Dan Furmedge @danfurmedge Twitter profile

Last Seen Profiles

@PiperVerre72507

@Tonyl16I

@jay10richardson

@bioBarber

@CharityShopGC

@MercedesBenzMx

@ArmandoFri92046

@BSCS_Global

@_abbyboyer_

@UUMigration

@SuvantoJussi

@203mmH

@galery_basah10

@GunnarMathis

@CanaryThom29766

@KTsukaru

@shotbychandler

@john64808893901

@AilisTea55647

@KaLeeVision

@AKoulovatos

@OgbonnaPre96549

@ZhangHaoBar0725

@RickJen02009803

@BezosCrypto

@Ukraine

@JohnDoty24

@aidenneo

@IYIHABER34

@TheFireTracker2

@psychtapes

@gg2dylan

@Demmy54129596

@_nick_gray_

@stw_pdg

@LisaReyes852651

Dan Furmedge

@danfurmedge

3 years

Yay. My ward is a COVID ward again. 😑

235

981

3K

Dan Furmedge

@danfurmedge

4 years

Things I don’t want to change after COVID: - the lifts are working efficiently - great team spirit and enthusiasm - whole of medicine comes together daily - get to meet to and chat with lots of consultants in other specialties - lots of red tape gone to get shit done

27

150

1K

Dan Furmedge

@danfurmedge

2 years

This weekend the St Thomas’ medical consultants on call are me, and one of my best friends that I met on the first day of university in halls. We still can’t quite fathom how it happened or who let it. 😂

9

5

855

Dan Furmedge

@danfurmedge

5 years

So we have a lady who was NBM for ages, now after a long time and lots of work from the SLT team she can have a normal diet and fluids. She says she has never had champagne. Guess what we are having on the ward round tomorrow? 🍾🥂

18

65

795

Dan Furmedge

@danfurmedge

7 years

Great to see @GrangerKate 's legacy living on in the brand new 10th edition of the Oxford Handbook of Clinical Medicine. @PointonChris

3

257

731

Dan Furmedge

@danfurmedge

10 months

Here we go, night 5/5 covering #JuniorDoctorsStrike Definitely don’t want to be here again in a month Forgot how antisocial nights can be - luckily with a great bunch of consulrant colleagues in medicine and ED Please sort it out @SteveBarclay @RishiSunak

24

92

712

Dan Furmedge

@danfurmedge

5 years

My kind and gentle Grandad has just died, at home, symptom free, with family thanks to frank discussions, an advance care plan and a great community nursing team. Has given me personal experience of how important is. Particular thanks @HurdJo for your support to my grandparents.

54

74

681

Dan Furmedge

@danfurmedge

4 years

Really wish I was one of those old school consultants with a massive house and garden who has everyone round for a summer BBQ/party. Would love to do once this is all over. Sadly my 1 bed flat probably ain’t gonna cut it... Will keep playing the lottery 🤞🏻

46

10

656

Dan Furmedge

@danfurmedge

10 months

The 1st nights were novelty. Now starting 1 of 5 night shifts to support doctors industrial action. Not looking forward. I’ll say it again, if this keeps happening, will be a lot more expensive than just agreeing a sensible pay rise. @SteveBarclay @RishiSunak

12

96

549

Dan Furmedge

@danfurmedge

4 years

Today I watched 10 doctors try to have a DNACPR discussion in the context of discussing a deteriorating patient. Even those most skilled in communication made the task so much more difficult that it needed to be. @DrLindaDykes we need to sort this out ⬇️

42

148

464

Dan Furmedge

@danfurmedge

4 years

😣 Fever, sore throat. Looks like it’s got me guys. Feel well atm. Main thing am gutted I can’t help the team at work with the mega stuff they have to get in place this week, in including acute take, doctor redeployment, care home planning. Good luck team see you in a week!

83

8

459

Dan Furmedge

@danfurmedge

8 years

@Jeremy_Hunt You are a lying, spinning, horror of a health secretary. You don't realise whole country is behind us. They won't forget.

18

158

413

Dan Furmedge

@danfurmedge

4 years

Been told in our trust that we may need to cover large numbers of locums as COVID19 takes off. But if i do this i will end up paying more than i earn in pension tax. @MattHancock this may be a national emergency, please suspend tax rules immediately so i and colleagues can help

16

127

428

Dan Furmedge

@danfurmedge

10 months

Just totting up how much it will cost just general medicine to cover the junior doctor strikes next month at our hospital alone. Honestly @SteveBarclay just put a sensible offer on the table. It’ll probably be a lot cheaper in the long run.

