and got the scrub techs replaced and all of the sudden, the patients were suddenly doing much better during and after surgery.
when she told this story she was like “people still call me a bitch, and maybe I am because I won’t let them walk all over me, but when you’ve got something to do, when you’ve got a life to save, you have to ignore their bullshit so that you can save someone’s fuckin life. Sexism should never stop you from accomplishing that”
and little eleven-year-old me still remembers that bc I was insecure and awkward and here was this woman who just did what she had to do and ignored all the people trying to stop here and she really was better than all the male doctors (like her patient stats were better) and I thought I should share with you this inspiring woman with the cool last name
Hey, unpopular opinion, apparently. But people don’t just “have pain for no reason” doctors say this all the time (especially to women and chronically ill people) and the truth is, Thats literally not possible. Even if your pains are psychosomatic (a word I hesitate to even use because of the way its used so often) there is a reason you are having those pains whether its mental illness, abuse, etc. If your doctor consistently tells you that “well some people just have pain for no reason” get a new doctor. That’s a doctor who is not going to give a shit what your actual symptoms or experiences are.
I just wanna add to clarify the psychosomatic thing.
That word DOES NOT MEAN you’re making it up. It doesn’t mean you’re imagining the symptom. What it means is that the symptom ISN’T DIRECTLY CAUSED BY ANY OF THE THINGS THAT WOULD NORMALLY CAUSE IT.
I fought to get a PCOS diagnosis for 2 and a half years. For the ENTIRE time I was fighting, I was dealing with 3 cysts that were not going away by themselves and eventually required surgery to remove. At one point close to the end of the battle, I suddenly went blind. I was visiting my parents and was standing on the veranda looking out over the tree we had planted in memory of my dog and suddenly I got one of the shooting pains that I was quite frankly used to at that point and my vision started to go dark. It was like the sun was setting while being completely hidden behind storm clouds but it was 2pm in the middle of Summer on a clear day. Within about 30 seconds I couldn’t see ANYTHING. I was 27 years old and I was screaming for my mother.
My mum raced me to her doctor (he was a 15 minute drive away as opposed to 45 minutes to the nearest hospital) and he quickly worked out that there was nothing wrong with my eyes and what had happened was totally unrelated to them. Then he said it was psychosomatic and I freaked out, yelling that I was NOT making this up and I definitely wasn’t imagining it. Very quickly he calmed me down and said he believed me and I had misunderstood. He explained that whatever was going on with my abdominal pains (he suggested PCOS which I hadn’t even heard of at that point) had been ignored for so long that my body was starting to do things other than the normal pain response to try to draw my attention to the problem. My sight going was my body basically jumping around in front of me going “HEY ARE YOU EVEN LISTENING TO ME HELLLOOOOOOO??????”
He gave me some prescription strength painkillers and my sight started to come back as soon as they started to kick in. About 45 minutes after it started I could see well enough to walk around without help and within a day and a half I was back to normal. On top of that I finally had a scan booked to figure out what the hell was causing all the pain.
Psychosomatic symptoms are NOT imagined or fabricated or happening for “no reason”. Experiencing them DOES NOT make you a liar. It makes you someone who has been battling with something serious for so long that your own body has started to get impatient with you.
I completely agree. Thank you for sharing this.
Psychosomatic symptoms are literally your body flipping random alarm switches just to get any alarm blaring because you’ve been ignoring the regular ones
I don’t usually add to posts but I thought it was important to add that this 100% goes for mental health, too.
When I was 18, only a few months after graduating from high school, I started having seizures. Serious, triggered at the drop of a hat, knock me unconscious for an hour or more and leave me dazed for days kind of seizures.
I was rushed to hospital two or three times within the space of a week after passing out in the middle of cooking dinner or talking with my family, but the hospital could not find anything wrong with me. I spent a week in the hospital in a planned admission, connected to an EEG monitor for 23 hours a day with the doctors hoping to catch my seizures in action and finally figure out what they were. I don’t know how many seizures I had during that week, but at the end of it, they said that even after all that, there was nothing wrong with me. After that, they sent me to a psychologist.
I was diagnosed with PNES - Psychogenic Non-Epileptic Siezures. Essentially, it was explained to me, I had been ignoring my anxiety and PTSD for so long that my body was acting out just like @kamorth ’s had. When they started treating me for anxiety and PTSD, my siezures eventually turned into panic or anxiety attacks, and then stopped altogether.
The moral of the story is don’t ignore pain. Whether it be physical, mental, whatever. Pain is your body’s way of telling you something is wrong and it has ways of making you listen to it eventually. Some of those ways are seriously disabling and once you get to that stage, it can be a long road to recovery.
