Tom @sleepy__doc Twitter profile

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Tom

@sleepy__doc

2 years

As a northerner in a southern hospital I had absolutely no idea when to prescribe this medication

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Tom

@sleepy__doc

2 years

Last night I admitted a patient with SVT (rate 150) and when the nurses did his covid swab he cardioverted 😭😭😭

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Tom

@sleepy__doc

3 years

Sometimes the worst part of being a dr is that no matter how stressed/close to tears/overworked you feel, you still need to display the happy-to-help joviality of a frankie and benny’s waitress. What an effort

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Tom

@sleepy__doc

1 year

This is for a mandatory exam we have to self fund that is an MCQ and I assume therefore computer marked. It’s daylight robbery tbh.

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Tom

@sleepy__doc

2 years

We moan about the NHS but I sent a patient for a CT KUB today and the only positive finding on the scan was (accurately) a fractured right distal radius

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Tom

@sleepy__doc

2 years

@Mybrainisbrian He had an incredibly fast heart rate due to an underlying arrhythmia and when the nurse did the swab, he converted out of the arrhythmia to a normal heart rate (have a look at valsalva manoeuvres)

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Tom

@sleepy__doc

1 year

“…and we used to have prescribe all their doses for the weekend and chase an INR on the Sunday if we were the F1 on call and write their discharge doses in a little yellow book and we’d never even heard of a NOAC!’

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Tom

@sleepy__doc

3 years

If anyone is finding themselves frustrated by ‘but did they die WITH or OF covid????’ feel free to use this argument I’ve constructed here

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Tom

@sleepy__doc

2 months

Love being a doctor, it’s what I’ve always wanted to do but honestly working for the NHS you’ve gotta ask yourself…at what cost

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Tom

@sleepy__doc

10 months

Thinking about the time some jnr drs presented an audit at grand round on successfully improving inhaler use in IPs and at the end a consultant put his hand up to tell them he’d calculated their results weren’t statistically significant

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Tom

@sleepy__doc

1 year

@Beska See also: - no thanks for the 99 times I do discuss escalation at 4am - ‘disappointing’ is such a profoundly shitty verdict - diagnostic uncertainty in view of frailty syndrome presentation and sensory/cognitive impairment I could go on 😤

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Tom

@sleepy__doc

2 months

Watching an obstetrician operate during an emergency is insane, their concentration is unmatched. You could walk into theatre on an elephant and they wouldn’t notice

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Tom

@sleepy__doc

10 months

Imagine being given 4 months to complete a complex, mandatory tick box exercise, someone suggests presenting it at GR for an extra point at interview and some professor elects to humiliate you in front of your entire cohort of colleagues. I’d be raging

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Tom

@sleepy__doc

11 months

Lol I did a 13 hour med reg night shift at £60/h as an emergency to help a friend and after tax, NI and student loan I managed to earn £374.70 what a joke

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Tom

@sleepy__doc

2 years

@BitBullish Their heart didn’t stop, it just stopped beating in that very rapid rhythm meaning we didn’t have to give any medication 😊

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Tom

@sleepy__doc

10 months

When you’re on your last night shift:

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Tom

@sleepy__doc

1 year

‘What is it that helps you get through the day then?’ Me:

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Tom

@sleepy__doc

1 year

Do you ever read your own notes and wonder what the hell you were thinking?? Apparently this patient’s legs weren’t breathing well

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Tom

@sleepy__doc

2 years

@gfreeman2012 Reverted from a very rapid heart rhythm due to an underlying rhythm disorder, to a ‘normal’ heart rhythm, which is a process that usually requires medications

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Tom

@sleepy__doc

2 months

@MStott88 Ok, I’ll let them know

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Tom

@sleepy__doc

6 months

We’ve all been there right

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Tom

@sleepy__doc

1 month

I’d be interested to know if you think a dangly earring is appropriate to wear to work as a doctor?

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Tom

@sleepy__doc

10 months

@ollieburtonmed Why? It’s humiliating and patronising. Appreciate you weren’t there to witness it but it was so needless

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Tom

@sleepy__doc

1 year

I feel like the most consistent theme of my medical career is elderly ladies asking me where I got my perm 😭😭😭

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Tom

@sleepy__doc

2 months

In hindsight, expecting F1s to be in charge of list management, having to come to the wars early to ensure it’s updated and accurate, is/was insane

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Tom

@sleepy__doc

1 year

I’m using MRCP pt 2 questions to revise atm bc the Geriatrics SCE exam contains quite a bit of gen med (and bc why not) and I can’t believe this shit is still flying around

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Tom

@sleepy__doc

7 months

Passed it though 😎

Tom

@sleepy__doc

1 year

This is for a mandatory exam we have to self fund that is an MCQ and I assume therefore computer marked. It’s daylight robbery tbh.

