Inpatient Consults: Not Helpful

[@danielkim5477]

As an oncology nurse, infectious disease is by far the most helpful specialty. This video is soooo accurate.

[@Liuhuayue]

Yet they get paid so little.

[@FunkyDumpsterKitty]

Fellow Oncology RN here, and I agree! We already have the Onc consult. :)

[@Erenmir]

As an I.D. doctor, thank you. Yet we almost never get called in our hospital for consults...

[@Asnlvl2]

As a nurse who reads many MD notes, this is 100%

[@lubystkaolamonola529]

In nursing homes 1) neurology: neuro check, CT 2) pulmonology: chest X ray, robitussin 3) GI: bm (bowel movement) 4) cardiology: VS, bp meds up or down 5) infectious disease: urine culture 6) dermatology : nystatin 7) ophthalmology: eye drops, glasses 8) audiology: hearning aid 9) psychiatry/psychology: involuntary petition, behavior monitoring 10) orthopedics X ray 11) hepatology/hematology: cbc, cmp, UA/CS 12) oncology: DNR 13) infection: keflex 14) wound: bacitracin

[@CC-ty6hn]

@@lubystkaolamonola529 oncology: DNR 😭😭

[@voicingsomeopinions7006]

@@lubystkaolamonola529 I'm an SLP but not in a hospital or SNF. However, based on what I've heard, SLP: the resident who's had pneumonia multiple times is coughing while eating? Order a barium swallow study. Oh, the resident isn't coughing while eating? Order a barium swallow study anyway.

[@madadivad1986]

Some of the most beautiful literature in human history is the consult notes written by infectious disease

[@leahgodson2319]

Psychiatry: It’s delirium, not for us Psychology: Call Psychiatry 😄

[@patricthime8000]

Psych here.How many times have I been called to the ER for someone wgo's "Just not right".....

[@brasschick4214]

Psych: Hi I’m from psychiatry and I’m here to see Mrs X the 86 yo woman that was seeing spiders crawling up the walls. Have you done the septic screen I suggested? Med: Errr yeah urinalysis was positive. Psych: 😒

[@Kookyxmnstr]

I'm a nurse and this is the most true thing I have heard loll especially stop checking the trops 🤣🤣

[@JohnJohn-nt9mf]

I had a patient... 3 troponin checks showed that levels are trending down from being high. and this new IM RESIDENT ordered for a 4th troponin check just to make sure. when the 4th one result came, it started to go up and was higher than the 3rd check. She told me, "We shouldn't have checked it the 4th time." 😂😂

[@xochitlyellow9140]

I’m not even a frickin medical professional, I’m just a scheduler for specialty MDs and I see about a hundred chart notes a day legit, can confirm the accuracy. I love this guy 😍

[@rachelm4051]

This is literally the hospital every day. Bravo👏👏👏

[@sailboatrn7372]

My very first code was a 87 yo f in ESRD, had had dialysis that day. Her kidney Doc wanted a surgical consult DURING the code! The poor surgical resident who I called asked if this was a joke. I had to tell him “No”. He came down during the code stood at the door way and said, “She is NOT a surgical candidate.” I wrote that he said exactly that. After coding the pt. for 45 minutes, the attending neph doc showed up and said he would call the patients family and tell them we did everything we could. I have never forgot that code nor the neph doc. He was on my LIST for the next two years. You know what I mean. 😂

[@LucasdaMatta]

hahah this is golden

[@catladyfromky4142]

I am an inpatient dialysis RN, and this is so true. One nephrologist I work with was telling the family of a 32 y.o. patient with liver failure and AKI (drug use) that the intensivist would work her up for a double transplant and to keep hope alive. We dialyzed her every day (sometimes 2x) for over a week until the intensivist decided it was enough. Don't forget all the FFP, platelets, and albumin we were running in her daily. It was horrible.

[@NatG2019]

Maybe it was a rough sue happy family or he’s had a bad experience and trying to cover his bases. I get it but maybe there was something more to his crazy request.

[@Cookie-mg8im]

Most of our kidney docs are great but we do have one who has a hero complex. It is NOT appropriate to start dialysis on a 90 year old with cancer and dementia. The extra stress on their body killed them faster than what they had going on

[@sheenawinfrey3133]

Wow! Just wow! Lol!! And, yes, I know the list well...lol!!

[@maggiewright9224]

I get auths and read medical notes all day. This is so accurate. I die a little inside when I can't get info from clinic notes and have to go to the IP consults. I stumbled on your video about calling to get info from nursing homes (I swear I have had the same conversation verbatim) and have now fallen down rabbit hole. You crack me up.