Just because therapy might be helpful for some psychosomatic symptoms doesn’t mean it was fake. It means your treatment worked.
This. And a half. With bells on.
If you are a #medblr, you need to read this post and LEARN FROM IT.
The way the doctor in the first story (blindness, PCOS) explained “psychosomatic” in such clear simple terms is EXCELLENT PATIENT CARE.
I wanna send this to the NP who told my mom that her persistent toe pain was “just her chronic pain syndrome.” She doesn’t have a chronic pain syndrome. She has advanced-for-her-age osteoarthritis. Which hurts. Good grief.
Pain is NOT a diagnosis.
I'm trying to get into med school but literally every person I've met who's doing medicine sounds like they're living the most miserable life imaginable and it's scaring me, like this isn't what I want..
I think there’s always this one breaking point during your journey in which your love for medicine should surpass all the frustrations, difficulties and hurdles life and school throws at you. So, yes, it’s not easy. And just because someone is venting about how much they’re suffering in medschool DOES NOT mean that they don’t love medicine, everyone has the right to vent and blow off steam. But the rants you see of people, 99% of them get right back up and face what’s ahead of them the next day. Even if they were completely broken the night before. And medschool does make you strong and compliant like that.
All I did on this website was complain about my time in medical school to be honest, but its only because it was my place to vent. Medical school is hard; its academically hard, its long contact hours and you’re also revising at the same time, there’s imposter syndrome to deal with, sometimes mental health problems crop up, you want to make friends, do extracuriculars, stay sane.
But I literally could not imagine studying anything else, and the shining moments carry you through.
Those moments in the library when you get to close your anatomy book because you’ve learned all the muscles in the arm, those moments when you can finally hear those murmurs or crackles through your stethoscope, when you take a history from a complex patient and you know you have more time to give them than a doctor would, when you’re on a placement and you know exactly how to diagnose and manage a patient because the training kicks in, when the practical skills like cannulation and venepuncture become second nature, when you’re on a night shift and you get to catch a newborn baby in your own hands, when the list of symptoms are attached to real patients you get to talk to and help.
You could choose to do research alongside clinical practice. You have countless numbers of specialties, from psychiatry to surgery, as well as loads of opportunities to teach. What other subject perfectly combines human biology with human nature, with sociology, psychology, with economy, epidemiology, spirituality? Medicine is broad, endless, and beautiful.
I would never say take the decision to go to medical school lightly, but as some one who came out the other side not that long ago, and came out incredibly battered and bruised I can tell you: it is completely worth it.
What it’s like on the front lines in NY for a physician
If you haven’t run across it yet, look at the posts u/madfrogurt (PGY3 MD in New York) has made (all links below) on reddit. They’re quite haunting. Some memorable lines are below. I highly recommend all his posts, for both healthcare workers and laymen. If you have a family member who still believes it’s a hoax, send this to them. Just a warning - you need to be prepared when you read this.
—–
“Was it a young guy?” “No, It was John.”
—–
Last night, immediately after I got home I vomited from the anxiety of the day. Held it together that long at least.
—–
I made the mistake of asking who the youngest intubated COVID patient on the unit was.
Younger than me.
—–
Feels like COVID is eroding the edges off everyone’s soul in the hospital.
—–
See, Intensivists ran every single Code Blue in the hospital before now. One Hospitalist said, “We haven’t run a Code since residency! The residents should run the Code Blues, they’re probably better trained than us.” The room of a couple dozen full-blown-attending Hospitalists nodded in agreement. I was the only resident there, too stunned to speak up. No final decision was made.
—–
That’s a word we get to use in charts. Dire. Seems almost melodramatic.
—–
Feels like I’m living in the time between a flash of lightning and the roll of thunder.
—–
You hope you wake up.
—–
Days 1-3 Days 4-6 The Story of You Days 8-10 Days 11-13
photo by yuribeliy.tumblr.com
The fabric mask thing...
So I have seen a lot of posts on Facebook and reddit and Tumblr from people making their own face masks out of fabric (or crochet, or knit)
Yes, I know some countries are enforc8ng mask wearing among their citizens when they leave the house. And that some hospital in America are so short on PPE that they are appealing to their communities for fabric masks.
But.
The evidence for these masks is bad.
This study shows that the rate of flu like illnesses was higher in those wearing a fabric mask for an entire shift than in those that followed normal protocol about mask wearing.
Objective The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The null
What does this mean? Wearing a fabric mask the entire time you are outside your home could increase your risk of infection.
