Mar

general internist. medical teacher.

[Shematologist, MD @acweyand]

Hot take: If you’re transfusing a patient for iron deficiency anemia (which is rarely indicated), you should also be giving them intravenous iron.

[Robert Oubre, MD | The Doctor of Documentation @Dr_Oubre]

In 10 years I’ve written and read >30,000 SOAP notes.

Most could be improved.

3 tips to writing better notes:

[Mar @mlphung]

@QueensUHealth @QueensuDOM Great news. Congratulations!

[Intensive Care Medicine @yourICM]

🫁 Let’s protect lung & its circulation to improve prognosis! Besides limiting VILI/improving oxygenation, proning protects pulmonary circulation, unloads RV, improves hemodynamics, maybe partly explaining its beneficial effect especially if RV failure.
🖇️ https://t.co/FNuzgSmtzP

[Raghu Venugopal MD @raghu_venugopal]

My patient in crisis tonight had no option but to lie on the ER floor. People stepped around them in the hallway. The patient lay shrouded with a paramedic blanket.

"I want to be clear, Ontarians continue to have access to the care they need, when they need it" - Premier Ford

[Dr. Brian Goldman @NightShiftMD]

A few weeks ago I called @KatharineSmart into question for her use of the term “collapse” because I didn’t look closely enough to see the outlines. I now believe we’re a lot closer to collapse than I realized.

[Kyle Stull @Agronomy_Guy]

I’m sorry but this is gold “we got a farmer who didn’t finish chores to come to the hospital”

[Michael Warner @drmwarner]

Tone deaf.
-highlighting perceived successes
-normalizing ER closures
-deferring responsibility to others
-no plan

[Michael Warner @drmwarner]

During the height of the pandemic MDs working overnight in ICUs (in physician or nursing support roles) were paid $450/h.

As per ONA contract, the hourly night shift premium for an RN is $2.88.

How can RNs feel valued when disparities like this exist?

[Birgit Umaigba-Omoruyi @birgitomo]

Dear HCWs,

Please stop feeling guilty for putting your health & wellbeing first. You cannot save a system that was designed to break you. You cannot do it all. You are doing your best. Please take care of yourself so you can be in a position to help others.

Sending love ❤️

[Birgit Umaigba-Omoruyi @birgitomo]

The staffing shortage in healthcare is severe. Medications delivered late as they're short pharmacists. Late meals as they're short kitchen staff. RTs, nurses, doctors, PSWs, porters, housekeeping staff, lab techs are stretched beyond limits. Be kind to those who show up.

[Birgit Umaigba-Omoruyi @birgitomo]

Unable to transfer my patient out of ICU. Know why?
The nurses who are to receive the patient are drowning. Only 2 nurses to 30 patients on a med-surg unit. At what point does the College of Nurses hold the government accountable for unsafe work? Who gets punished for errors?

[Naheed Dosani @NaheedD]

Please know that nurses are specialized experts. They cannot be replaced by physicians, or any other health workers. They are the backbone of our entire healthcare system.

Make no mistake: We will never rescue our collapsing healthcare system if we do not truly support nurses.

[Adam Grant @AdamMGrant]

Impostor syndrome: “I don't know what I'm doing. It's only a matter of time until everyone finds out."

Growth mindset: "I don't know what I'm doing yet. It's only a matter of time until I figure it out."

The highest form of self-confidence is believing in your ability to learn.

[Dr. Alika Lafontaine MD @AlikaMD]

There’s a reason a nurse needs to go to nursing school. Nurses are uniquely skilled, experienced and competent at what they do.

The idea that non-nurses can just pick up nursing work without training, mentorship and support is non-sensical.

[NEJM Clinician @NEJMClinician]

Perioperative #stroke risk is highest for surgeries performed soon after ischemic stroke, but the question of how long to delay elective surgery in such patients remains unsettled. https://t.co/PjEovLRK7w @rbganatra

[Josh Trebach, MD @jtrebach]

on one hand, why did this need an RCT

on the other hand, now I can reference this RCT

[The Royal College @Royal_College]

#Residents & #RCFellows: $40k total for up to 2 yrs of study with our Robert Maudsley Fellowship for Studies in #MedEd #research. Deadline Sept. 27: https://t.co/p6wFX2qxCp @ResidentDoctors @MarResDocs @ResidentDocsSK @para_ab @PARIMResidents @ResidentDocsBC @fmrq Pls RT!

[Tara Kiran @tara_kiran]

Primary care is the foundation of the healthcare system

Like a good building foundation, we forget about it when it’s working well

It’s unseen, unsexy, and no one really wants to spend extra on it

But, when it starts to crumble, the whole home can give way 🧵