[@theclawsoncrew13]

As a neurology nurse who attends consults with my MD this is 💯 accurate..... especially neurosurgery

[@juliafelicione2667]

Been on a neurosurgery team… yep 😂

[@kristincarr4248]

As an ID doctor, this is pretty true. Usually people reach out to our team when they get the above answers from other consultants, even for non-infectious cases. Rheumatology and Neurology also are helpful for the mystery cases. However, most of the time we are consulted so we can write their discharge summary or review records for a patient transfer.

[@cameronno6039]

😂This is the very sad cheat code. I recall being advised about consulting ID for summaries on complex patients. It's tragic. With that said, ID is always among the most respected medicine specialties I've worked with. Truly special people to undergo more education for less pay.

[@radon.19]

Yesterday I had case which I was discussing to refer to ortho spine or neuro spine, but offcourse we get to irradiate it first.

[@nicolehessabi5116]

ID Consult for the win!!

[@juliaspoonie3627]

Is it concerning that we -the patients - see that as well? 😂 it’s a Ping-Pong game and we‘re the ball, unfortunately sometimes we get just as frustrated as you. Hugs

[@noctusowl]

99% of the times the original clinician is right but they don't want to act and take responsibility because it's not their specialty. Then the other specialist might have an opinion but has no experience with the "baseline" problem so does not want to get too involved.

[@lachyt5247]

Blame the overly litigious system, take responsibility for something that could be construed as 'outside your lane' and it goes wrong; welcome to the hell of malpractice suits.

[@bhuiyadip]

@@lachyt5247 That's the REAL truth of modern medicine even in India

[@jazmeen04]

noctusowl I used to think it was so the patient will get the best care

[@Pipsquacky]

Ping pong that the patient pays for.

[@FacundoMD]

SO funny ! ER doctor here ! jaja Very Accurate ! I can predict each one !

[@Missing_Xindi]

I've been there as a patient. Spot on with infectious disease. Well done.

[@KristenRowenPliske]

So accurate! There was an MD at the hospital where I worked that consulted EVERYONE whenever he had a patient. He rarely did anything for his patients, made rounds at 3am & sometimes didn’t even go into his patient’s room. Despite having a private practice & who knows how many years of residency, he still had to have a supervising MD to make sure he did what he was supposed to do. The nurses all knew he was useless & sexist. The docs knew it, too, but the guy never got disciplined as far as I know.

[@considerthelilies91]

Did anyone actually see him attend medical school?

[@amyill9280]

Oh man. We have a hospitalist who consults everyone too. The dietitians dread the days he works because 95% of his consults are inappropriate inpatient "weight management" consults just because someone's BMI is high. Like, sorry, it isn't appropriate to give weight loss advice to a sedated dementia patient on a ventilator in the ICU. Not a good time. That same doctor also often admits patients as inpatients, and the other hospitalists who later take on the patient are confused as to why the patient was even admitted in the first place.

[@horschiday9449]

“Cardiology: stop checking troponin”... 100% true 😂😂

[@whatausernamethisis8893]

I don't get it. Explain?

[@juliafelicione2667]

@@whatausernamethisis8893 if it’s high it’s goons stay high for awhile. Tracking it leads to useless notifications and doesn’t help ID cause or help prescribe treatment or indicate if the patients improving or worsening

[@lekeAchgeketum]

Totally true!! I find the most help comes from the healthcare providers who follow the patient: primary care provider, social work, case management, home nursing, & nursing assistants who interact the most frequently with them. Acute care inpatient providers just don't have time and keep rotating their patients, making it difficult to provide appropriate care so much of the time.

[@interconnectedlsa3266]

This is so accurate. I read all the consult notes and it’s like a well played ping pong match 😆. Specially the patients that are chronically ill and have every medical condition know to man.

[@mindymorgan8479]

Yes! Spot on. In the hospital currently but most specialties want to "see as outpatient" so annoying since there is no other copay on the procedures while admitted. Like literally most of the patients don't show back up because they can't pay the additional 3k for an outpatient scope! And as a nurse. I love when we consult ID! They are always spot on and their notes are crazy good!

[@fbbWaddell]

When I had viral meningitis and my doc called neurology, he actually gave a diagnosis. But you know, it happens.

[@julieromley]

Haha this is gold. Everyday when I read these MD notes this is in it...

[@trangcao4927]

As a nurse working on general medicine floor, this is 100% accurate 🤣🤣🤣🤣

[@daisycocoa2557]

Wow! You just answered the question as to why they always refuse to send in a consult on my father when he goes into the hospital! Thanks!