Something fabric masks can do is make you less likely to touch your face which is good, but is unlikely to outweigh the increased infection risk.
If you still want to make your own mask, this study shows the best material to make it from. They co pared multiple common household materials. The best materials and tea towels, pillowcases and t shirts.
PDF | This study examined homemade masks as an alternative to commercial face masks. Several household materials were evaluated for the capa
For making your own mask, the below link is to a good pattern, that references the materials study, and uses multiple layers of fabric.
Many makers have asked for a pattern to sew homemade surgical masks for hospitals. The DIY pattern in this post will teach you to make a sta
An important thing if you are going to use a fabric mask - WASH IT FREQUENTLY! If you leave the house three times in one day then ideally use a different mask each time. Wash it as hot as you can and dry it very well (moisture is not your friend with a facemask)
In a toss up at work between no mask or a fabric mask, I would chose the fabric mask. Outside of work? I'd chose no mask.
Masks made out of yarn, be it knit or crochet, will have gaps too big to stop getting anything getting through. Again, they might help stop you touching your face, but will likely be more difficult to wash than a fabric mask. You could line your knit/crochet mask but at that point, you're putting a lot of effort into something that isn't going to help you much.
TL;DR - homemade masks aren't great, but depending on situation can be better than nothing, follow your government's guidance for whether to wear one
Hopefully this will be helpful to somebody!
This is all excellent info (though not exactly what the articles are stating: check the notes, others have already explained this), and I’d just like to add this is also why wearing vogmasks to prevent contagion is not a good idea because vogmasks cannot be washed due to the nature of the built in filter. If you do need to wear a vogmask to protect you from contagion, you need to be prepared to throw it away immediately after use, and considering they’re $30+ that’s an expensive waste of money and resources people with chronic health issues require.
So when they do come back on the market: please do not buy them unless you suffer from allergies/fragrance disabilities or live in an area where the air quality is poor due to things like smoke, pollen or pollution and need to protect yourself from these things. They will not help you fight COVID-19, and some of us need them to breathe, even in our own homes.
Side note: masks are good to wear if YOU are sick, as it will help you not spread your sickness around, so while they won’t prevent you from getting ill, they can substantially help reduce the spread of contagion, but they do need to be handled with care and sanitized regularly.
(Also read the notes, there’s some good info in there about what the articles actually say, on masks vs no masks at all.)
I think OP misinterpreted these studies. From the first study: . Moisture retention, reuse of cloth masks and poor filtration may* result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally.
Basically it COULD increase infection rates but it still blocks some particles. further research is needed, but it still does something.
The second one actually says the OPPOSITE of what you're saying. From the study: "Both masks significantly reduced* the number of microorganisms expelled by volunteers, although the surgical mask was 3 times more effective in blocking transmission than the homemade mask. Our findings suggest that a homemade mask should only be considered as a last resort to prevent droplet transmission from infected individuals, but it would be better than no protection.*"
I do think it’s interesting that the rates do seem to differ WIDELY between the two studies since 1/3 as effective versus letting in 97% of particles seems pretty huge. Unfortunately I’m not sure what could cause that.
So yes, wash frequently and try to have several sets BUT it's still better than nothing. And as mentioned vogmasks are even worse because you can’t wash them.
*emphasis mine
Thank you, I’m rapidly running out of energy and couldn’t respond coherently enough to say what you said 💖
That fits with everything I've read. Even the goddamn CDC recommends using cloth facemasks, even bandanas or scarves, for healthcare workers IF there are no surgical masks available (and they recommend use of face shields with them, but again, this is for healthcare workers).
The CDC also recommends cloth facemasks for those who are sick, adding that healthy people do not need to wear masks. Personally, I have a ton of scrap fabric and elastic and a sewing machine, so I went ahead and made one and wore it to pick up my meds and get groceries, because fuck it, you know?
The long and short of it is you cannot depend on a cloth facemask ALONE, and you have to be fairly religious about cleaning it and washing/sanitizing your hands before and after touching it. But it is BETTER THAN NOTHING. And in these times, that counts for a hell of a lot.
(Also if you don't follow proper protocols even the best masks won't help, js, leave those for the healthcare workers who actually know what they're fucking doing)
OK, so my original post wasn't great, but for some added context:
I am in the UK. Our guidance here remains that the general public do not need to wear masks (current date is 4th April)
Up until a couple of days after I made the original post, everyone I had seen online talking about wearing masks, was acting like this was going to make them completely invulnerable to catching covid, rather than people trying to stop themselves spreading it
Lots of people have been saying in comments that a fabric mask is better than no mask, which I do acknowledge in my original post. Currently, I would still not wear a mask outside of work because a) my government do not recommend it, and b) other than when I am at work, I am completely following our lockdown.