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Tom

@sleepy__doc

2 years

@czbikerchick Yes! From the rapid and potentially life threatening SVT, back to a normal, safer, slower heart rate

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Tom

@sleepy__doc

11 months

Don’t get me wrong the money is nice but is it really worth the stress of being the senior medic on site, the sleep disturbance, the effects on my health, the lack of sunlight??

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Tom

@sleepy__doc

3 years

Friends and families of my patients. I know you’re angry I know you feel let down I know you’re making sacrifices But NHS staff can’t be the emotional punching bags for these frustrations. I have no control over vaccines, lockdowns or restrictions. And I’m trying my best.

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Tom

@sleepy__doc

2 months

Just to clarify I was in the theatre for less than 30s bang in the middle of a MOH and crash CS. I’m a med reg. Let’s not over complicate this. It was a brief observation of a clinical situation that I’m not used to. We don’t need your feedback

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Tom

@sleepy__doc

1 year

@Jingstar Aha thanks Jahangir! That means a lot mate

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Tom

@sleepy__doc

2 years

@GladysVanDriver My old haunt! I know that speed bump well ha

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Tom

@sleepy__doc

1 year

@Faezalamodi Actually for me, why can’t the vignette be ‘a 42 yo man who was recently diagnosed as HIV +ve…’ bc then a) we’re not making diagnostic assumptions based only on demographics which can reinforce biases and narrow clinical judgement but also b) it’s irrelevant detail

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Tom

@sleepy__doc

1 year

#NewProfilePic

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Tom

@sleepy__doc

4 months

My death certificate will only say one thing and it’ll be 1a) acid reflux

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Tom

@sleepy__doc

2 years

Teaching at med school: this is how this works Teaching after med school: this is not, in fact, how anything works and everything you know is wrong

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Tom

@sleepy__doc

3 years

Hard pill- the pandemic has made some drs difficult to work with, because they are absolutely, unequivocally burnt out but we don’t create a culture where this can be a) admitted or b) managed so instead of having time off they soldier on, becoming increasingly irritable and rude

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Tom

@sleepy__doc

2 years

@Tepps19 Curveball- turns out it was around 4pm

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Tom

@sleepy__doc

2 years

@haamfish Up north, dinner is a meal eaten around midday (evening meal is ‘tea’)

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Tom

@sleepy__doc

3 months

Can we call neuro to see if they want the mri. Ok can we call radiology to vet the mri. Ok can we call the coordinator to book the mri. Ok can we call the radiographers to do the mri. Ok can we call the family to consent for the mri. Ok the mri is broken. Ok can we call neuro to

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Tom

@sleepy__doc

10 months

I see it’s that time of the year where we have to do reams and reams of frustrating paperwork in our own personal time for the next rotating hospital bc HR departments have an inexplicable ability to communicate or create a centralised database

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Tom

@sleepy__doc

1 month

Completely unexplained insomnia last night. Woke up at 00.30 after 1h sleep, then was awake until about 6. Alarm goes off at 6.40. I’ve taken the day off work for obvious reasons but I feel completely fraudulent. I’ll be back tomorrow but insomnia truly is hell

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Tom

@sleepy__doc

2 years

@Mr_Goomantash Up north dinner is eaten at midday

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Tom

@sleepy__doc

7 months

I’m on wk 3 at my new trust and my 1hr 20min commute for an 8.30 start is absolutely killing me. I’m not a morning person anyway but I’m constantly knackered, not what I need for the 9h shifts. Not sure I can do this for 12 months. Genuinely don’t know what to do ☹️

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Tom

@sleepy__doc

3 years

@_B_e_t_h_B_ @darylthedevine I’ve been a waiter in a high end pub and it was sometimes *worse* than being a dr because it’s as phys/mentally exhausting but has an unfavourable power balance (customer is always right) which is why I reject the ‘unskilled work’ rhetoric re. minimum wages

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Tom

@sleepy__doc

2 years

I can see we’ve had some *cynics* in the comments

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Tom

@sleepy__doc

1 year

Todays NHS bullshit is sponsored by My patient wasn’t discharged because in the notes we wrote ‘recovered from sepsis, home today’ instead of ‘MFFD’.

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Tom

@sleepy__doc

5 months

I really hate the new Geris specialty CiPs. Two of them aren’t even pure Geris (Stroke and Movement Disorders), one isn’t hospital based and one is continence. What happened to frailty? Memory disorders? Palliative care and ACP?

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Tom

@sleepy__doc

2 years

Doing QIPs doesn’t make me a better doctor, it makes me a compliant trainee

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Tom

@sleepy__doc

7 months

Who bleeps for advice at 12.30 honestly I’m elbow deep in the salad bar and waiting for my costa soy latte

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Tom

@sleepy__doc

2 months

@o_burbidge Personal mental health cost I mean

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Tom

@sleepy__doc

3 years

It’s happening all over again. “Previously f+w…loss of taste with cough…RR 35 and HR 125…bilateral infiltrates with lymphopaenia…pO2 5.2 on NRB…” I’m tired.

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Tom

@sleepy__doc

8 months

>90 yo patient a/w fits. CT head- 3 metastatic lesions. PMH: Mod-Sev dementia, CFS 6, not suitable for SACT, for BSC. O/e massive, tender hepatomegaly, CXR nil obvious. Qu: do you perform CT CAP before d/c to NH with Comm Pall Care?

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Tom

@sleepy__doc

1 year

I love when the consultants who write exam questions produce a full Enid Blyton style autobiography for their imaginary patients like I need to know where this lady was doing her Xmas shopping. Was it John Lewis? Was it TK Maxx?? We’ll never know

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Tom

@sleepy__doc

1 year

I have a feeling a lot more hospitals are actually in a severe crisis but feel it’s easier to let healthcare professionals continue to struggle than it is to publicly admit it

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Tom

@sleepy__doc

1 year

@alienfromzog That’s disgusting

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Tom

@sleepy__doc

1 year

Today’s other frustration is why are we calling a nonagenarian being admitted with suicidality during a period of bereavement a ‘social admission’

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Tom

@sleepy__doc

6 months

“Patient is full recovered from the acute illness and is clinically appropriate for discharge home with no further medical or therapy input required” “OK but we need you to write MO or she can’t go”

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Tom

@sleepy__doc

10 months

At a Helsinki wedding and explaining to Finns what I do for a job

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Tom

@sleepy__doc

2 years

I really feel like if an older person falls, but it’s due to acute pathology like heart failure or sepsis we should instead call it ‘collapse’ to avoid tick box medicine. Why are you doing a 24h tape on a 90 year old with Klebsiella bacteraemia???

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Tom

@sleepy__doc

5 months

One of my old consultants shares a name with a historian who writes books about the sex lives of peasants (I’m not joking) and they’ve used my consultant’s photo in an online review of one of her books, instead of the author’s 💀💀💀

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Tom

@sleepy__doc

1 year

People who get mad at healthcare professionals who don’t take food/leftovers to work as a cost saving idea sometimes underestimate both the lack of, and restrictions on, food storage and heating in NHS wards. Also the microwaves are always filthy

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Tom

@sleepy__doc

2 years

Discovering one of the ear pieces on my stethoscope is broken might explain why everyone I’ve examined for the last two weeks has had ‘reduced air entry throughout both lung fields’

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Tom

@sleepy__doc

2 years

Seen not in a primary school or playgroup but an NHS ward

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Tom

@sleepy__doc

8 months

Why is there such a reluctance to use Diltiazem or Verapamil for control of AFRVR? Treatment seems to be either BB or Dig, such that we almost seem to become deskilled at using CCBs acutely

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Tom

@sleepy__doc

2 years

Are your sickle cell patients crying in pain because they’re drug seeking or have you assumed they’re drug seeking so they’re now crying in pain?

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Tom

@sleepy__doc

2 years

This is apparently how long I’ve been timing a patient’s respiratory rate at work

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Tom

@sleepy__doc

2 years

How I feel giving advice to the new F1 doctors

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Tom

@sleepy__doc

3 years

I’ve had a tax rebate almost every year of being of a dr and I think it’s because when I was an F3, my new hospital thought I was a locum ophthalmology consultant

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Tom

@sleepy__doc

1 year

@LouiseHogh @sleepy_doc Kingston is still at the top of my list for me to come be a consultant at so as long as the pigeons have moved on I’ll be applying!

