Yea, you see more demographic information about patients from medicine (and t's basically essential when it's psych). Also the joke is kind of a nod to the fact that medicine reports are rife with information that surgeons often find non-relevent. Living with nurse had worked in the OR for ages-- he's always like-- it's great when patients are honest-- but they're almost always stretching the truth or just flat out lying (under reporting or not report substance use, or lying fasting, forgetting to mention they took NSAIDs yesterday) and they have wing-it or end the case & reschedule. What is considered essential info is different. You'll notice both said a lot of the same stuff but in a different order (different priorities) and the medicine report had way more additional info, recommendations about where the what direction plan of care was heading
To be fair, the rented flat could have hidden mold issues, having a dog puts him at risk of several infectious diseases, living with a wife and 3 daughters means he might be able to head home before he's 100% functional (as with 4 other people in the house they can likely work it out so that there's always at least 1 around). All relevant.
Shut up!! 🤣🤣😂 I'm literally in that year of med school and the memes of the living situation with patients have me like 🤡 but tbh semio is really important 😅
Internal Medicine turned me into an overly analytical detail oriented talkative and reflects in even my style of conversing with anyone and even my text messages which are paragraphs long. 🤦🏾♂️
Well, the surgeon ordered a blood transfusion & the medical doc ordered all the lab work to check for another reason outside of surgery. They’ll try everything else & run every test they can think of before taking the patient back to surgery & cut him open again to look for a possible bleed. Not cuz they don’t want to surgery again but they don’t want to do an unnecessary surgery & put the patient under even more risk for complications.
They gave Iv fluids to a patient on dialysis, as well as a whole unit of blood. Like, i'd assume it was a well thought our best of two bad options except they didn't even mention he was a dialysis patient!!
I mean considering his surgery he was most likely bowel rest so perhaps NPO or cl liquids at most. Patient probably had a fluid volume deficit. Patient was probably also anemic at baseline being a dialysis patient and if he were going to dialysis they could give him the blood there.
@@TheMCFARTPANTS we can do some fluid removal in dialysis and give epo, but we need to stabilize that low BP first, but did we try the leg raise trick, give their scheduled midodrine at 0600, and used an appropriate sized cuff to ensure the most accurate BP? also the bed wasn’t zeroed so Mr Jones’ wet weight is completely inaccurate. Don’t worry; I can always get Jones on the scale before a treatment ;)
@@ekekekekk doc stated that after the iv fluids were given the blood pressure stabilized. Pull off necessary fluid during dialysis with the administration of blood and perhaps erythropoietin.
@@Doc_Schmidt I am a urologist🇬🇧. Absolutely tremendous material. Just goes to show how universal our practice is no matter where you work in the world. Please keep producing your incredible material. Always instantly relatable to every doctor. Joys, rewards, frustrations the works. Insuperable, ineffable, irrecusable. I am all out of superlatives. 🎉🍾🌶🤓🛍🥂💐🎊🎶👍🏾🤗😎😂
So Doc, what you’re trying to tell me is you just fluid overloaded my dialysis patient that now nephrology is going to call me in to do emergent dialysis because he can’t breathe!
I love it when different depts argue for a couple of days on which scan is best, wait a couple days till they're in coma that they didn't even notice, then do a scan anyway, give results of scan that it's end stage cancer, not a 6 month chest infection that 5 lots of antibiotics didn't fix, and the patient dies in about an hour. But you can't sue for negligence because they were going to die anyway!!! Love it.
I like how they both cover the patients conditions, both doing what they know best, and well, and still miss that an anemic patient who is normally hypertensive is now hypotensive after a surgery and noone is addressing it...
@@AkaiAzul lol they would've confirmed the GI bleed and chucked them back to surgery AGAIN after giving them more units if they were still even stable at that point.
I was working in ICU here in okc. I had a patient that I called the on-call for. It was a teaching hospital. I told the doctor pt needed Lasix. He said "ok give 20mg iv" I said "really?" He said "I don't know, I'm OB/Gyn, that's how much we normally give. How much do you think?" I said "like 80mg, this guy is drowning!" He goes, "give him what you think, I'll sign the order" ..... lol. He was scared to death!