13

57

399

Dan Furmedge

@danfurmedge

3 years

If the Nightingale in London is to be reopened at all as a step down/rehab/medically stable bed base I sincerely hope that this time round they get a geriatrician in.

12

15

376

Dan Furmedge

@danfurmedge

4 years

Judging by the medical take this weekend, we are returning to usual - have seen core presentations in geriatrics, cardiology, respiratory, haematology, gastroenterology, neurology, stroke, toxicology (+++), nephrology, oncology... And just a couple of ?COVID

9

34

373

Dan Furmedge

@danfurmedge

3 years

Here he is, Bill “the bed” Addison says hello to you all and says he is too old for social media but looked sort of pleased to have been mentioned! Massive @GSTTnhs hero for many years for anyone who has worked at St Thomas! @mancunianmedic @TYoungstein @b_modarai @Pinkywyatt1

20

16

372

Dan Furmedge

@danfurmedge

2 years

About to do a year 2 MBBS lecture. There are 500 students in a year. Looks like <30 have shown up in the preceding lecture. I know it’s all adult learning and can watch online. But seriously? I’m not going to bother next year if you can’t be bothered to come.

85

17

370

Dan Furmedge

@danfurmedge

2 years

Friend has text me with a knee swelling. Obviously a simple bursitis. 111 asked him to attend ED. No wonder ED is fucked. Honestly.

31

11

359

Dan Furmedge

@danfurmedge

17 days

Seen in the notes: 2/7 SOB O/e crackles, widespread wheeze Plan D-dimer ?CTPA Salbutamol neb We are losing the plot. Clinical thinking, problem solving, interpreting history and signs. Need to sort out how we train people to think in medicine.

54

23

350

Dan Furmedge

@danfurmedge

4 years

Absolutely outrageous and frankly disgusting. I will be writing to Chair of NMC again. THIS is how nurses will be scared into doing the wrong thing. Because they fear for their registration. Appalling.

Nursing Standard

@NurseStandard

4 years

Latest from our legal expert on CPR: nurses must start resuscitation if there's no DNAR notice, despite what best practice guidance says. Read his professional view on recent NMC case

73

80

75

28

94

343

Dan Furmedge

@danfurmedge

4 years

Consultants, once again, encourage encourage encourage everyone to use your first name. It’s no longer 1951.

RCP London Trainees

@RCPL_trainees

4 years

31% of medical trainees address consultants by first names despite 76% believing those they addressed by first names were more approachable. Do you think this impacts likelihood of raising concerns, staff wellbeing, recruitment and staff satisfaction?

9

13

59

65

41

312

Dan Furmedge

@danfurmedge

8 years

@SarahMillican75 working. Because unlike Jeremy H would have you believe, we all work weekends!

12

166

299

Dan Furmedge

@danfurmedge

4 years

Last night, paying for some drinks with my NatWest debit card from what is still technically a NatWest student account. Spotted one of the new F1s buying theirs with a gold American Express card. Wondering where did my life go so wrong? 😂😂

17

5

296

Dan Furmedge

@danfurmedge

5 years

Pulse of 110 and temperature of over 38. However in the context of severe coryzal symptoms and generalized malaise, my own clinical judgment tells me I do not need IV antibiotics, a lactate or a catheter. #notalwayssepsis #useclinicaljudgement

29

41

299

Dan Furmedge

@danfurmedge

1 year

Medical consultants right now falling into 2 categories 😎 Med Reg vibes reactivated 🫣 Checks booked AL on strike dates

10

6

286

Dan Furmedge

@danfurmedge

4 months

UK citizen born here, until A-levels. Moved to Oz for uni MBBS. Worked in Oz 3y as dr. Completed FY1/2 equiv. Had to return to UK pers reasons. @Sydney_Uni MBBS NOT RECOGNISED Can’t work Has to do PLAB 6 months part 1 wait Now 6m part 2 wait 12 months. WTAF @gmcuk WTAF

34

30

287

Dan Furmedge

@danfurmedge

2 years

Omicron can be renamed the silver wave. Little respiratory illness but lots and lots of frail older folk with falls, delirium, functional decline needing geriatricians, PT/OT/SS and care home beds and we have nowhere near enough. Really exacerbates a long standing problem.

6

81

280

Dan Furmedge

@danfurmedge

9 months

Have worked >80 hours this week due to normal on call and strike cover. V lucky to be on with this bunch of awesome medical consultant colleagues covering acute/general/geriatric med @GSTTnhs and providing support to ED. We’ve managed to find half an hour to grab lunch together!

15

13

282

Dan Furmedge

@danfurmedge

5 years

Again on take today, 3 patients with advanced cancer. None had ever been given a prognosis or a chance to discuss TEP/resus status or prognosis. All had thought deeply about it and knew exactly what they wanted but hadn’t been given the chance to say. FFS #havetheconversation

19

72

270

Dan Furmedge

@danfurmedge

3 years

Don’t delete the on site gym and squash courts etc. and pretend the NHS is bothered about well-being Don’t cripple us with pensions tax Don’t continue the real terms pay cuts Don’t fuck up recruitment for junior doctors to specialty training …

Shaun Lintern

@ShaunLintern

3 years

Minister ‘not sure what more we can do’ for NHS staff as MP's described burnout ‘emergency’

93

108

165

5

38

259

Dan Furmedge

@danfurmedge

6 years

I once phone the GOLD director on call at night as SpR due to an extremely unsafe environment. They refused to talk to me and asked the general manager on call to speak to me. I was told “this is just how it is round here”. #IamHadiza #bawagarba

21

174

252

Dan Furmedge

@danfurmedge

6 years

When we do our mortality review in geriatric medicine, by far the most common question is: Did we do too much for too long/should we have considered palliative/end of life care earlier? Yes this seems so hard for so many doctors.

20

90

253

Dan Furmedge

@danfurmedge

6 years

Today I completed “fast track” paperwork for a patient to move to a nursing home who is rapidly approaching end of life. Documents submitted by email to CCG. Message back. We are unable to accept these-need written signature then rescan and send back. Give me fucking strength.

37

68

245

Dan Furmedge

@danfurmedge

5 years

Just voted in favour of a move to support assisted dying. It would need extremely robust safeguards. But I believe that in some circumstances, people should be allowed to choose when they die. Palliative care can be amazing cannot solve the deep issues for everyone.

17

24

216

Dan Furmedge

@danfurmedge

1 year

I am 5 years in. If I have this similar bill my savings will be wiped (and more) and I will leave for Australia where I have been offered a job for 3x my current salary with much better working conditions.

Emma Stapleton

@otolaryngolofox

1 year

I’ve been an NHS Consultant Surgeon for less than 5yrs. Today I settled a £28k tax bill on my theoretical future pension. I’m 23 years from retirement but already planning an earlier exit. Thanks @gdcuk @jack_needham for expert advice, and @goldstone_tony for leading the way.

68

250

1K

10

46

213

Dan Furmedge

@danfurmedge

2 years

Can anyone explain why the London weighting for doctors remains about £5-7k lower than other NHS professionals and hasn’t changed since its introduction in the early 2000s?

20

17

205

Dan Furmedge

@danfurmedge

6 years

Very satisfying weekend in the Acute Older Persons Unit this weekend: 19 patients seen 15 home, many w community services 2 admitted 2 aiming for discharge tomorrow Services used: H @home team Rapid response RH carers Families Rapid geriatric HOT clinics Old age psych ☺️

13

43

202

Dan Furmedge

@danfurmedge

2 years

Just added up everything I do at work currently and it adds up to 17 PAs 😱 for which I get paid 12 and that doesn’t include all the PACES and RCP committees and other extra bits. Time to drop some stuff and get a life 😂

13

0

202

Dan Furmedge

@danfurmedge

3 years

Made it...

20

1

201

Dan Furmedge

@danfurmedge

9 months

Something that upsets me most is relentlessly pursuing tissue diagnosis and delaying decision making in b frail new cancer pts, giving hope to families, whilst patient doing downhill when clear they will never be suitable for treatment. Geriatricians we need to step up here.

18

17

192

Dan Furmedge

@danfurmedge

6 years

A lady undergoing non-curative Rx for metastatic cancer. A man with advanced cardiorenal disease. A nonogenerian with multiple comorbdities. None with #DNACPR discussions despite many opportunities. All were happy to discuss and plan on PTWR tonight. #havetheconversation

7

51

190

Dan Furmedge

@danfurmedge

4 years

@RowansHospice @RobertIger we hear you are the only one who can make this happen. Someone dying, won’t make release on 20th Dec. Wants to see the new Star Wars before he dies... can you help?

2

17

186

Dan Furmedge

@danfurmedge

4 years

Just a reminder that a high CRP does not always need admission. Young people tolerate infection well, are usually sensible, will take abx and will come back. Can share any risk with them. Have sent a 40F home before with a CRP 544. She got better with oral abx.

26

32

185

Dan Furmedge

@danfurmedge

7 years

Hi . @Jeremy_Hunt we have no beds, 20 patients in ED waiting for beds and more coming and it's the same in every hospital in UK...

28

336

180

Dan Furmedge

@danfurmedge

6 years

We are not teaching Medical SpRs to be take consultant. They are too busy on calls, coordinating and clerking. Then suddenly as Consultant, have to review all the patients on the take. Completely different skill. Senior Medical SpRs need to do the PTWR themselves. Before CCT.

18

33

175

Dan Furmedge

@danfurmedge

3 years

I have seen a lot of COVID in the last 10 months, but when someone you know dies at 55 from it after a very rapid illness it suddenly seems all the more real and the worry for other family members increases. Thank you to @QAHospitalNews @icu_portsmouth for looking after her.

28

11

175

Dan Furmedge

@danfurmedge

2 years

1 Delirium secondary to UTI 2 Asymptomatic covid-19 +ve Obviously the evidence for UTI was 1+ leukocyte on a urine dip and no other symptoms 🤦🏼‍♂️😑😭🙉🤡🤬

15

6

177

Dan Furmedge

@danfurmedge

5 years

Some thoughts after a week on AMU and recent examining PACES. If we focused on proper teaching (inc. consultants) in following areas we could avoid a lot of unnecessary tests and admissions: 1. Syncope 2. Troponin 3. Acute headache 4. Accepting and managing risk 5. TIA

17

23

171

Dan Furmedge

@danfurmedge

5 years

And thank you again to his carers, who have just turned up having heard he has died, and cried and consoled my grandmother, then offered to clean him. 🙏🏻

Dan Furmedge

@danfurmedge

5 years

My kind and gentle Grandad has just died, at home, symptom free, with family thanks to frank discussions, an advance care plan and a great community nursing team. Has given me personal experience of how important is. Particular thanks @HurdJo for your support to my grandparents.

54

74

681

9

16

171

Dan Furmedge

@danfurmedge

4 years

To all my consultant colleagues who are doing ward and have a new team since August: Have you taken your new team for coffee yet? If not why not? Have you done a reverse ward round yet? INWN? Have you proactively done a CBD/ACAT/MiniCEX yes? INWN?

15

170

Dan Furmedge

@danfurmedge

7 years

My letter to . @damejanetfinch Chair of . @nmcnews about the caution given to nurse who did not do CPR on a clearly dead frail nursing home pt

25

92

163

Dan Furmedge

@danfurmedge

7 years

How I record my reflections in my eportfolio ever since that awful legal case where a reflection was used against a trainee.

14

69

165

Dan Furmedge

@danfurmedge

6 years

Brother texts at 1400 to say he thinks my stepdad is having a heart attack. Less than 3 hours later he is sat on CCU, 2 stents in place and cracking a joke cos he feels much better. Great work and thanks to @SCAS999 and @QAHospitalNews . cc @MCubbonNHS

4

22

156

Dan Furmedge

@danfurmedge

2 years

Stop filling in then sending me your own SLEs 😩 “Good presentation” “Remember to do x” I’m supposed to write the feedback not you. Is it that bad that we expect trainees to fill their own feedback cos they know consultants won’t do it? If it is then the system isnt working.

48

6

163

Dan Furmedge

@danfurmedge

3 years

Yesterday - inpatient covid ward Today - hospital at home (lots of covid) Tomorrow and Sunday - acute medical take (lots more covid...) Life of a geriatrician Happy New Year!