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Tom

@sleepy__doc

1 year

@DrKidneyAsh Agreed, the temptation to just see them is pretty strong but it’s never safe especially if you’re the take reg

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Tom

@sleepy__doc

1 month

It only takes one relative to ruin your evening doesn’t it

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Tom

@sleepy__doc

3 years

Nothing is gonna get my med reg blood boiling more than someone referring 3 patients at the same time at 7.15am

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Tom

@sleepy__doc

2 months

Why are there always national shortages of medications?? IV Paracetamol, Salbutamol, Bumetanide…is it the B word 😬

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Tom

@sleepy__doc

3 years

@mevparekh I’m glad the mask hides half my face cos I would not be winning any awards

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Tom

@sleepy__doc

7 months

😴

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Tom

@sleepy__doc

3 years

Broadly speaking a good dr is: ☑️ clinically proficient ☑️ kind and compassionate to patients ☑️ kind and compassionate to (all) colleagues I will not think highly of you until you’re all three, no matter how many letters follow your name

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Tom

@sleepy__doc

9 months

Is there anything more stressful than receiving a new rota? On call on induction week, working Xmas *and* NY once again, on call during weddings, planned visits home, an hour commute for an 8.30 start/17.30 finish…

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Tom

@sleepy__doc

2 months

@Medic_Mermaid All of the above

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Tom

@sleepy__doc

2 years

I’ve injured my foot recently but it seems to be getting better so today I’m going to try TWOC (trial without crutch)

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Tom

@sleepy__doc

1 year

@DrHelenOram It’s from the Pastest MRCP part 2 question bank, I downloaded the app yesterday and was one of the first questions to come up! But I passed part 2 in 2015/6 and I remember similar questions appearing then

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Tom

@sleepy__doc

2 months

Today will be the 5th Take shift I’ve done in the last 7 days because of a rather short sighted swap. 65 hours of answering bleeps

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Tom

@sleepy__doc

2 months

Lol wars. You know what I mean

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Tom

@sleepy__doc

11 days

My next hospital is my last training hospital and until I find out where that is I feel like planning my life for the next 12-18 months is on hold

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Tom

@sleepy__doc

3 years

Delirium can be so strangely diagnoses. You can have a patient in MOF 2nd to severe sepsis and it’s delirium ?cause but someone else has 1+ of leucs and all of a sudden it’s 2nd to UTI? It’s strange how these (questionable) associations stick

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Tom

@sleepy__doc

2 months

@wparrysmith Just to clarify I was in the theatre for less than 30s bang in the middle of a MOH and crash CS. I’m a med reg. Let’s not over complicate this. It was a brief observation of a clinical situation that I’m not used to.

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Tom

@sleepy__doc

5 months

I was at a seminar on Thursday and a female Geris Cons asked a qu about frailty and the speaker said ‘perhaps you could tell us what frailty is first?’ and an unknown man in the audience interrupted, told a story about frailty and didn’t even answer the question

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Tom

@sleepy__doc

2 months

It’s Brexit isn’t it. Of course it is.

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Tom

@sleepy__doc

3 years

#NewProfilePic

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Tom

@sleepy__doc

3 years

Seeing many pts whose NOK report declining cognition coinciding with lockdown starting; perhaps subclinical cognitive impairment now becoming apparent due to loss of social support, exacerbated by loneliness and temporal disorientation?

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Tom

@sleepy__doc

1 year

I finished nights on Friday and yet today bc of sleep patterns I’ve been up since 3.30. Insane how, were it not for annual leave id be back at work today, expected to do my usual clinical duties

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Tom

@sleepy__doc

2 years

Christ

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Tom

@sleepy__doc

2 months

@ConkerLover I’m glad you get it

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Tom

@sleepy__doc

2 years

When it’s “We’d like you to kindly review this patient” and they’ve already been in hospital for 67 days

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Tom

@sleepy__doc

3 years

Getting apologies from ED drs who believe their referrals for elderly patients are ‘bad’. But any acute condition can exacerbate frailty- it doesn’t have to be overwhelming illness. If it’s safer to admit for therapy and symptom control then surely that’s a very *good* referral?

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Tom

@sleepy__doc

3 years

Naming wards after fun things always sounds like a good idea until you’re ringing the cardiology reg in a medical emergency like ‘Hi, is this Hotdog A? I’m ringing from Jane Austen B about a patient on the Microwave Unit’

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Tom

@sleepy__doc

3 months

At #Dementias2024 National Conference today, will attempt to tweet some things of interest. Currently hearing about new potential pharmacological therapies in the research pipeline for treatment of Alzheimer’s dementia (thought to be ~28!)

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Tom

@sleepy__doc

3 years

Finished nights this morning and now have 2 weeks of annual leave

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Tom

@sleepy__doc

1 year

I’ve got ALS next week

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