Cause I have a spare 10 min
Jul. 16th, 2025 08:13 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriterLoss of filter
Do we loose our filters as we age? My mother must be so used to just being at home alone, that she just can't stop herself picking her own nose in front of her own grand children who now, also just sit there doing the same.
Sighs. The price of free childcare.
Considering what they charge for a meal outside at a resteraunt, childcare seems cheap in my opinion in comparison.
Today's patient
I drew the lucky straw having the morning shift. The pt family who was described to me as "intense", were planning to come for a family meeting at 1pm which as usual always means they start trickling in around 12:40pm.
The family, was so large (only 1/3rd arrived) ish and they had to open up the education room which is 3x the size of any of the family rooms available.
lolz. I was late to the meeting and the poor social worker is so young and just, inexperienced - that I only found them because I bumped into her in the hallway looking for tissue boxes and she said "the doctor doesn't seem like he's doing a very good job of selling what was happening" but when I went in, it really sounded like a very reasonable and normal conversation that is often had, and was being done well. From what I've seen before - and there's quite a variety in how they all like to do it. This consultant was taking the Dr W approach. He was saying this is what we should do (Extubate) and its unreasonable for me to ask you to decide about what we should do, but I would like to inform you of what will happen after it happens. And that keeping him on a ventilator (the patient, that is) is really doing a disservice to his progression. It will make him get slowly with time more weak and then dependent on the machine, While if we remove it now we can see if he can get better on his own (unlikely but not impossible) or if he will at some point pass away - of which we cannot tell when this will be.
It's a ?lebanese muslim family and so I thought they held it all remarkably well. I probably missed the worst part of the meeting and so here I am unfairly judging the social worker as inexperienced. Although she does look all of 21. Maybe 25. But I'd doubt she'd be older.
I was trying to explain it to her earlier. That you know- he's a strong looking guy - he might do just fine off a ventilator. Like maybe not. But maybe yes. Although in hindsight like he was on 18 of single strength norad and frequently apnoea alarming lol. But he did responde when I told him to breathe.
They wanted the 2nd book in the quran played over and over again - and I was so bored , and slightly curious so I looked it up. It's basically a longish text (the thing took youtube 1.5 hours to read out to this poor man) and one of the main stories is that about a cow, -- Here is my 1 min summary from a 2 min time I had to read--
There was a bunch of people, and they were told to kill a particular cow, and they laughed at the man that told them to do it - but they did it anyway, they had to discover this cow - and then they took a peice of it and touched a dead man and he came back to life and said who his murderer was.
And this was meant to be some sort of display to show that God is like, mysterious and we shouldn't question what he wants us to do or something.
I was Haram and played some coldplay to the poor man inbetween the quran stuff because I was literally falling asleep with the lulling quality of the chanting. Surely it cannot be a sin to take a break? Who knows. Terrible I am.
When i left he had a Sp02 of 100% on 40% FiO2 via HFNP but his noradrenaline requirement was up to 25 and they restarted argipressin. I think they need to put a ceiling on the noradrenaline. He's going to max out at some point. He looked crap and I don't think he would have made it much more past the night.
I also rushed my handover to the next staff cause I was hoping to make the family meeting. She was mildly late because of parking. One of the super oldie staffers who lately, started to get a tremmor in her head and hands so I wonder how long until she can't work clinically anymore. She's lovely though.
Do we loose our filters as we age? My mother must be so used to just being at home alone, that she just can't stop herself picking her own nose in front of her own grand children who now, also just sit there doing the same.
Sighs. The price of free childcare.
Considering what they charge for a meal outside at a resteraunt, childcare seems cheap in my opinion in comparison.
Today's patient
I drew the lucky straw having the morning shift. The pt family who was described to me as "intense", were planning to come for a family meeting at 1pm which as usual always means they start trickling in around 12:40pm.
The family, was so large (only 1/3rd arrived) ish and they had to open up the education room which is 3x the size of any of the family rooms available.
lolz. I was late to the meeting and the poor social worker is so young and just, inexperienced - that I only found them because I bumped into her in the hallway looking for tissue boxes and she said "the doctor doesn't seem like he's doing a very good job of selling what was happening" but when I went in, it really sounded like a very reasonable and normal conversation that is often had, and was being done well. From what I've seen before - and there's quite a variety in how they all like to do it. This consultant was taking the Dr W approach. He was saying this is what we should do (Extubate) and its unreasonable for me to ask you to decide about what we should do, but I would like to inform you of what will happen after it happens. And that keeping him on a ventilator (the patient, that is) is really doing a disservice to his progression. It will make him get slowly with time more weak and then dependent on the machine, While if we remove it now we can see if he can get better on his own (unlikely but not impossible) or if he will at some point pass away - of which we cannot tell when this will be.
It's a ?lebanese muslim family and so I thought they held it all remarkably well. I probably missed the worst part of the meeting and so here I am unfairly judging the social worker as inexperienced. Although she does look all of 21. Maybe 25. But I'd doubt she'd be older.
I was trying to explain it to her earlier. That you know- he's a strong looking guy - he might do just fine off a ventilator. Like maybe not. But maybe yes. Although in hindsight like he was on 18 of single strength norad and frequently apnoea alarming lol. But he did responde when I told him to breathe.
They wanted the 2nd book in the quran played over and over again - and I was so bored , and slightly curious so I looked it up. It's basically a longish text (the thing took youtube 1.5 hours to read out to this poor man) and one of the main stories is that about a cow, -- Here is my 1 min summary from a 2 min time I had to read--
There was a bunch of people, and they were told to kill a particular cow, and they laughed at the man that told them to do it - but they did it anyway, they had to discover this cow - and then they took a peice of it and touched a dead man and he came back to life and said who his murderer was.
And this was meant to be some sort of display to show that God is like, mysterious and we shouldn't question what he wants us to do or something.
I was Haram and played some coldplay to the poor man inbetween the quran stuff because I was literally falling asleep with the lulling quality of the chanting. Surely it cannot be a sin to take a break? Who knows. Terrible I am.
When i left he had a Sp02 of 100% on 40% FiO2 via HFNP but his noradrenaline requirement was up to 25 and they restarted argipressin. I think they need to put a ceiling on the noradrenaline. He's going to max out at some point. He looked crap and I don't think he would have made it much more past the night.
I also rushed my handover to the next staff cause I was hoping to make the family meeting. She was mildly late because of parking. One of the super oldie staffers who lately, started to get a tremmor in her head and hands so I wonder how long until she can't work clinically anymore. She's lovely though.
