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NLengr

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Everything posted by NLengr

  1. I have told my fellow staff and co-workers: We are going to wartime footing. The country needs to react like this is a war. So far, we have been.
  2. Honestly, once/if the volume starts to increase it will be all hands on deck if needed. Both the resident and the staff will be seeing different COVID patients.
  3. That's what happened in 2009 with H1N1. The med students and residents just kept working. This has the potential to overwhelm the hospital system in Canada, so everybody will be needed to help, residents included.
  4. Just wanted to comment on lines since it got mentioned way up this thread. Femoral lines are a great back up for both central venous access and arterial lines. They are relatively easy, can be done blind and unlike subclavian and IJ lines, there isn't a mess of important stuff in the area to hit. And unlike a radial art line, a femoral art line is a nice big pulsing vessel, making it easy to get.
  5. You certainly don't have a criminal record if all you did was get sued and found liable. Just call CMPA. It's probably not a major issue. Lots of doctors get into financial difficulty and can still practice.
  6. My buddies in business have had all non essential travel cancelled. They work in Canada.
  7. I agree with the above. Bowel sounds are BS. The colon, small bowel and stomach all start moving at different times post ileus. Do the presence of bowel sounds means nothing about the lack of ileus.
  8. I don't think academic guys work more than community. Plus, they also have residents and fellows who do a ton of work for them and shield them on call. My buddy is an academic IM guy, and even covering general IM call in a tertiary center, he is in there was less than I am as a community surgeon in a rural center because he has residents protecting him. The way I look at academic vs community is you get paid less in the academic world for a trade off of less crap cases, residents/fellows to do all your scut/call work and a large community in which to live. ***just realized thi
  9. I would try to spend time with people who are gonna be on the selection committee. Also, would general peds give you a better idea of what the program is like overall vs. a subspecialty elective?
  10. Hang in there. It's an awful year and now complicated by an awful situation. You will get through it. Like my grandfather used to say to my dad, my dad to me and now me to my own kids when everything looks bleak: "This too shall pass".
  11. Cancel. Europe is going to shit and will get worse. Plus if you get sick at all within 14 days of your return, you'll have to self quarantine.
  12. The stability comes as a very high price of limited mobility. It is far, far easier to move jobs as a mid level than it is as a physician, especially if you are in a specialty with limited job opportunities. I frequently wonder if it is worth it. The autonomy is mostly for FFS physicians (I worked a salaried corporate non medicine job before I went to med school). Salaried physicians have much less autonomy than FFS.
  13. In my opinion, we have too many RNs working in the OR. LPNs could easily do the majority of the work. It's organization and planning work to a large degree (making sure proper equipment is avaliable, planning how to get the OR to run efficiently that day etc.). It's very important and doing it well is a skill but it isn't like you need core nursing skills to do it. Part of the overall "shortage" hype is political/union rhetoric. We could improve the shortage by more efficiently using the RNs we have (like using more LPNs in the OR and putting the RNs in other areas that need RN skills) bu
  14. Read this article today. As someone who is on on the other side of training, I found it very interesting and ringing true, especially the part about needing intrinsic motivation and the lack of external validation as a staff. I also like the fact it reminded me of how awesome being a teenager was. Hahaha https://www.medscape.com/viewarticle/924457
  15. Quick and simple example: Severe shortage of OR nurses in our facility due to recent injuries, unplanned leaves and short notice retirements. We are at the point where surgeries may be getting cancelled for lack of staff. We have several nurses with some OR experience and have completed the specific OR nursing course who are interested in coming to the OR to fill the vacancies. Easy fit, you can drop them in to the position and they are ready to perform their job at full capacity within a short period. Union somehow got it put in the contract that OR nursing positions are "teachable"
  16. Mine doesn't pick up anything but a Lub and a Dub for the heart. Not because the thing is faulty. It's because every other sound is made up by cardiologists to protect their turf. Hahaha
  17. I started a family during a surgical residency. Added a second during fellowship. I'm a dude so the whole carrying the child/breastfeeding was a non issue. It's do-able. Your spouse has to shoulder a lot of work and be amazing though.
  18. If you are debating between the specialties, I would strongly consider attending lifestyle and try not to sweat residency lifestyle. Residency will suck no matter what you do for 5 years. But you need to work your attending job for 30 years. All residency sucks. Any surgical specialty will be horrible (maybe not optho?). I imagine IM residency also sucks the big one much of the time.
  19. In the community IM is the worst of the three for after hours work. The IMs at my center seem pretty busy on call but we are a rural secondary center so we don't have most subspecialties. So for MI's, AKI needing dialysis, ICU admits etc. general IM is handling those instead of cardiology, critical care, nephro etc. And the patients are not easy patients a lot of the time (grandma with mild dementia, pneumonia and CHF). Gen Surg seems tolerable at our center than IM but milage may vary. Urology is almost as busy as gen surg when it comes to volume of on call cases (we recently reviewed all th
  20. The whole rush in for a stat C/S st 4 am (or stay in house for a stat c/s at 4 am in some centers) really makes it less appealing. You are committing yourself to middle of the night work on a regular basis for life. That sounds fun at 23. It's a lot different at 43.
  21. What drives me nuts from an admin point of view is the nursing union promotes themselves as guardians of healthcare and very interested in saving the public system, but the minute we try to improve the system in any way that isn't simply adding more nursing jobs, they act as a roadblock. In my experience, the union is a massive barrier to improving the system. Probably the biggest internal barrier we have.
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