Wait, how come a male patient needed an OB GYN? Lol!! But yes that’s as bad as when you have a confused/delirious agitated pt who is starting to swing and the doctor says to give them 6.25mg lo seroquel….ummm good luck getting that in them and it has legit no effect
Back in the days before hospitalists I was on call and got a call from the Ob/Gyn on call who said he had a 20 year old patient who had just had a septic miscarriage. Her pressure was 60/0 and her temperature was 102 and he was like, I gave her some fluids. Can you consult and help? I basically told him to call the ICU to get her transferred ASAP and I would call them from my car. She actually did great. We had her intubated on a couple of pressors and broad spectrum antibiotics for about 24 hours and then she bounced right back and was out of the ICU within 48 hours. (Just to note-I am a general internist, and not critical care but it was 3 AM and pulmonary/critical care wasn't going to be there before 7). Come to think of it, I had another patient call a couple of days ago saying she was pregnant and had Covid and she called her Ob/Gyn who told her to call me to deal with it. Pregnant patients are like post-op wounds. I try not to deal with them if possible.Every prescription comes with a message to ask their Ob if they can take it. Finally, in my favorite moment from training, a past-cardiac cath patient went into atrial fibrillation. We called his cardiologist who had done the cath and he asked "Why are you calling me? You need to consult arrythmia. I am a coronary flow specialist!"
Unfortunately I understand most of what he said. My husband has been in ICU for over 2 months. I love watching his videos bc I need to find laughter during this crisis.
@@Cyblps I am truly sorry for all your Husband is going through, Yun💝~ Can only imagine how difficult a time this is for you, while supporting his recovery...Sending many PRAYers today from Arizona to you BOTH🙏🌠!!
The “some kind of” THREW ME ALL THE WAY OFF!! Um…there is so much truth…thank you for revealing what is really behind this Medical System curtain. 😮🤭🤦🏾♀️
I Looooove thiiis hahahaha so relatable hahah and then, in my country as a family doctor, I get complete medical records after patient's check out from hospital, and have to take care of both those - surgical and internal medicine things
I’ve never felt more important than when in the MICU and there would be a team there every morning consulting on ME! 😊 and the pre-consult run through , but that only had like 2 people
Cortisol deficiency , so glad to hear he will be checking the hormones. I have Cortisol deficiency and therefore I am on Cortisol dependent meds. Also, it is very dangerous to be Cortisol dependent.
LMAO then there’s the one nurse with a report that sounds like the first when I’m like, there’s nothing going on because the medicine team already nailed it.
No, we surgeons would mention his electrolytes, bowel sounds, NGT output. Also, our orders would be to ask IM to follow his blood sugar and nephro to ask how much fluids to give and whether we need to adjust any doses. Come on! We are not that stupid.
Surgery: gave fluids and blood. So basically, we will boost up the numbers so we can transfer to Medicine. Medicine: we will investigate and overthink everything, but won't touch the bandage because it's yucky. Yup. Nailed it.
Good Job Doc! If these can be considered “art,” then this one is your best work. Without explaining yourself, we appreciate how you’re conveying multiple important messages to the viewer, but leaving it up to them to determine what that message is. Everyone can come away from this with different conclusions, but hopefully at least a few people get the main points - because seeing they do not see, and hearing they do not hear, nor do they understand.
YEP I never understand any of what they say. So I’ve learned to just ask “ is my elderly father gonna live?? And what do I need to do when I take him home? 😜
Reminds me of when I worked in open heart recovery. Smh There would be all types Dr with specialties coming through writing orders…. Nope, nope, and nope. Me: “Ya gotta run that by the surgeon.” Other Dr: “Ok run it by the surgeon.” Me: “No, I’m not going to explain nor defend your order.” “Call him, you got this, in the meantime I got 28 pages of standing orders, and yours is not one of them.”