People have also been saying in the comments that masks stop you touching your face. I say this in my original post.
I wholeheartedly agree that masks will help reduce spread from people who are asymptomatic. However, poor mask wearing (I've seen people with masks that cover mouth but not nose) and mask hygiene are important factors in this.
Thank you for replying. I have been seeing lots of different posts on this subject, including many that say "oh handmade masks are no good lmao why even bother" so I think maybe I had those in mind and they warped my perception of your post, which on reread is more nuanced regardless of very minor inaccuracies which could simply be a result of the constant stream of new info we're all being subjected to. Plus I'm assuming you're just like...a normal layperson, and I'm a med-school flunkie, so people should be taking both our words with due skepticism regardless.
And I guess I need to bone up on more than just CDC guidelines if I'm gonna be spouting off in an international space like tumblr lmao. I've been meaning to look at the WHO pages for all this. The CDC is an excellent resource (and tbh just from a quick look-around I found it more accessible than the WHO?) but they are very much America-centric since we're literally the ones they're serving, while the WHO is by design more relevant internationally
I'm not sure what the best resources are for UK-specific information, do you have any recommendations?
(Doctor not lay person)
I think partly the inaccuracies are I had read the information and really simplified it to explain it to my family, then tried to slightly science it up again without rereading.
The NHS website has good information and gov.uk has an entire page on covid with loads of information from public health England. Gov.uk is definitely the more thorough and is where all our up to date advice is. It's then up to individual NHS trusts to interpret the information into their own guidelines
To the nurse who knows there are no more ventilators left and their patient will die by morning.
To the nurse who was fired for wearing their own mask.
To the nurse who has been told they’ll be written up for not adhering to hospital policy.
To the nurse who catches a glimpse of the freezer truck parked out back that is being used as morgue overflow.
To the nurse who has been told they can trust policy because it’s based on, “CDC guidelines.”
To the nurse who has worked 4, 5, 6, 7 consecutive, 12 hour shifts.
To the nurse who is supposed to get married soon.
To the nurse who has a spouse also on the front lines.
To the nurse who was verbally assaulted on their way to work.
To the nurse who was physically assaulted by a patient when they got there.
To the nurse who hasn’t hugged or kissed their family in weeks.
To the nurse who has no childcare but must report to work.
To the nurse who is pregnant and feels guilty for not accepting COVID cases.
To the nurse who is immunocompromised, but can’t help but feel like she’s failing her coworkers.
To the nurse who watches some people on the outside defy social distancing recommendations.
To the nurse who now has skin breakdown from prolonged mask-use.
To the nurse who just graduated and is in their first year of nursing.
To the nurse who has been denied COVID- testing.
To the nurse who is a single parent and has had to send their kid away to live with relatives.
To the nurse who only sheds tears in the shower so that it can drain with the water.
To the nurse who has had no food or drink their entire shift.
To the nurse who is diabetic and now their glucose is low.
To the nurse who is skilled in operating the ventilators.
To the nurse who wonders what was the point of all those ethics papers back in nursing school.
To the nurse being bombarded by the media to make statements about their experience.
To the nurse who works on a unit that does not have pulse ox cords in some of the rooms.
To the nurse who was told they no longer need an N95, "per the CDC."
To the nurse who filled out their Advance Directive- Medical POA after a tough shift.
To the nurse who must find their voice and now use their patient advocacy skills, for themselves.
To the nurse on the floor who has been cancelled for the 3rd time, displaced, or redeployed.
To the nurse who knows deep down this is not just droplet + contact.
To the nurse who’s 25-year old abdominal pain patient was found to have ground-glass opacities on the CT.
To the nurse who realizes none of the team wore PPE, since abdominal pain was not part of the criteria.
To the nurse who is hiding their pre-existing condition for fear of retaliation, or coming up short for their coworkers.
To the nurse who was just handed their one mask and plastic bag for the day, for the week.
To the nurse who has been living out of a motel to avoid infecting their family.
To the nurse who is running out of sick leave and PTO.
To the nurse who found out their patient was COVID (+) via word of mouth, through the grape vine.
To the nurse who didn’t pack lunch today because their work schedule does not permit time to buy groceries.
To the nurse who stayed up last night sewing together pieces of fabric so that they’d have a mask.
To the nurse who wonders when that mysterious tent that was put up outside will be put into use.
To the nurse in charge who has received 3 CPRs, a stroke, and a trauma, back to back.