[@jrmckim]

As a former RN and patient with chronic illnesses... very accurate!

[@vikk838]

Doc Schmidt your videos ring true when it comes to hospital setting in my country. I guess everywhere it's the same.

[@medic2807]

Infectious disease: No change in current antimicrobial therapy recommended. Unless my patient vacationed on Cameroon recently, I usually just break out the Sanford guide.

[@AD-oy8nm]

Sanford + Uptodate = an infectious disease specialist in the hand lol

[@catlinboy]

'Where's patient from room 2?' 'He went over to surgical.' 'Really?!'

[@JimMorgan]

My wife loved this one. She's a doc and would like to request a tox consult sometime

[@runnerrunner2169]

Legit 100% nailed it. The ID team is where it's at. And the neuro spine debate... yup.

[@folumb]

Corollary: This is what you get when you call any consult on a weekend or after 5pm

[@susanbazinet9664]

I'm laughing so hard!!!!# Dr. Schmidt also has a great voice. Love this guy.

[@patchyxx]

I always know when certain ED docs are in because of the number of consults to my department!!!!

[@sapnam1984]

As a fellow nurse this is exactly what the doctor’s notes say 😂🤣😂🤣

[@RiDawg333]

"Stop checking troponins" is what got me

[@whatausernamethisis8893]

What does that mean?

[@cardiyansane1414]

Hahaha usually the poor nurse and patient are caught in between this mess

[@kathyt2108]

Transcription here. Even I could tell you what their recommendations would be. Spot on about ID though

[@wholeNwon]

I feel very sorry for hospital transcriptionists. I've heard operative procedure dictations that were completely unintelligible. And I knew precisely what they were trying to say. I received a thank-you note from one of them for spelling unusual terms that they were unlikely to have encountered before.

[@daolieu4261]

Seriously… spot on. So true!

[@zanazui]

Documentation Improvement Specialists approve this message.

[@shirleymadden9859]

I love these. So true!

[@DocTami]

As a vascular neurologist, I second that wholeheartedly - but remember, reason our recommendations are useless is coz the question we're asked is often pure BS, something that's not our specialty & often most basic medical knowledge that makes rounding students roll their eyes. Every time a hospitalist sends an "altered mental status" consult for a patient with an acute changed BUN of 80, I have to try REALLY hard not to ask if they bought their MD degree online. What med school on the planet allows their grads to leave school this clueless? I had one call me last night asking what she should do for a pt with headache with SBP 255... I'd love to know what thought process (if any) makes a fully trained medicine MD call the specialist/subspecialist with such confoundingly basic questions.

[@simplystreeptacular]

The thought process is probably lawyers.

[@DocTami]

@@simplystreeptacular I'd buy that IF their question was above and beyond their level of training; for a medicine MD to ask anyone else how to treat symptomatic BP...well, that's exactly what a lawyer would pounce on i.e. why they don't even know their OWN job

[@cameronno6039]

​@DocTami The patient wasn't FMD or RAS with treatment refractory disease, eh?😅 I'm just curious because that is wicked high. Cocaine?

[@midwestgirlinabigcity2550]

I'm a new grad RN and Omg doc, this is sooooo true

[@kathybrady4033]

Agree, ID docs are the smartest; next to pathology 😄

[@kridswonderhowell4541]

ID ..... YUP ..... NAILED THAT ONE TOO..... they'll surely give insight and some useful direction!

[@MD-bf2ce]

Toxic-metabolic encephalopathy is a result of infections, toxins, or organ failure. When the electrolytes, hormones, or other chemicals in the body are off their normal balance, they can impact the brain's function. This can also include the presence of an infection in the body or presence of toxic chemicals. Ya learn something new everyday

[@doc6]

These videos are relatable all over the world

[@robb8234]

hahahahahaahaha, I'm so glad your channel was recommended to me.. love your humour.. thankyou..

[@doubleu1017]

Flomax and outpatient follow up... 🙋🏾‍♀️

[@Judo593]

with a voiding trial

[@katherineg9396]

I LOVE when they say no more trop levels.

[@mybabynicky]

This was very funny and accurate xD

[@drelizaanam]

So true about infectious diseases.

[@wholeNwon]

I always love it when half the staff has touched a skin lesion before ID has consulted!!!!