Infectious disease: Add swish and swallow Nystatin for Fungal coverage. One time dose of Zosyn and flagyl start scheduled Tylenol 650 q4 and CRRT for the fevers, confirm downtrending wbc on the next AM labs and discontinue all antibiotics.... sign off like a stewardship boss. 72 hours later with an elevated lactate, On the reconsult. Surgical and medical team should establish source control, consider exploratory washout 😂 then and start amoxicillin.
*Lab enters the chat* ummm a BMP and CBC might be fine because of the recent transfusion…butwhatdoiknowimjustreportingresults okay bye and the A1C might be a send out but I’ll get back to you on that 👀
You forgot the "He lives in a rented flat with his wife and his three daughters and their dog" during the medical presentation.
Is there a joke I’m missing here? Sorry not a med school insider
Yea, you see more demographic information about patients from medicine (and t's basically essential when it's psych). Also the joke is kind of a nod to the fact that medicine reports are rife with information that surgeons often find non-relevent. Living with nurse had worked in the OR for ages-- he's always like-- it's great when patients are honest-- but they're almost always stretching the truth or just flat out lying (under reporting or not report substance use, or lying fasting, forgetting to mention they took NSAIDs yesterday) and they have wing-it or end the case & reschedule. What is considered essential info is different. You'll notice both said a lot of the same stuff but in a different order (different priorities) and the medicine report had way more additional info, recommendations about where the what direction plan of care was heading
To be fair, the rented flat could have hidden mold issues, having a dog puts him at risk of several infectious diseases, living with a wife and 3 daughters means he might be able to head home before he's 100% functional (as with 4 other people in the house they can likely work it out so that there's always at least 1 around). All relevant.
Shut up!! 🤣🤣😂 I'm literally in that year of med school and the memes of the living situation with patients have me like 🤡 but tbh semio is really important 😅
Thats the med students job 🤣🤣
the surgical presentation was 10 seconds too long
Agreed
Passing flatus and had a bowel movement? Ok advance diet. Surgically stable for discharge 🙂
I came here to say that.
Me presenting a patient: That's Johnes. He's sick.
Lmao
Lol same
you are ortho?
@@sidragulzar7081Sounds likely. Could be ophthalmology, dermatology, or psychiatry though.
Internal Medicine turned me into an overly analytical detail oriented talkative and reflects in even my style of conversing with anyone and even my text messages which are paragraphs long. 🤦🏾♂️
Nice to know I'm not alone!😂
Lmao same!
even your comments are paragraph long
It shows🤣🤣🤣
This is my personality. 😂 I thought I was a weirdo. But I haven’t yet studied medicine,I can’t imagine when I do.
Ah, the joy of being a med student and giving a med-type presentation on your first day in surgery.
Yea my surg attending would have interrupted me less than halfway through that
@@clarisaxpianistsame
😂
And between them no one is investigating his potential post op bleed - hypotension in a normally hypertensive pt with resistant anaemia.
Possibly the most accurate part 🤣
I agree
Thats what nurses are for. We are the ones who usually notice vital sign trends and differences from baseline.
And neither team wants to deal with it. They say "call the other doctor"
Well, the surgeon ordered a blood transfusion & the medical doc ordered all the lab work to check for another reason outside of surgery. They’ll try everything else & run every test they can think of before taking the patient back to surgery & cut him open again to look for a possible bleed. Not cuz they don’t want to surgery again but they don’t want to do an unnecessary surgery & put the patient under even more risk for complications.
I love how neither of their presentations were wrong.. just different ☺️☺️
Good god this may be your best yet 😂
DITTO!!
"Some kind of abdominal surgery earlier this week", I felt that one.
They gave Iv fluids to a patient on dialysis, as well as a whole unit of blood. Like, i'd assume it was a well thought our best of two bad options except they didn't even mention he was a dialysis patient!!
I mean considering his surgery he was most likely bowel rest so perhaps NPO or cl liquids at most. Patient probably had a fluid volume deficit. Patient was probably also anemic at baseline being a dialysis patient and if he were going to dialysis they could give him the blood there.
