Life in the slow lane @drokane Twitter profile

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Life in the slow lane

@drokane

17 days

Acute Medicine, third edition (Student Medicine) #Amazon via @Amazon

Acute Medicine, third edition (Student Medicine)

www.amazon.co.uk

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Life in the slow lane

@drokane

2 years

Today I saw a patient who has been constipated longer than Kwasi was chancellor

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@drokane

2 years

Half a ward round done and just stopping for a can of Stella and ward sister is mixing cocktails and the physio is opening a keg #torylies

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@drokane

2 months

My Dad is in a care home dying of end-stage dementia and the GP keeps wanting to admit him to an ED corridor as his pulse is 40. I told him to stop the beta blocker. Dad is singing in his room and happy. GP doesn't get it. Very distressing.

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@drokane

1 year

Pret a manger don't expect their employees to pay to register to the General Coffee council at £420 per year, join the royal barista college at £390 per annum and take Barista exams at £ 785 a year to continue to work for them for 14 quid an hour

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Life in the slow lane

@drokane

1 year

Elderly family member discharged from an expensive London private hospital 10 days ago Day 2 following shoulder replacement. No OT/PT discussion how she would manage with one arm for weeks. No equipment for showering discussed. No relative called. NHS would not have done that.

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Life in the slow lane

@drokane

1 year

You are asked to look at the CXR so they can restart feeding on the way out the door at 5 pm. What would you do next.

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Life in the slow lane

@drokane

1 year

The NHS acute emergency care is failing spectacularly and unless you are within the 4 walls of the ED you will not know this unless it is you who needs our care.

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Life in the slow lane

@drokane

2 years

My kid had a fever. I called the GP who said it was something viral and take calpol. I checked Google and I know it’s malaria, I went to the ED and they sort of maybe diagnosed malaria. Bloody GPs. And before you ask we never leave England.

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Life in the slow lane

@drokane

2 years

Just because an older patient wishes to go home against the view of a medical/surgical team does not mean that they loose the right to transport and help and a discharge letter to the GP. I saw this happen today and stepped in and all sorted.

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Life in the slow lane

@drokane

2 months

@v_j_freeman Fuss about a painting and none about the Genocide by Bibi

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@drokane

4 months

I am pleased to announce new Pilot associates. They have a geography background. They do a year working in a travel agents and as cabin crew. They can then fly any plane. There are no regulations which is amazing. Day night storms. Next time you want to fly go Pilot associates

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Life in the slow lane

@drokane

3 years

@KilclooneyJohn John is disapointed that an Orangeman is leaving the Whitehouse

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Life in the slow lane

@drokane

12 days

I had an email from RCP London about cancelling FRCP. Very keen to say that I must not use my F. However, if I want to rejoin in the next 3 years I need to backpay all the fees I missed. So I have decided to F off. Wife and I will have an annual weekend break on the money saved.

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Life in the slow lane

@drokane

2 years

Absent mindedly put my own details in the DNACPR form I was completing.

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Life in the slow lane

@drokane

2 years

How to write to Clinicians: Management 101: "Dear Doc, I realise you are working this weekend. If there is anything we can help with please that would facilitate discharges or care do not hesitate to call us. Thank you". Such a difference.

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Life in the slow lane

@drokane

2 months

Damaging the uk medical degree will also prevent emigration or even doing fellowships abroad. It’s so deliberate.

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Life in the slow lane

@drokane

2 years

I saw a 101 year old lady yesterday. She has never run a marathon or done a 10k. My unproven theory is that Gin plays a role in protecting telomeres.

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Life in the slow lane

@drokane

2 years

Hi I am your new ex Cambridge F1 and wanted to let you know all your patients are being mismanaged

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Life in the slow lane

@drokane

10 months

@EM_RESUS Vaccination has saved millions of lives and will continue to do so. The risks are small and gains are huge.

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Life in the slow lane

@drokane

2 years

Really upset my team told me that the WHSMITH plastic file box that I carry in my on call week to speed us up and contains clinical sheets and DNACPR forms is known at med school as a Twat box. I have feelings.

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Life in the slow lane

@drokane

2 months

If you work under my supervision. I am accountable. I and my consultant colleagues set the terms. The BMA has done a service to PAs.

Physician Associate Association UK (PAAUK)

@PPaauk

2 months

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Life in the slow lane

@drokane

3 years

I buy the coffees. Med students and team listen to my old and tired anecdotes. It seems a fair deal.

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Life in the slow lane

@drokane

1 year

@DeakinSue1 All doctors on nights need a hug from the day team at 8 am.

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Life in the slow lane

@drokane

2 years

At a certain age you read the BMJ backwards. Deaths and then fantasise about better jobs and then realise the current clinical director was your F1.

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Life in the slow lane

@drokane

2 years

@HarryCobeans @simonharris_mbd You are wrong. He showed up the tory gaslighting by parodying it. He made it all more real. Sorry you don't get it.

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@drokane

2 years

The subtext is a blame game that bed shortages are due to bad clinicians and have nothing to do with poor management decisions and resource allocations

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Life in the slow lane

@drokane

28 days

I spoke with a clever FY1 yesterday reluctant to even alter an insulin dose in case he screwed up. We need to empower our juniors to do more. How do we do this.

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Life in the slow lane

@drokane

2 years

@DGlaucomflecken Serial 7's are done backwards in the UK We understand US synapses are a bit slow

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Life in the slow lane

@drokane

3 years

Geriatricians should really be called Cardiorespiratoryneurogastrohepatodermaonconephrorheumaorthoopthalmotraumapalliative specialists but sadly we can't get it on the badge

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Life in the slow lane

@drokane

2 months

GP Referral...please see patient with a TIA. I see pt who tells me he googled it and he had a TIA. Clever chap a teacher. I say no it was TGA. I google TGA and he says golly doc you're right. A fool with Google is still a fool.

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Life in the slow lane

@drokane

2 months

One of our clever managers looked at a recent few weeks when our discharges went drastically up and almost cleared the ED corridor. It was actually because there was an identical peak of community deaths freeing up carers and nursing homes and other beds.

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Life in the slow lane

@drokane

2 years

Yes it's Multi disciplinary tipple time

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Life in the slow lane

@drokane

4 months

@ShaunLintern It is dreadful everywhere. Nothing to do with strikes., all to do with lack of social care funding and inability to dicharge well patients.

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Life in the slow lane

@drokane

1 year

@EM_RESUS On a tangent....Had a pig farmer who would grab an electrified fence to treat his SVT. Not cardioverted but the shock made him valsalva and that did the trick.

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Life in the slow lane

@drokane

1 year

Steve Barclay Gaslighting

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Life in the slow lane

@drokane

2 years

Sad to say but the longer you work in the NHS the angrier you get at those who run our country and their actions to destroy it while pretending they care.

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Life in the slow lane

@drokane

4 years

@thewanreport @gtconway3d @JoelAchenbach If you are elderly now is a good time to stay home and binge watch dvd and keep in phone contact with family and get the to drop off shopping.

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Life in the slow lane

@drokane

2 years

What I really said was "I find your comments both disrespectful and unhelpful."

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Life in the slow lane

@drokane

1 year

Fun fact: Warfarin is an acronym Wisconsin Alumni Research Foundation + arin for coumarin

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Life in the slow lane

@drokane

2 years

We really need to developing OSCEs that involve taking a history and examining a patient in a corridor.

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Life in the slow lane

@drokane

2 years

@miffythegamer I prefer Princess Margaret's

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Life in the slow lane

@drokane

2 years

@IsabelOakeshott @trussliz No one could contact her when they were in the same room

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Life in the slow lane

@drokane

2 months

@RoisinHealy3 Just up the road from you. I made it clear in writing what we expect that he stays in his lovely care home and when time comes dies there and not distressed and then sedated in ED corridor. We have POA. He says as a doctor I should have no say in dictating care. GP "not happy"

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Life in the slow lane

@drokane

4 years

Attempt at a one page stroke Crib sheet. Please DM me if any errors or omissions.

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Life in the slow lane

@drokane

3 months

Twenty years ago we had a geriatric day hospital where we could see patients and give transfusions. Managers closed it. Now the new thing is SDEC where we can now give transfusions and see patients. Managers love it.

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Life in the slow lane

@drokane

1 year

@DrRobgalloway @SteveBarclay @RishiSunak I am on the weekend and expecting to witness peak awfulness. Remember this is on all those who voted for the tories in the past 12 years.

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Life in the slow lane

@drokane

2 months

@indigosphinx That's the request I've made

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Life in the slow lane

@drokane

4 months

@DrAsifQasim @DHSCgovuk @gmcuk There are more difficult medical questions in GCSE biology

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Life in the slow lane

@drokane

2 years

@BillKristol

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Life in the slow lane

@drokane

12 days

I would like a refund of the past 16 years of fees paid whilst you all were screwing medical profession @RCPhysicians

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Life in the slow lane

@drokane

28 days

If PAs teach me one thing it is that we do not push our trainee doctors to think and make decisions enough. Too much waiting for senior review. Too much prepping. Go and see assess and make a decision. Trainer wheels are off. Tnen I can feedback and you learn quicker.

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Life in the slow lane

@drokane

1 year

I try to avoid them if I can. This is 1 of 2 in 20 years. If we CXR everyone it delays feeding by many hours. pH testing is the national standard. I am not sure if pH was misinterpreted here with initial insertion. If tube that is not in midline remove it stat.

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Life in the slow lane

@drokane

2 months

Tricky one for PACES

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@drokane

2 years

@JolyonMaugham @ShelaghFogarty The met police when you break COVID laws to commemorate a woman killed by a met officer

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Life in the slow lane

@drokane

1 year

Steve Barclay reminds me of that rare awful doctor we have all met who just refuses to come and see the sick patient.

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Life in the slow lane

@drokane

2 years

@jaydbint Know your ABCs arrive blame criticise depart

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Life in the slow lane

@drokane

3 years

@sean_sommers @Basalus Matthew 5:9 Blessed are the pacemakers

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Life in the slow lane

@drokane

1 year

Furious with the disgraceful state the politicians have allowed our NHS to descend to. There is no room left in the ED. Amazing care and compassion and support from NHS staff and managers. Very distressing for old and frail. Patients know where the blame lies.

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Life in the slow lane

@drokane

1 year

Big efficiency across the NHS if you get rid of bloody bleeps. They are a curse. We need instant messaging and ability to chat. It's just so obvious. They cause such inefficiencies.

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Life in the slow lane

@drokane

2 months

GMC thinks PAs can diagnose and treat all this. No national exams. Some bogus assessment. I suspect Jamie/Jeanine copied and pasted it with little understanding or oversight. @gmcuk

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Life in the slow lane

@drokane

1 year

We stepped in and took her to ours but that was just a fluke. I had to take a week off work of my annual leave. Not impressed.

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Life in the slow lane

@drokane

2 years

@Dr_DeanS An orthopod did that once deliberately with 11 page rant attached called "11 years a slave"....yes a slave with an aston martin

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Life in the slow lane

@drokane

1 year

Trying to get a cheat sheet for acute medicine drugs - any additions or changes ? Please DM me

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@drokane

1 year

Lastly for those who feel comfort as they have bupa it doesn't cover acute care. They will tell you to phone 999.

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Life in the slow lane

@drokane

2 months

If he wanted this changed he would have. He wants to be seen as a doctor. It's the plan. PAs like this want to replace docs not work with.

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Life in the slow lane

@drokane

3 years

In flight emergencies

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Life in the slow lane

@drokane

2 years

@chesterBirdbath @lexfridman Its like saying 10-2 in a soccer match is a partial win for the losing side

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Life in the slow lane

@drokane

2 months

Climber A: spends years training practising climbing everything then scales everest Climber B: Climbs hills then brought to everest base camp and gets helicopter to summit and a photo and back down. Both look the same to the General mountaineering Council. They aren't.

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Life in the slow lane

@drokane

3 months

@gmcuk This is a disgraceful scheme. You are reducing the standards of UK medical care by allowing the undereducated, undertrained and underexamined to take on roles for which they have neither the training education or experience, It is against patients and the core GMC principles.

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Life in the slow lane

@drokane

1 year

For those who will die due to this, this is manslaughter. This is how it is. You have been made aware. We can do no more. What we need to do will take time and we have none left.

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Life in the slow lane

@drokane

1 year

We have many ways to assess for end organ damage nowadays - Echo, CT scan, Urine. It is high time management of acute HTN didn't mean a busy reg has to find an ophthalmoscope that works at 2 am and look through a miosed pupil in a confused patient.

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Life in the slow lane

@drokane

2 months

@PPaauk If you work under my supervision then I am accountable. My consultant colleagues and I set the terms. The BMA has done a service to PAs.

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Life in the slow lane

@drokane

1 year

If you or those you love have sepsis meningitis a fracture a stroke a heart attack, pneumonia your care and treatment will be delayed significantly. It will get worse as the cause has not been fixed.

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Life in the slow lane

@drokane

1 year

@jordanbpeterson You want money

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Life in the slow lane

@drokane

5 months

What concerns me is I am guessing the psychiatrist needs a PA to do the "medicine" for him where he feels deskilled. So who is the PA checking up with if the boss has not got the knowledge to oversee the PA.

NHS England

@NHSEngland

5 months

Physician associates support the wider clinical team, reduce workload pressure and enhance patient experience. The NHS Long Term Workforce Plan sets out how to build the right staffing and skills mix for the future, including expanding roles like these.