To the nurse who searches anxiously for a new mask; they’re locked up now.
To the nurse who is thinking about putting in their resignation.
To the nurse who wonders well what about the ANA Code of Ethics, you know, provisions 5 and 6?
To the nurse who has arrived at a shift with 8 call outs.
To the nurse who stands alone in their PPE next to their intubated patient, as they silently have an anxiety attack.
To the nurse who just gave themselves a Cardi-B pep-talk so they can get back out there.
To the nurse who has been told to cohort the cancer patient with the suspected COVID patient, because there’s just no more space.
To the nurse who was told they signed up for this.
To the nurse who is active in the union and spends off days writing up Demands and Calls to Action.
To the nurse who just performed the last round of CPR on their 30-year old patient.
To the nurse who stepped outside to catch their breath but instead ended up pulling an unconscious man out of a car.
To the nurse who is on a travel assignment and nowhere close to their loved ones.
To the nurse who just risked their job by sounding the alarm and exposing their hospital.
To the nurse who just received a lab call notifying them that their COVID patient’s blood work has hemolyzed.
To the nurse who has been made to feel like their life does not matter.
To the nurse who realizes the public did not truly know what nurses, “do,” until now.
To the nurse who is being reassured by leadership shift after shift that PPE stockpiles exist... somewhere.
To the nurse who woke up to a text message that another one of their coworkers has died.
To the nurse who can feel their spirit breaking.
To the nurse who is not being offered mental health support.
To the nurse rushing to don their PPE as their patient de-sats.
To the nurse being told by higher ups during huddle to abandon all they’ve ever known to be true about appropriate infection control and safety precautions.
To the nurse who muttered under their breath, “yea, but I bet you wouldn’t go in there without an N95.”
To the nurse who just wrapped themselves in a trash bag before entering the room.
To the nurse who was abandoned by the same system they dedicated their life to.
To the nurse who woke up in the middle of the night with a fever and cough.
To the nurse who has tested positive for COVID-19.
To the nurse who can no longer breathe on their own.
To the nurse who has been admitted to the ICU.
To the nurse who was just intubated by their own colleague.
To the nurse who did chest compressions on this nurse with tears streaming down their face.
To the nurse who backs away for the last time, as time of death is called.
To the nurse who has been referred to as, “just a nurse.”
To the nurse who wonders if this is how they treat, “heroes.”
Every day, you write you names and the date on your face masks and eye shields. Every day, you show up stronger, more capable, and braver than the day before. Not just for your patients, but for one another.
This is not my post, I copied it from Facebook, from an ER nurse named Aída. I am not a nurse. I am a doctor’s wife who works in administration.
This is the Year of the Nurse.
Never again will you be, “just a nurse.”🩺🏥💉
I love nurses.
imagine being on duty for that poor, poor hospital tonight and getting that pre-alert
“pre-alert for the Hot Zone, 55 year old male arriving in thirty (three zero) minutes, EWS 0…it’s boris. sorry lads″
Do’s and Don'ts of Designing for Accessibility
Anxiety
Autistic Spectrum
Dyslexia
Physical or Motor Disabilities
Low Vision
Screen Readers
Deaf or Hard of Hearing
Find the PDFs for Do’s and Don’ts of Designing for Accessibility here.
I’ve seen a few posts about the new coronavirus that’s hitting China hard, and being a medical semi-professional (two more years!), I thought I would give what advice I can for those who are scared.
Coronaviruses are enveloped, which means they’re surrounded by a membrane that makes them vulnerable to harsh drying agents. A diluted bleach solution (10% or less in water, wiped up well afterwards) or rubbing alcohol will kill the viral particles. In other words: hand sanitizer is actually a good investment for this one, unlike some cold viruses.
Wash your hands! That probably goes without saying, but when in doubt, wash for at least 15 seconds with soap and water. Make sure to get the backs of your hands and under your nails.
According to my lab colleague and his wife, who have family in China, most of those who have died so far did so in the first wave of sickness, before people really knew what was going on. The coronavirus is serious, but supportive care in the hospital significantly decreases your chances of dying or even coming away with serious complications, especially if you’re young and healthy.
If you’re sick, or seriously worried about becoming sick, wear a mask. N95 respirator masks, which fit closer and keep out more than surgical masks, aren’t terribly expensive and can be purchased at the hardware store.
Don’t cough, sneeze, or breathe on people if you’re sick, even if it’s not with the coronavirus. The flu is already terrible this year and we don’t need an immunosuppressed population. Think of your community, and keep them safe!
Mr Darcy exists
Eizabeth Bennet: