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Discoholic 🪩
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art blog(derogatory)
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occasionally subtle
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almost home
seen from Germany
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@road-to-rcn
Google like a boss!
This is relevant to librarian-ing.
This would make such an excellent hand out for students.
Wheee I use these! They make Google a much more effective search tool.
Thank you! Ppl don’t know these things when I tell them they don’t know how to use a computer
march goals
Academic - sign up for spring/summer courses!!! - submit preceptorship application!!! (AHHHHH) - pass dosage first try - all weekly online coursework done by friday
Financial - continue not spending $$$ - finish note taking by fridays
Fitness/Nutrition - remember to take fish oil and probiotic daily - something active 12x - (yoga at least 2x a week, gym 1x) - more veggies - close all activity rings 5/7 days - 3L of water daily
Apartment - make bed daily - vacuum/mop weekly - litter every other day - tidy clothes daily - tidy dining table daily
Mental/Self-love/All else ` - text dad daily, call weekly - stop picking at nails/paint them when i can - work on changing negative thought processes - read most nights before bed
september goals
Financial - No needless spending - Pay tuition fees when they come in - Some sort of income - Email work about reading week shift
Academic - Stay on top of online course, work on it for sure Mondays and Wednesdays between classes - Library 2x a week - Make guidance appt re: possible second major - Spend one hour a week (divided if I want) on HESI/EAQ questions
Fitness/Nutrition - Something active 10x - Follow new eating plan - Stretch daily in morning - Stay consistent with supplements - 3L h20 daily - Less drinking - Less mindless snacking - Actually try and meal prep properly
Apartment Things - Make bed daily - Sweep and vacuum weekly - Clean bathroom weekly - Empty litter box every other day - Dishes daily - Tidy living room daily - Deep clean desk and dresser
Mental/Self-love/All else - Shower daily - Begin practicing meditation - Lavender tea and diffuser before bed - Plan for week ahead Sunday nights - Text dad every other day at least, call once a week - Face masks and hair masks and shaving and painted toes and white strips cos they all make me feel good!!! - Mail cards to L and W - Utilize planner - Clean makeup brushes weekly - Skin care routine nightly
How can I organize my time, school work, study schedules, etc?
Check out these blogs:
6 Tips to organize your life and studying
10 Tips to start the semester off right
Time Management Tips for Students
Deadlines Suck
25 Techniques to Help You Study
We also have this awesome study schedule:
There’s a link to a free printable PDF of it in the first blog listed.
how to feel like you have your shit together
make your bed every morning, it will make your room look tidier and it just feels better to go to sleep in a premade bed
clean your footwear regularly
start using a planner
following on that, keep a journal to drop down your ideas, quotes and anything you find relevant really
set 3 main goals each day with one of them being your number 1 priority, overloading your to-do list makes you more likely to procrastinate
have morning and night routines, treat yourself
have a folder with all your important documents so that they are all in one place
start writing down your finances and stop stupid spending
make your own coffees/smoothies
start your own recipe book
10 tips to get your life together
1. Start a skincare routine
I know this sounds silly but this is a very easy and simple way to make you feel motivated and organised. Starting a skin routine will not only make you feel better, it will also make you feel healthier and more confident. It only takes 10 minutes, morning and night, and you can cater your skin routine to fit your personal needs. Also it will make your skin look AMAZING.
2. Start a diary/to-do list
My tip for this, coming from an excessive procrastinator, is only put 3 things to do each day. This way you don’t overwhelm yourself with tasks, and it is easy to complete and after you have done it you will feel a lot better about yourself. Instead of doing 15 things in one day, do 3 things a day for a period of 5 days. Starting a to-do list/diary will give you the push to actually do what you have put on it. Writing down all of the things that you have to do will make the tasks seem easier and it will be less overwhelming.
3. Read a book
Reading a book that you enjoy, not one that you have to read, is a great way to clear your mind. I recommend reading for 30 minutes before going to bed. Make sure you have the book in a physical copy, not on your phone/other electronic devise, as using these before bed can negatively affect your sleep. This kills two birds with one stone: Reading, and not going on your phone before bed
4. Exercise!
Whether this is 15 star jumps in the morning or 3 hours in the gym, exercise is a great way to feel more confident about yourself. Also, when you exercise, your body releases endorphins which make you happy! :) This will also help you to be healthier which is an added bonus.
5.Do your homework the night you get it
Obviously this is only if its possible, but leaving your homework until the night before its due in is a terrible habit to get into, which just ends up in you feeling stressed. Getting your homework out of the way the night it’s set will help you feel more prepared and less worried.
6. Read ahead
About to start a new topic? Read ahead. This means you will be ahead of everyone in your class, which will make you feel more confident, and it means that once it is taught to you, you will have a better understanding of it and if you don’t understand anything, you can ask once it is taught.
7. Clean your room every night
Cleaning your room every night will mean that you will feel more organised and you won’t have much to clean up the next night. Trying to work in a messy room will make you feel unmotivated and you will be more likely to procrastinate.The same goes for if your desk is messy. A clean room is a clean mind!
8. Make your bed in the morning
I see this posted everywhere, but still people don’t understand the importance of it! Making your bed in the morning will make you feel prepared and you will start your day will a clear mind. Its one thing off of your list of things to do.
9. Drink lots of water!
Being dehydrated can be a cause for headaches, fatigue and many other things that will make you feel unmotivated and down. Drinking at least 5 glasses of water a day will not only make you healthier, it will also make you feel generally better and happier.
10. Get at least 8 hours sleep!
This one is so important! For teenagers, 7 or less hours sleep is considered as sleep deprivation. Being sleep deprived can cause things such as: Bad concentration skills, a lack of motivation and also decreases your chances of remembering something by 40%! Enough sleep is crucial for having a good day and getting those A* grades your aiming for!
Any questions, feel free to ask!
How to GET SHIT DONE
Because it comes up a lot for all of us trying to manage schedules that slam more than 24 hours of work into a day, I thought I would make one giant productivity post for everyone to help us all out (including myself).
10 steps to GET MORE SHIT DONE in a day
JUST START—I think most of us find that sometimes the hardest part to starting a task is overcoming the “ugh—fuck this shit, I don’t want to do this” feeling. So, trick yourself into it. Instead of saying you’re going to work for 8 hours, tell yourself you’ll do an hour… and watch that hour turn into 2 or 3 or 4 magically.
Action fights anxiety—If you’re terrified of a project hanging over your head, just start it!! Instead of waiting till tomorrow or next week when things might be right, just start right now! Do something to help yourself feel better about it. You’ll feel better getting through the rest of your day if you don’t have the fear. If you wake up at 2 am panicked you haven’t replied to an email, get up and do it now so you can go back to sleep in peace!
Make a list—Never underestimate the power of writing it down and crossing it off.
Take care of yourself—It’s hard to work when you’re tired or hungry or haven’t worked out, etc. So, prioritize—make yourself #1! You’re fucking worth it. So work out, eat breakfast, sleep 6 or 8 or 9 hours (whatever you need). Do whatever it takes to make yourself feel ready to take on the day.
Stay organized—I have a slightly OCD-type personality. If the desk is a mess, it’s hard for me to do my work. So put things back where they belong, take the time to keep things tidy so you can do your best work.
Don’t multitask—We all think we’re good at this—but the truth is we’re shit. We’re complete and utter shit at multitasking. Do one thing very well instead of four things poorly.
Shut off—Turning away from the work for just a minute can really decrease your productivity. Unless you are actively waiting on a text to hear the test results from your mother’s biopsy or an emergency call from your best friend that your house is burning down almost anything else can wait another hour until you finish your task. Even an email from your boss can probably wait another 10 minutes for you to finish what you’re working on.
Be competitive—Be a better you than you were yesterday. Do more. Show yesterday-you that they’re a lazy bitch and you can do better!
Refocus—here’s a list of how to do it in 3 minutes or less.
Give a fuck!!—If you actually care about what you’re doing, you’ll be more motivated to do it!
10 very specific ways to get more shit done
Work when you work best—This rule that people work better in the morning is bullshit. Some people work best from 5 am to 7 am, but some of us do our best work from 1 pm to 3 pm or 10 pm to midnight. Work when you do your best work and get things done—whenever that is!!
Localize—Put it all in one place. Stop moving between eight study resources or you’ll fail to focus on one thing well—instead condense all your study materials into one place and then focus on that ONE thing.
Multi-task on the stuff that doesn’t matter—It takes no brain power to clean a counter, so when you have to clean your apartment you can also return the phone calls you’ve put off. When you have to stand in line for coffee you can also answer emails, while your lunch is heating in the microwave you can put away the dishes in the dish washer. Get more done in the spaces between.
Be contrary—Who says you have to buy groceries on the busiest shopping day? Go at a weird time when other people won’t be there and you can get in and out faster. Don’t waste your time waiting in line just because that’s when everyone else does something. Do things when you can do it fastest!! Hit the post office at 3 pm when everyone else is at work, go to the gym late in the evening after the post-work rush is over. Do it when you can get it done fast!
Buy the right shit—Go ahead and buy the best tool for the task. If you don’t set yourself up right, you’ll just spend more time fighting for things to work than actually working!!
In arm’s reach or screw it—When you sit down to work, get all the things you need ready to go so you don’t have to keep getting up for more paper or some water. If it’s not within arm’s reach, move it or screw it!
Bribe yourself—Never underestimate the power of a piece of chocolate, or a night out at the end of the week, or an online shopping spree for that shirt you’ve wanted.
Turn it up (or turn it down)—If you hate the quiet play music, but if the sound is too distracting shut it the fuck off. Work in a space that works for you.
Deep end—welcome to it--Do the hard stuff first. You’ll lose energy as the day goes on, so leave the easy things for when you’re tired and don’t need as much will power.
One touch—You’ve probably heard this one before, but here’s my irreverent version of it. Pick it up—don’t put it the fuck down until you’re done. If you get an email from your professor saying you all have to complete a required form, do the fucking form now and email it back immediately. Why spend more time later having to look at that damn email again? If you realize you’re out of paper towels, check your level of tin foil and tissues while you’re at it so you can go to the store one time. Do it once, do it right, don’t fuck around.
Oh, and don’t forget to give yourself a break when you need it. Not every day can be a day where everything gets done. :)
Most bang-for-buck things every intern should know before starting inpatient wards
Source. A collection of Meddit resources and advice on what bread-and-butter topics interns would most benefit from brushing up on/memorizing prior to the beginning of their internship. 1) Fluids. How and when to use them, dosage, timing and other pearls.
Review of fluids (not how to use them per se) by Dr. Strong /u/ericstrong
Maintenance Intravenous Fluids in Acutely Ill Patients - NEJM.
Pretty thorough review of fluid management on openanesthesia.org
2) Nausea. When to treat, how to treat and at what dose.
3) Standard pn orders: pain killers, sleep aids and antiemetics aka how to reduce nighttime calls from nurses by 25%
4) “Reflex” antibiotic choice for routine inpatient infections.
http://www.bpac.org.nz/Supplement/2013/July/antibiotics-guide.aspx /u/ChristianM and /u/ive_been_up_allnight
5) Initial work-up and treatment of dyspnea. (more realistic to approach by symptoms as, unfortunately, you first have to diagnose whats wrong. E.g. heart failure, pulmonary edema, embolism, COPD, pneumonia).
6) Initial work-up and treatment of oliguria/anuria.
7) A sensible initial approach to suspected ileus.
8) Blood. When, how, why to replace.
9) Pain. Optimal management without inducing narcosis.
Managing cancer pain: Frequently asked questions: CCJM
10) Potassium. When, why and how to shift or replace.
A review on both potassium and sodium disorders by Dr. Strong /u/ericstrong (Not reposted in 12) hyponatremia but applies there as well) https://www.youtube.com/playlist?list=PLYojB5NEEakXVIAapcSEleP4doUdHVtld
11) Hyponatremia. Most common electrolyte disturbance, commonly mismanaged.
12) Resuscitation aka commit the ACLS algorithms to memory.
Current ACLS guidelines. https://www.acls.net/aclsalg.htm
Would love a video series, interactive cases etc.
13) Basic EKG interpretation.
Whole EKG video courses
A whole free youtube EKG video review course by meddit’s own u/ericstrong
An alternative EKG course that takes you through all the basics. This however has no free version and costs 96$ a year. The quality is amazing. Here are 6 basic sample videos on youtube. The paid course is available on http://www.ecgteacher.com/
I have to admit I haven’t used this course personally but his free youtube videos are on-point and he seems like a good teacher. Also behind paywall. Free youtube samples are here. The full course can be found here https://www.ecgacademy.com.
EKG video cases
Amazing case-of-the-week emergency medicine EKG videos on youtube by Dr. Amal Mattu
– If you like Dr. Mattu’s cases (and you most certainly will) he is still posting every single week on his new site https://ecgweekly.com. It costs 4 starbucks coffees a year and is going to save someones life.
Practice EKGs with answers
Watching videos isn’t enough, you still have to grind out EKGs to keep your game strong. Visit http://ecgmadesimple.com and http://ecg.bidmc.harvard.edu/maven/mavenmain.asp for this.
EKG blogs
I recommend signing up for some kind of RSS feed (e.g. https://feedly.com/) and subscribing to the following EKG blogs:
http://hqmeded-ecg.blogspot.is (Dr. Smiths ECG blog)
http://www.ems12lead.com
http://ecg-interpretation.blogspot.is
http://jhcedecg.blogspot.is
EKG resource libraries
Life in the fastlane has a nice resource to look up a specific EKG finding, criteria or concept.
http://www.practicalclinicalskills.com/ekg.aspx /u/collidge
14) Know when to order ABGs and how to interpret them.
Almost too detailed video lecture series on ABGs and how to interpret them by Dr. Eric Strong (/u/ericstrong)
Practice makes perfect. ABG interpretation generator. https://abg.ninja/abg
Bonus 15) Basic CXR interpretation
CXR video lecture course
Again, Dr. Eric Strong has an excellent video course for free on youtube
Step-by-step guides to basic CXR interpretation
The Radiology Assistant: Chest X-ray - Basic interpretation
Radiology Masterclass step-by-step basic CXR
University of Virginia’s step-by-step basic CXR
All inclusive resources
The art and science of thoracic imaging All inclusive resource for all things thoracic! Jokes aside amazing resource.
UPenns CXR learning website
Loyola Universities excellent CXR Atlas Most outdated look but amazing content.
Checklist approach to CXR
Bonus 16) Overnight o-shit-what’s-that Head CT interpretation
Midnight radiology: Emergency CT of the head
University of Virginia’s guide to the Head CT
Hey, self: review before NCLEX. Xo, me.
Oh hell yes
For future reference.
Must. Study.
Scheduled to post right before intern year starts. Gulp.
Reblog to save a life. You got this, bbs.
It’s almost July – Intern is coming.
A User’s Guide To The Brain
More about the human brain and behaviour on @tobeagenius
Anti-epileptics/Anti-convulsants Made Incredibly Easy
TREATMENT STRATEGIES:
Start therapy after the second seizure; first ONLY if recurrence is high = MRI abnormal, EEG abnormal, or status epilepticus.
Monotherapy until seizures are controlled.
If failed: titrate up to maximum tolerated dose –> shift to alternative drug –> use drug combination –> VNS, DBS.
Full drug therapy for 2 – 3 years after the last fit.
Gradual withdrawal over at least 6 months.
Rx Profile:
(Drawings are courtesy of @mynotes4usmle)
Carbamazepine
Mainly for generalized tonic-clonic seizures
Trigeminal neuralgia
Bipolar disorders (with depressive predomince) - mood stabelizier
NEVER in abscence seizures
SE:
Lamotrigine
Safer profile, with minimal interactions.
Bipolar disorders (with depressive predominance) - mood stabilizer
SE: maculopapular rash; SJS
Topiramate
Broad spectrum anti-seizure; used in migraine.
SE of TopIRamate: enzyme Inhibitor + Renal stones.
TREATMENT PROTOCOL:
Green: first line; Yellow: second line; Orange: third line; Red: contraindications. (Graph reproduced from Oxford Handbook of Clinical Medicine)
Epilepsy & Pregnancy:
Non-enzyme-inducing AEDS have no effect on the pill. Enzyme inhibitors prolong the half life of OCP (=Valproate) so better for birth control , and vice versa.
Most of AEDs are teratogenic; Category D
Therapy not stopped; uncontrolled seizure is risky to fetus & mother. Give lowest effective dose.
Avoid phenytoin, valproate and barbiturates (use Lamotrigine)
Most AEDs cause folate deficiency …. Folic acid (prior to or early in conception)
Most AEDs are competitive inhibitors of vit. K-dependent clotting factor: Vit. K to mother 10 days before labor & to newborn.
Most except carbamazepine and valproate are present in breast milk. Lamotrigine is safe on infants.
Status Epilepticus:
WHAT? Seizures lasting for >30min, OR repeated seizures without intervening consciousness.
Things to be done:
Bedside glucose, the following tests can be done once Rx has started: lab glucose, ABG, U&E, Ca2+, FBC, ECG.
Consider anticonvulsant levels, toxicology screen, LP, cultures, EEG, CT, CO level.
Pulse oximetry, cardiac monitor.
How to treat?
THE END
Love this post! Thanks!!!
WHEN YOU DON’T HAVE ENOUGH TIME TO LEAVE THE ROOM WHILE THEY ARE DOING A PORTABLE CHEST X-RAY
quotes from my art institute this week
•"i can’t find my BACKUP CARDIGAN.“ -a kid who came barreling into the classroom in a frenzy •"i think that everything can be art! like body modifications and-” [unanimous eyeroll] •"you’re all FASCISTS.“ •[loud crash] “i’m having A PROBLEM.” •"i mean like i didn’t grow up on heavy metal but like-” •"i need a KNIFE -your sweater is such a beautiful color orange i love it- KNIFE.“ •"oh she made a full sized coffin??” “fucking edgy.” •"you see i put my piece on the trashcan bc…….the colors……contrast? okay………it’s trash and i got a second degree burn while making it.“ •"you see, my piece is based off a whole list of visual puns.” [flips open notebook] “let’s begin.” •"i drew me because i like drawing and i like me.“ •"stop i LOVE YOUR TEXTURE.” •"i’m a GENIUS. A GENIUS.“ [loud crash] •"who will FIGHT FOR THIS LAST STICKER.” •"it looks like duchamp.“ “YEEEESSSSSS!!!!!!” •"oh FUCK ME we’re eating zapps??“ •"so i made this big cross and then it hit me, i’m not christian.” •"well you see my friends suggested……my acquaintances suggested…..i’m not sure what our relationship is.“ •"is this box masculine or feminine?“ •"so i painted this piece with my own blood.” “what the fuck.” •"okay so i mostly paint nudes so if you’re, what’s the word…..offended, i’m sorry.“ •"i brought this piece today because it’s the only piece my mom likes.“ •"alexander hamilton was a capricorn y'all.”
“You cannot save the world, but you might save the man in front of you, if you work fast enough.” - Diana Gabaldon
Meanwhile on Twitter | https://twitter.com/mckellogs/status/811339472205910016
I would encourage this.
that’s fucking briliant
Incredible!
No society can legitimately call itself civilised if a sick person is denied medical aid because of a lack of means.
Aneurin Bevan, Founder of the National Health Service (via overjoyed-one-twenty-three)
I saw my first code today.
The morning was running smoothly. One of my team members brought bagels for social rounds, I had seen my patient that morning and they were doing fine, and I was on my way to meet the attending for our team rounds when I got the text.
“234 coding in dialysis.”
Me and the other students raced to the 5th floor, where I was met with my first code.
I stood in the corner during all of it, quietly observing and trying to hold back the emotions that were clawing at my throat while my senior partner tried talking me through the ACLS algorithm.
But I wasn’t listening.
All I could see was this young woman’s lifeless body, with needles and IVs and defibrillators attached to it. The way that the patient’s body flopped with each chest compression.
All I could hear were the orders being shouted, calls for more bicarb and crash carts and EKGs. The bustling of the doctors and nurses as they worked around the patient, switching people off for CPR when someone got too tired. The silence of my attending as she watched and observed the others working tirelessly to get her patient back into sinus.
All I could think was how just yesterday, I had seen this patient during rounds with my team. Just yesterday, I called volunteer services to have dog therapy visit this patient, because my team thought he might enjoy it. Just yesterday, when I came to ask his roommate if they had any dog allergies, I could see this patient out of the corner of my eye on the edge of his bed, hunched over a basin.
Until finally, the bustling stopped. Everyone paused and waited for a decision. And the time of death was called. My attending asked for a moment of silence for the patient.
I watched my first code today, quietly in the corner, for 35 minutes this morning. She was going to be the first patient we saw on rounds - but it wasn’t supposed to be like this.
She was the youngest patient on my team’s service. Just five years older than me. She was supposed to be discharged two days ago. I keep wondering why, or how, this could happen. I’m so confused as to what went wrong.
I watched my first code today, and I unapologetically cried and felt sorrow for this patient that wasn’t even mine. I have never been this close to death. But today, this morning, for 35 minutes, I witnessed this patient balance on the thin line between life and death. And unfortunately, the patient fell to to the other side.
I know there will be many more code blues that I will experience during my career, and they will be patients that will actually be in my care. I just never thought that I would have to experience my first one a week into my internal medicine rotation. But then again, I don’t think anybody else expected this either. No one ever does.