@@TheMCFARTPANTS we can do some fluid removal in dialysis and give epo, but we need to stabilize that low BP first, but did we try the leg raise trick, give their scheduled midodrine at 0600, and used an appropriate sized cuff to ensure the most accurate BP? also the bed wasn’t zeroed so Mr Jones’ wet weight is completely inaccurate. Don’t worry; I can always get Jones on the scale before a treatment ;)
@@ekekekekk doc stated that after the iv fluids were given the blood pressure stabilized. Pull off necessary fluid during dialysis with the administration of blood and perhaps erythropoietin.
@@ekekekekk possibly could have done blood cultures, but abx have already been started for fever
Yeah. It’s not a surgeon’s area. Usually they’d have a renal doc
This guy is just absolutely awesome. Quite right! Everyone stick to what they do best 😂🌶😂
thanks!
@@Doc_Schmidt I am a urologist🇬🇧. Absolutely tremendous material. Just goes to show how universal our practice is no matter where you work in the world. Please keep producing your incredible material. Always instantly relatable to every doctor. Joys, rewards, frustrations the works. Insuperable, ineffable, irrecusable. I am all out of superlatives. 🎉🍾🌶🤓🛍🥂💐🎊🎶👍🏾🤗😎😂
One main principle of medicine. Don't open can of worms you don't want to smell.
lol
As a surgical nurse, this feels spot on.
Nailed it. Especially with the medical consultant wearing glasses
So Doc, what you’re trying to tell me is you just fluid overloaded my dialysis patient that now nephrology is going to call me in to do emergent dialysis because he can’t breathe!
Respiratory will bring the bipap 🤗
lol
At 3 am with a leaky portable. Don't ask me how I know. Lol
Hello beautiful
And that’s why I like medicine so much better than surgery. We cover so much more and I like being super thorough.
"Yeah, English is my first language. Why? Did you need me to translate something?"
I love it when different depts argue for a couple of days on which scan is best, wait a couple days till they're in coma that they didn't even notice, then do a scan anyway, give results of scan that it's end stage cancer, not a 6 month chest infection that 5 lots of antibiotics didn't fix, and the patient dies in about an hour. But you can't sue for negligence because they were going to die anyway!!! Love it.
I like how they both cover the patients conditions, both doing what they know best, and well, and still miss that an anemic patient who is normally hypertensive is now hypotensive after a surgery and noone is addressing it...
let along he has ESRD
Isn't that what the IV fluids and blood transfusion is for?
@@AkaiAzul that only fixes the symptoms, it does not treat the underlying condition causing them. EG, an internal bleed.
@@ButtcheekOnaStick That is a good point. I suppose that's why they ordered lab work and rectal exam to confirm a GI bleed.
@@AkaiAzul lol they would've confirmed the GI bleed and chucked them back to surgery AGAIN after giving them more units if they were still even stable at that point.
I was working in ICU here in okc. I had a patient that I called the on-call for. It was a teaching hospital. I told the doctor pt needed Lasix. He said "ok give 20mg iv" I said "really?" He said "I don't know, I'm OB/Gyn, that's how much we normally give. How much do you think?" I said "like 80mg, this guy is drowning!" He goes, "give him what you think, I'll sign the order" ..... lol. He was scared to death!
Omg!!!!! This is awful.
20mg? That's practically a homeopathic dose.
Wait, how come a male patient needed an OB GYN? Lol!! But yes that’s as bad as when you have a confused/delirious agitated pt who is starting to swing and the doctor says to give them 6.25mg lo seroquel….ummm good luck getting that in them and it has legit no effect
Good team work.
