I’ve never seen an EMR that runs on Linux and if I did I’d have to find an employer willing to run it.

Most psych nurses will tell you we love our patients for the most part (we get worried when the little old dual schiz / dementia homeless ladies with no teeth stop threatening to murder us) but admin + families are hell.

Got stuck as the charge nurse of acute psych almost every single night I worked for over a year. “But no one else can handle it like you” (I’m aware–acute is what I do) but I needed a fucking break. I told them 1/3 days I wanted to either be a floor nurse on med-psych or be the BERRT / consult nurse to the medsurg nurses for behavioral codes. They humored me one day a month for like three months then shoved my head right back under.

Then the supervisor came in to critique my morning reports twice in one week and honestly I didn’t even snap I literally just said “OK understood can I finish report now” so she tried to corner me in a side room but I haven’t survived ten years in acute psych without major injury by not being able to clock aggressive body language so I just walked right back into the nurses station to let everybody see her yell at me then handed her my badge and keys and left. Had a new job lined up within the week.

Current boss started out with the same sort of compliments like “oh you’re so calm when people are threatening to murder you” etc like yeah, as I said, this is what I do, and once I was settled in, everybody got used to asking me for advice on the EMR, meds, they got me teaching the violence deescalation classes the supervisor was tired of, made myself indispensable etc, I straight up told her I’ll do all of this, you can even enjoy my fun side projects I get up to when I’m bored–but if you make me charge nurse or let the house supers get shitty with me I’m out as soon as my contract is up.

So far she hasn’t pushed it.

That much melatonin will give you weird sweat nightmares. I just mention this because a lot of people think more mg = more sleep but at 10+ mg melatonin does real weird shit to your REM cycle. Most evidence shows that the optimal dose is often less than 1 mg. Just in case you’re curious.

Completely unrelated but “beep boop!” is what I say to patients (along with appropriate gestures) to request that they show me their wristband so that I can scan it to verify dosage etc. when administering medications.

As an aside, some garments (especially fancy ones) have pockets that are sewn shut so that they stay flat in transport and lay perfectly on a mannequin, but with thin thread and loose stitches so that it’s easy to pull them out with just a few quick snips. Same with the back vent on long coats. It would be difficult to pack and transport them neatly and non destructively (with flappy bits all over the pace and pockets that could get stuck on machinery) but the stitches are weak and meant to be removed by the end consumer just the same as the tags are meant to be removed. Although I did have a coworker who wore fancy sneakers with the tag still on which was an absolutely mystifying thing to see on multiple levels at a healthcare job, but apparently that’s some kind of sneaker culture thing (and while they were a lovely person they did eventually decide that healthcare was not their jam).

Most offenders I’ve interacted with have no specific attraction to children at all. They want to rape someone and children just happen to make ideal victims by being smaller and weaker and depending on age and upbringing may not even realize a crime had occurred or be able to advocate for themselves. Most of the offenders would have / often had also raped the elderly or disabled if given the chance. They would even attempt to prey on the smaller or weaker staff members or other patients if given the opportunity.

There were a few edge cases of profoundly psychotic / ID patients who genuinely just didn’t know any better but again it was rarely a specific attraction and more of an overall disinhibition, they would generally also have trespassing, petty theft, and property damage charges and were showing their genitals to just about anyone. Violent and sexual intrusive thoughts can be a part of some OCD presentations but the thoughts usually go away when the underlying anxiety is treated with medication and behavioral therapy. Pts with violent and sexual intrusive thoughts also pretty much never offend, to the extent that I never really interacted with that population until after leaving forensics. They’re a super high suicide risk though due to not understanding the actual psychological mechanism of the thoughts (self-reinforcing through anxiety, not attraction).

I’m not saying attraction to children doesn’t exist, but when we’re taking about the actual issue of child sexual assault it’s just an unproductive line of discussion that relates very little to the actual core issues. The “can’t help being attracted” is mostly pop-psychology TV shows use to tell a more emotionally charged story.

Now that said, we do have a huge issue as a society with allowing the high of righteous fury to interfere with victims actually receiving justice. Those accused have just as much of a right to due process as anyone accused of any other crime. Interfering with that right either creates massive overreach by the legal system or in individual cases damages evidence that would be used to fairly prosecute an offender. It also creates a social environment where people protect their offending loved ones out of fear for them, when they should feel secure in the knowledge that while they will probably always love the offender, they can and will be safely separated from the rest of society (or at least be forced to live under monitoring and away from possible victims) for the rest of their natural life.

I happen to find working with patients at high risk of violent behaviors to be fulfilling. That said I think if people were less worried about what immediate benefit my patients have to society (as opposed to the fact that any of those people in the community could slip in the shower and get a TBI and become a very unpleasant person in under a month and would want someone to care for them too) I would probably be allocated more resources to do my job a lot more safely.

I mean it’s a shitty take and really doesn’t evidence good understanding of the topic (I used to work forensic psych and have met a LOT of pedophiles) but as far as shitty internet takes go it’s meh at most and wild to me that you went to the effort to dig that out from two weeks ago for this discussion.

And make sure the strike plate is set into a hardwood frame with 3" screws.

I read “premium premium” which is both spiritually similar and also just fucking hilarious.

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I picked cachy because I was always curious about Arch and I’m LoveHating every second of it.

Or physical therapy. I’ve never seen either of the major clotting labs abbreviated “PT.” You typically say PTT for prothrombin time or INR for the PT-INR.

Easier to write. We spend 5 minutes talking about you at handoff (and I need to write down everything AS the other person is talking) then I have to write a mini essay about each person by morning. Abbreviations are highly specific to specialty (ROM = “range of motion” in most specialties but “rupture of membranes” in obstetrics), but much easier than writing things out. An example from my specialty might be:

SI / attempt r/o. BIBA GSW LA + lig marks neck (suspect DV but pt denies). WC placed, CT (-). Hx DM2 diet managed.

Which is to say

Ruling out a suicide attempt. The ambulance brought them to the ED for a gunshot wound to the left arm and strangulation marks on the neck. We’re pretty sure the spouse did it but the patient is refusing to talk about how it happened. The wound consult is in and they did a CT of their neck already, no severe injury noted. History of diabetes, but it’s type 2 and managed by diet (as opposed to insulin).

…which is like 3 times as long.

I honestly think children should be working as young as 12 even if they’re up to it but it should be like. A couple hours a week maximum with OSHA standing behind their employer with a baseball bat with nails in it. Honestly my trades class in highschool was one of the few good things for me psychologically.

…now guess what it means if a patient is S.O.B.

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Epigenetics does play a role in a way medications are starting to be able to address (basically there’s extra little hormones and stuff your DNA makes when recent generations have been stressed, so if the great depression hit your great grandma particularly hard your genes might still think you need to hang onto some extra fluff just in case). But yeah a lot of it is social stuff that just isn’t going anywhere like McDonald’s being the only place you can get calories at after job #1 and still be on time for job #2.

Jupiter Ascending should have been a trilogy. It’s garbage but in that beautiful way that overdramatic high sci-fi fantasy that thinks it has some deep societal moral to impart is, and I just really loved having just one with a female protagonist and her himbo love interest.