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@drokane

2 years

In many ways they need gratitude as they are giving up a bed for someone else and they are the ones who are taking the risk. I always tell them that they can come back anytime. Important not to make them feel penalised. They might just want to feed the damn cat or dog.

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Life in the slow lane

@drokane

1 year

This needs a government solution but they have done nothing substantial now for years. The whole situation feels deliberate.

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Life in the slow lane

@drokane

2 months

The entitlement . We want we want. We failed to get into medical school. No. The public deserve the best. Maybe work a bit harder. My Parents left school at 14. Not elite.

IncogPA

@IncogAssociate

2 months

This is: Scapegoating Elitism Protectionism This has NOTHING to do with patient safety. This is: You do not have 'Dr' in front of your name so you can not care for patients. You can not join our club. You can't sit with us. Punching down. Nothing to be proud of. #RCPEGM

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Life in the slow lane

@drokane

4 years

@adamboultonSKY @BorisJohnson @jeremycorbyn A turnip is preferable to Corbyn. Turnips don't encourage the IRA.

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Life in the slow lane

@drokane

1 year

Guardian give this guy a rest. We will need him next week.

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Life in the slow lane

@drokane

3 years

Crib sheets @drkeithsiau Anaemia

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Life in the slow lane

@drokane

2 years

I have personally had a life changing diagnosis made by a GP (Dr Salmon in Cambridge). I am deeply ashamed I never wrote and thanked him so this is my small act. I cannot begin to say how good you all are. An amazing asset to the UK. Don't let the whingers and whiners win.

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Life in the slow lane

@drokane

3 years

All stroke docs need this handy

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Life in the slow lane

@drokane

2 years

Crib sheet Heart failure

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Life in the slow lane

@drokane

2 years

It is our role to put the patient first and to respect their informed decisions. Fine to ask them to sign a form. But they deserve same support and kindness as any other patient.

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Life in the slow lane

@drokane

1 year

It's out.

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Life in the slow lane

@drokane

10 months

@JohnGreenwoodMD @AmericanAir @BayhealthDE @MaineMed fainting in America everyone is a hero

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Life in the slow lane

@drokane

4 months

PAs are simply a wedge issue to put doctors in their place. They are saying know your place, we will replace you. What you do we devalue. Anyone can do. We pay people who know less and less qualified more. It is spite. PAs are being misled and misused. It is shameless.

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Life in the slow lane

@drokane

14 days

Post office knew Horizon IT was unsafe Gosh they are all so sorry now PAs the GMC knew that there were safety issues They will all suddenly be sorry later @gmcuk @drcolinm

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Life in the slow lane

@drokane

1 year

The only way to get space is to discharge patients many of whom are just waiting for social care. But there is no social care as council funds limited, no carers as poor pay and brexit and better jobs elsewhere. We could put beds in sports halls or hotels but still need carers.

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Life in the slow lane

@drokane

2 years

The MET team have arrived

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Life in the slow lane

@drokane

1 year

There is no privacy we see and examine people on the chair or trolley. We try to see the sickest. Those who need urgent treatments wait hours or days. It is a shambles. But 100 m away you wouldn't know a thing was wrong.

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Life in the slow lane

@drokane

28 days

@drkeithsiau If you are a trainee doctor or med student who feels abused, mistreated, abandoned and sidelined as well as underpaid, tired, broke from exams and underpayment, betrayed by the consultant class and royal colleges then please like and speak up. You are the best of us.

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Life in the slow lane

@drokane

1 year

The hospital is full. No beds. This has meant that we cannot get patients out of ED to safe areas. ED is just crowds of people lying on trolleys, sitting on chairs and standing around and we are tying to get through the crowds to see them get tests done. More keep arriving

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Life in the slow lane

@drokane

10 months

Ward cover nostalgia: In all seriousness I remember when nurses didn't do ECGS, take bloods or site cannulas or give IV drugs or put up bags of blood without a doctor. They do so much more. We really should be more grateful. Thank-you. I have been very well supported today.

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Life in the slow lane

@drokane

2 months

@wesstreeting Concerns about unsupervised PAs is not bullying

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Life in the slow lane

@drokane

1 year

@metpoliceuk If you don't agree we will arrest you.

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Life in the slow lane

@drokane

1 year

NG tubes are not the silver bullet safe option for nutrition in those unable to swallow. Even if tube is sited properly the stomach is filled with feed and reflux and aspiration is common especially if stroke and poor airway protection e.g. unable to cough effectively.

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Life in the slow lane

@drokane

10 months

@andrew_lilico A surgeon is a type of doctor

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Life in the slow lane

@drokane

1 year

When the registrar brings the only needle left for the LP at which all else have failed

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