Back in the days before hospitalists I was on call and got a call from the Ob/Gyn on call who said he had a 20 year old patient who had just had a septic miscarriage. Her pressure was 60/0 and her temperature was 102 and he was like, I gave her some fluids. Can you consult and help? I basically told him to call the ICU to get her transferred ASAP and I would call them from my car. She actually did great. We had her intubated on a couple of pressors and broad spectrum antibiotics for about 24 hours and then she bounced right back and was out of the ICU within 48 hours. (Just to note-I am a general internist, and not critical care but it was 3 AM and pulmonary/critical care wasn't going to be there before 7). Come to think of it, I had another patient call a couple of days ago saying she was pregnant and had Covid and she called her Ob/Gyn who told her to call me to deal with it. Pregnant patients are like post-op wounds. I try not to deal with them if possible.Every prescription comes with a message to ask their Ob if they can take it.
Finally, in my favorite moment from training, a past-cardiac cath patient went into atrial fibrillation. We called his cardiologist who had done the cath and he asked "Why are you calling me? You need to consult arrythmia. I am a coronary flow specialist!"
I understood all of this 😂 thanks IBS!
Unfortunately I understand most of what he said. My husband has been in ICU for over 2 months. I love watching his videos bc I need to find laughter during this crisis.
@@Cyblps I am truly sorry for all your Husband is going through, Yun💝~
Can only imagine how difficult a time this is for you, while supporting his recovery...Sending many PRAYers today from Arizona to you BOTH🙏🌠!!
Hello
I am just so impressed! Beyond words.
I need this guy as my caregiver. Would solve all the anxiety of going to appointments lol
Me, a first year med student: ah yes, sick person who recently had surgery and is being treated for... stuff
Can I just say like 3 years ago I would've had no idea what they were talking about but now I can keep up
A surgeon: knows nothing, can do everything.
A internal doctor: knows everything, can do nothing.
A orthopedist: knows nothing, can do nothing.
Man I run all those tests. Scarry how short staff we are so no one is getting their results in a timely manner
I like your funky words, magic man
You are speaking big words magic man.
The fact that I'm so chronically ill that I fully understood all the medical verbiage.😂
The “some kind of” THREW ME ALL THE WAY OFF!! Um…there is so much truth…thank you for revealing what is really behind this Medical System curtain. 😮🤭🤦🏾♀️
I Looooove thiiis hahahaha so relatable hahah and then, in my country as a family doctor, I get complete medical records after patient's check out from hospital, and have to take care of both those - surgical and internal medicine things
'A surgeons knowledge ends at the tip of his scalpel'
SOOOOO TRUE!!! Surgery notes 8 lines, Medical notes 4 pages
I totally understood all of those…..word things.
Oh my gosh this is so accurate
I’ve never felt more important than when in the MICU and there would be a team there every morning consulting on ME! 😊 and the pre-consult run through , but that only had like 2 people
This is why I love surgery ❤️
Omg this is so accurate! Lol
CHECKING FOR CORTISOL DEFICIENCY!👏🏼thank you from the adrenal insufficiency folks!
Cortisol deficiency , so glad to hear he will be checking the hormones. I have Cortisol deficiency and therefore I am on Cortisol dependent meds. Also, it is very dangerous to be Cortisol dependent.
This reminds me how much I don’t miss my hospital years. 😂
I continue to learn from your videos!! Thank you!!! Very informative, interesting and funny lol
LMAO then there’s the one nurse with a report that sounds like the first when I’m like, there’s nothing going on because the medicine team already nailed it.
I so recognize myself as the surgeon. That could so - word by word - have been my presentation...😂😂😂
Lab: Haha he’s getting R1R2 K+k+
As a former transcriptionist I was sobbing
I too have my moments where I’m a bit “hypothesize”
You're wonderful
No, we surgeons would mention his electrolytes, bowel sounds, NGT output. Also, our orders would be to ask IM to follow his blood sugar and nephro to ask how much fluids to give and whether we need to adjust any doses. Come on! We are not that stupid.
As a surgical nurse, I'd say it depends on how many years you've got under your belt. Some of the fresh residents running the show overnight....ehh...
@@starkeclipse ughh. As a premed hoping to become a surgeon someday, I hope I get down with good quality care earlier than those residents.
@@josephdahdouh2725 You've got this! Keep your ears open to what your nurses say. We often catch a lot of the errors that slip thru. 🙂
Bullseye!! Nailed it!!