11

3

154

Dan Furmedge

@danfurmedge

3 years

Well this has maybe backfired! Looks like am going to have to be night medical reg 24/25/26 😂

Dan Furmedge

@danfurmedge

3 years

Hoping that I will be “needed” at work at some point as 5 festive days alone in my flat now I can’t go home which includes Christmas, my birthday and New Years doesn’t sound that fun! 😂😭

20

0

115

20

3

154

Dan Furmedge

@danfurmedge

4 years

Fully supportive of the thought to increase and honour medical school places BUT there would need to be a commitment to providing additional Foundation Programme (and beyond) posts for these doctors in 5-6 years time. @MattHancock

6

16

150

Dan Furmedge

@danfurmedge

1 year

@timricketts_ That frail older people usually can’t come back to bloody outpatients. Just see them as an inpatient and let’s make a sensible plan which avoids them waiting for transport for hours and being stretchered into hospital having just been discharged from a long stay a few weeks ago!

0

3

148

Dan Furmedge

@danfurmedge

5 years

For anyone who hasnt done one a reverse ward round is great - junior doctor gets to run the show with feedback - consultant gets chance to a) write notes how they like it and b) review other stuff and think at the same tine Obviously need to pick your times but highly recommend

Jac Totterdell

@TotterdellJac

5 years

One of my meetings yesterday was with Navindi who is a final yr med student @StGeorgesUni . We talked a lot about leadership but what she also described was ‘Reverse Ward Rounds’ - taken by the FY1 and scribed by the Consultant. A bit more to it than that - but any one up for it?

3

8

73

11

27

138

Dan Furmedge

@danfurmedge

3 years

Virtual lecturing is SO soul destroying 😩

16

3

134

Dan Furmedge

@danfurmedge

3 years

Wow. Of those ventilated for covid-19 just 13% 71-80 and 6% 80+ survived. Remember these are those selected as candidates for ventilation. And if you arrest with covid 0-1% survival at any age, slightly higher if young and arrest on an ICU. Remember to #havetheconversation

6

61

134

Dan Furmedge

@danfurmedge

4 years

Sorry but I’m afraid I just have to share how cute my 6 month old niece is 1/2 😍

11

1

132

Dan Furmedge

@danfurmedge

7 years

. @Jeremy_Hunt came to my hospital today and had to be hidden and flanked by multiple police. If thats what he needs as the boss says it all.

11

135

130

Dan Furmedge

@danfurmedge

3 years

Well. I’ve seen 50 patients on the medical take today from 0800-2030. Was working with an amazingly efficient clerking and acute medicine unit team. Now my brain has slowed to a dawdle I am going to sleep. 😂😴

5

1

131

Dan Furmedge

@danfurmedge

6 years

To the orthopaedic SpR who just asked my team “why are we even bothering” to as you about management of our 81 year old’s wrist bone fracture. I don’t quite know what to say. Apart from have you seen Mary Berry?

11

21

125

Dan Furmedge

@danfurmedge

4 years

1. If a patient is likely to die say it. They are probably going to die. Stop using eupehmisms because tou think that you are being gentle or kind. Youre not. Patient/NOk doesnt know what you mean by very poor prognosis. Be honest. Even if there is a 20% chance of death, say it.

3

14

125

Dan Furmedge

@danfurmedge

1 year

Despite the psychological doom I now remember at the start of 4 night shifts, I head in to the first tonight, thinking I will do this time and time again if needed. Nobody starting medicine 10-15 years ago could have predicted the stall in pay this government has created.

3

118

Dan Furmedge

@danfurmedge

2 years

Current world heros are #anonymous taking down Russian government websites and playing Ukrainian music and war scenes on all national Russian TV challenge to counter the propaganda there and much more. Outstanding. 🇺🇦

0

28

116

Dan Furmedge

@danfurmedge

1 year

So anyone want to form a group to retrospectively review GMC MPTS outcomes in the last year? Would be interesting to review and publish outcomes compared to what jobbing doctors think is right. And perhaps could do a patient arm too to see what they think. What a mess.

22

9

116

Dan Furmedge

@danfurmedge

3 years

This is a true CFS of 1 in a 90 year old @drvabennett

DW News

@dwnews

3 years

Japan's oldest fitness trainer is a woman in her 90s and she has no intention of stopping before she turns 100 🏋️‍♀‍ via @dw_arabic

25

238

855

6

18

116

Dan Furmedge

@danfurmedge

4 years

Currently acutely suicidal at the #exitpoll - any medical recruiters from australia or canada or new zealand feel free to get in touch #RIPUK

19

112

Dan Furmedge

@danfurmedge

7 years

Did a ward round today. 8 patients 'for CPR'. When asked, 7 did not agree with CPR. 4 vehemently so. Doctors must stop assuming.

13

74

113

Dan Furmedge

@danfurmedge

3 years

Hoping that I will be “needed” at work at some point as 5 festive days alone in my flat now I can’t go home which includes Christmas, my birthday and New Years doesn’t sound that fun! 😂😭

20

0

115

Dan Furmedge

@danfurmedge

3 years

Love that we are being annexed by the world - the strain has been going round since September, you’ve all got it, you just haven’t spotted it yet. Except Australia and Denmark cos they are also excellent gene sequencers.

5

12

113

Dan Furmedge

@danfurmedge

4 years

Off to bed. Feel fine. Mild fever only real symptom so this could be any old viral lurgy. Wish I could test. Thanks all for well wishes and offers of help! Feel like fraud as feel OK! Lots of good chat and sharing resources with other community docs today today. Good luck all.

19

2

109

Dan Furmedge

@danfurmedge

6 years

Pneumonia is often a last illness in frail older patients. Recognise this, be explicit with juniors/patients/NOK about risk of deterioration/death, set expectations and if patients do well, think about further discussions about the future. #BGSconf

4

40

108

Dan Furmedge

@danfurmedge

5 years

Sad when the F2 you are on take with tells you that this was the first time anyone had ever observed her interacting with a patient as a doctor and given feedback. Why are we still not getting this right?

11

15

111

Dan Furmedge

@danfurmedge

6 years

Getting pretty fucked off with the system trapping people in hospital. Feel so helpless to move them on. Particularly those with behavioural issues, so much worse in hospital who apparently fall in that limbo land between mental health, medicine, and social care services.

6

15

111

Dan Furmedge

@danfurmedge

5 years

What a difference 10 years makes... 10 years ago as FY1 living at Guys Hospital vs. Now

9

0

108

Dan Furmedge

@danfurmedge

6 months

We just got EPIC. Promised an intuitive amazing system. We will get there and it will be OK but absolutely not impressed. Awful clunky non intuitive system not designed for NHS that someone is making a lot of money from. Very disappointed.

Dr. Glaucomflecken

@DGlaucomflecken

6 months

“Dad, what was it like before EPIC when you wrote all your notes on a piece of paper?”

83

113

2K

50

11

107

Dan Furmedge

@danfurmedge

4 years

So those in favour of first names of consultants for the rest of the health team esp junior doctors: - almost all junior doctors - allied health professionals - many consultants Those against or who feel their ego requires being called doctor - a few consultants 🤷🏻‍♂️🔥

27

6

108

Dan Furmedge

@danfurmedge

3 years

We need 1. Many more therapists to actually rehab people in hospital 2. Social work working inside health sector, not as separate system 3. A needs first, work out who pays later model to avoid delays about “funding” 4. Much better intermediate care and hospital at home services

Dr Linda Dykes @[email protected]

@DrLindaDykes

3 years

This is a bloody stupid idea. In fact it is beyond stupidity. It is verging on insanity. Is it really beyond the wit of man to grasp the need to unblock flow right through the system? Expanding ED without a magic staff tree will result in dead patients.

97

355

1K

7

11

107

Dan Furmedge

@danfurmedge

6 years

Hospitals are rarely a place where people come in, stay a while, are treated and come out cured. More people are living with increasing complex comorbidity and we have to address expectations early that they probably won’t be the same when they get discharged. #bgsconf

1

57

104

Dan Furmedge

@danfurmedge

2 years

“UTI” of the week Woman seen - TEXTBOOK history of polymyalgia rheumatica Because of fever, ⬆️ CRP and + urine dip she was seen and discharged with abx for UTI. Represents 5 days later. We gave steroids and 5 days later much improved. Give this geriatrician strength. 💀

17

9

105

Dan Furmedge

@danfurmedge

5 years

Am now a fully signed up @MRCPUK PACES examiner which is nice but my God we need some more women to examine. If you are a female consultant physician and want more info or check the website or let me know.

19

44

104

Dan Furmedge

@danfurmedge

4 years

These discussions are completely easy in 9/10 cases if you approach it right. Everyone makes it so hard for themselves and it just doesnt need to be.

11

7

101

Dan Furmedge

@danfurmedge

5 years

So my grandad has had a rapidly progressive deterioration over the last 6 months going from no care, to a double handed four times a day package with fast track, now in his last days. They often get such a back rep but I just want to talk about his carers. ⬇️

14

21

101

Dan Furmedge

@danfurmedge

2 months

I could not agree with this more - and hospitals need to stop referring frail immobile people to an outpatient memory clinic for assessment. Which they physically can’t get to or remember. If it’s really unclear then consider a community memory assessment at home.

Sean Ninan

@sean9n

2 months

geriatricians should diagnose straightforward cases of dementia when everything is clear, even when seeing people as an acute admission. story in @GeriSoc

12

35

131

8

22

102

Dan Furmedge

@danfurmedge

3 years

Family friend w met prostate cancer, PSA >150. Pain+weight loss. Oncology: no need to involve palliative care yet, we are not there yet. 🤯🤯🤯 Metastatic cancer or noncurative approach -TELL the patient they won’t be cured and involve pall care early. Please. Good evidence.

8

5

98

Dan Furmedge

@danfurmedge

3 years

On call in AMU last 2 evenings: 1. Real medicine is back huge breadth of pathology 2. Complexity of patients absolutely sky high need for specialist involvement, much delving into old notes and engaging brain 3. It’s busy again but not with Covid Great fun #medicineisbrilliant

5

3

96

Dan Furmedge

@danfurmedge

5 years

They get paid £9/hr, don’t get paid for travel or between visits. But still they have the thought and care to do this for my Grandma. Why do we treat carers this way? It’s abhorrent. We need to change this. But meanwhile thank you so much, particularly to Linda, Chris and Ali 🙏🏻

3

11

95

Dan Furmedge

@danfurmedge

4 years

So, it turns out a wide range of views on letting health professionals, esp junior doctors call consultants by their first names. Have had some interesting replies, some raising interesting points. But WTF you lot? Doctors ARE NOT special. ⬇️

19

7

94

Dan Furmedge

@danfurmedge

6 years

Specialties When geris team ask specifically for an inpatient review, even if it doesn’t seem urgent or needed as an inpatient, please humour us and come. Many of our patients are too frail/a huge challenge for them to come to outpts and your review is appreciated. Thank you!

4

18

92

Dan Furmedge

@danfurmedge

6 years

Junior doctors please stop giving patients. ‘STAT’ doses of amlodipine in asymptomatic hypertension ~180. Just not needed. Reassure and educate nursing colleagues who are concerned about why. Also remember mirabegron which you will see more often can cause... hypertension.

22

39

91

Dan Furmedge

@danfurmedge

6 years

Crash teams please have the confidence to stop CPR early where it is clearly futile. You do not need to continue just because you’ve been called or until the gas comes back.

Dr Gordon Caldwell

@doctorcaldwell

6 years

I can fully support this paragraph in Advanced Life Support from ⁦ @ResusCouncilUK ⁩ ⁦ @katemasters67 ⁩

10

110

192

10

33

90

Dan Furmedge

@danfurmedge

2 years

First proper feedback from our IMT3s today - all loving being Med/ward Reg, all are getting bespoke Reg level experience in specialty ward, clinic, referrals, time for own development. Balint style teaching going well. So relieved. Watching them develop and so confident is 👊🏻👌🏻

6

2

90

Dan Furmedge

@danfurmedge

10 months

I love my care home work. We have a fab team-geriatrician, GP and nurse,p’cist, almost all of our residents now stay within the care home for their care. We’ve massively reduced admissions, outpatient appointments and the amazing nursing team do most ACP discussions. The future.

Martin Vernon

@runnermandoc

10 months

Can high quality nursing home care reduce avoidable ED visits among people dying with dementia? Basically yes Sadly something not fully recognised by ⁦ @NHSEngland ⁩ & ⁦ @DHSCgovuk ⁩ as the pandemic swept in despite funded policy to support it😖

8

20

44

4

12

88

Dan Furmedge

@danfurmedge

6 years

GPs - know you’re busy but a plea If a relative/other health professional asks you to visit a frail person with new confusion, please see the patient and don’t just send a script for ‘UTI’ Most delirium is not in fact a UTI - this weeks missed diagnosis - bowel obstruction

11

39

89