The accuracy is kind of scary ☠️
I like your funny words medicine man
all in a day's work. so relatable 😁😁
Sooo True! You nailed it!
Love your videos! Can you find a colleague to post breast cancer post op scenarios? So difficult to find info.
I like your funny words magic man
Meanwhile the attending be like:
Why dont you send a consultant reference? Dont waste my time.
Wow!
This is perfect ! 🤣🔥
Greatness
Surgery: gave fluids and blood. So basically, we will boost up the numbers so we can transfer to Medicine.
Medicine: we will investigate and overthink everything, but won't touch the bandage because it's yucky.
Yup. Nailed it.
So Dr House really does exist.
True internationally
Good Job Doc! If these can be considered “art,” then this one is your best work. Without explaining yourself, we appreciate how you’re conveying multiple important messages to the viewer, but leaving it up to them to determine what that message is. Everyone can come away from this with different conclusions, but hopefully at least a few people get the main points - because seeing they do not see, and hearing they do not hear, nor do they understand.
Wait a second, a hormone workup? How do you come by this magical thing because all my doctors ever check is my gotdang TSH
As an IM resident, accurate
YEP I never understand any of what they say. So I’ve learned to just ask “ is my elderly father gonna live?? And what do I need to do when I take him home? 😜
When you have absolutely no idea of what’s being said in the video but you find it amusing anyways 😁
Ironically its opposite in my experience. IM handles everything. Surgery just focuses in intraop and postop wounds
My brain hurts.
Why was this my IM in Med-Peds residency exactly?!
Lol so relatable!
The accracy 🤣
He was a bit hypothesize 😂
So true
Have you ever heard a surgeon say anything other than, “Went great!”
Seriously? They say all is going as expected no matter what happens!
Ok, I actually lol'd. 😁
And this is exactly why I went into pediatrics. . .
lol
Yes ofcourse, i also speak medicine yes. I do understand much much. Diabetes, hypertension something something yes yes
👍👍
Reminds me of when I worked in open heart recovery. Smh
There would be all types Dr with specialties coming through writing orders….
Nope, nope, and nope.
Me: “Ya gotta run that by the surgeon.”
Other Dr: “Ok run it by the surgeon.”
Me: “No, I’m not going to explain nor defend your order.” “Call him, you got this, in the meantime I got 28 pages of standing orders, and yours is not one of them.”
And once the patient is transferred to the step down floor, then the other doctors can have their way with him (or her) or whatever they identify as.
Brilliant as always 😂
As the nurse I am 😂😂😳😳😂😂 because I am treating my patient’s symptoms
This is the best
All I understood was that you think the guy had a fungal infection and you are concerned about the surgical site
Infectious disease: Add swish and swallow Nystatin for Fungal coverage. One time dose of Zosyn and flagyl start scheduled Tylenol 650 q4 and CRRT for the fevers, confirm downtrending wbc on the next AM labs and discontinue all antibiotics.... sign off like a stewardship boss. 72 hours later with an elevated lactate, On the reconsult. Surgical and medical team should establish source control, consider exploratory washout 😂 then and start amoxicillin.
As a RMA in ID I need to hear the consult to ID 😂😂😂😂😂
I like your big words funny man
And they say we shouldn’t work in silos?
You forgot to mention that you ordered IS and Q4 duonebs because obviously "the fever is due to post-op atelectasis"...
Cortisol deficiency had me loling
Yeah. Keep him alive no matter how much pain he has to endure. Capitalize on his fear of death. Tap that insurance to the hilt.
10/10 LOL
Rectal Exam nothing I caught required that
Absolutely accurate hahahaha
This is so so true :D
What are you 😵💫😂😐 talking about? 🤯 Breath!🤣🤣🤣🤣
*Lab enters the chat* ummm a BMP and CBC might be fine because of the recent transfusion…butwhatdoiknowimjustreportingresults okay bye and the A1C might be a send out but I’ll get back to you on that 👀
👍