[@amysenchuk369]

Im a nurse, this is so accurate

[@Masrafi]

annoyingly accurate. maybe it was the culture at my hospital, but i feel like there was no ownership of patients or even a semblance of an attempt to treat or think about things before consulting. any hint of an AKI->nephro c/s who is inevitably going to say IVF, avoid nephrotoxins because its just a mild to moderate AKI w normal lytes. ID consult with no culture results or sensitivities on day 1 of admission is just going to result in agree with empiric coverage. ophtho is never going to do anything ever because the hospital doesnt have any of the specialized equipment or staff needed to diagnose or laser or operate on anyone. and the bumped trops in the guy with florid sepsis or multiorgan failure is always going to be demand ischemia. and if we havent done any sort of workup yet for AMS, guess what neuro is going to say? MRI+/-MRV MRA LP EEG probably toxic met enceph /rant

[@BeLoud13]

Cardiology: STOP CHECKING TROPONINS! HAHA

[@bodyofhope]

Wrong! Neuro would order at least 3 more tests 🙄😂

[@naciamaj]

EEG, CT head lol

[@kimboxdorfer7010]

And the patient gets charged $2500 a pop

[@Meganmama]

The accuracy is painful. Kudos to ID.

[@dominic5065]

This makes me love the fact I'm ID

[@kimmcintyre935]

😁 Your Freaking Funni, Doc Shimit 🧐🤣👍

[@wholeNwon]

As one of those consultants, pretty close to reality.

[@superpramey]

I think consults are often less about opinions and more about cya

[@AnthonyRaynor]

Oh so true, oh so true.

[@critterwatcher8009]

You must be the next generation's Samuel Shem. I see so much "House of God" in these.

[@kbo8029]

Yep... Sounds about right.

[@dr.eseosaighodaromdphd8662]

I love this!

[@gk.8541]

Urology ➡️ Flomax. Yes. Every single time!

[@alona270]

Ahhhh…yes…the Sherlock Holmes of medicine hahahahaha

[@000JayDub]

You forgot nutrition: is he pooping? Ok then let him eat some food. And stop checking residuals.- Sincerely, all RDNs

[@AshLee-tm7fl]

*And stop holding his feeds for 100ml residuals - Another RD

[@voicingsomeopinions7006]

SLP: that's a nutrition question, call nutrition. OR SLP: a thin liquid doesn't stop being a thin liquid if you eat it with a spoon. Thicken the damn soup. OR SLP: no, really, swallowing is in our scope of practice. Please listen to me on this. Disclaimer: I don't work in a hospital setting.

[@HeavyProfessor]

Awesome

[@MaximillianTiberius]

Oh man, you are cracking me up :D

[@h7mody7]

💯% accurate

[@kridswonderhowell4541]

Flomax..... baaaahaaaahaaaa Baaaahaaaahaaaa ..... nailed it

[@SN-hg6bx]

Turfing left and right 🤣😂. ID..ouuuuhhhhh

[@mateo_7641]

They’re forgot ENT, oh never mind outpatient consult

[@catdogmom155]

Spot on

[@MascarasAndMixers]

Haha. GI here. Either scope here or outpatient

[@collinsanderson4970]

Should have ended with: Infectious Disease: "Stop the vancomycin"

[@Lucky-ff9pd]

so so so true

[@FilipeFBarbosa]

Consults are about defensive medicine

[@wholeNwon]

And "defensive medicine" means being certain that all the i's are dotted and all the t's crossed in a case (i.e. nothing has been overlooked by anyone) so that the pt. has had the benefits of the best possible diagnostic and therapeutic efforts. Doing it right and doing it well are the best defenses, if defense is ever needed.

[@elisarose5159]

100% accurate 🤣

[@Tawny593]

Hilariously accurate.

[@ideasmatter4737]

Except GI almost always has to do an EGD for patients in my unit! Why do we get all the bleeders?!

[@wholeNwon]

Why not? Have something better to do?

[@theresetugade5909]

Infectious disease!!! We love them!! Lol

[@blancan918]

Cardio here: I FEEL SEEN

[@checkedoutdoc2750]

so good

[@mckayblazian9224]

Honestly, dead on 😂

[@DomNom69]

Yea ID is the best usually

[@virgomyst9]

Always call ID!!!

[@alvashoemaker8536]

“DOC”, THIS is encouraging to anyone who reads this…??!! 😃🤣😂🩴👣

[@mays_alpha]

Countries Around the World Please don’t forget to research your own resources to help, as well as other countries, and check out other informative and helpful content! For the videos, there are resources in the description as well as in the comments section. Free 🇮🇶 🇾🇪 🇸🇾 🇮🇳 🇨🇴 🇵🇰 (Uighur Flag) Here is a video by Jay Palfrey talking about multiple countries and what’s going on there 🇮🇳🇨🇴 etc.: kzbin.info/www/bejne/qJK4p5SifKl-jMU Here is a resource for the medical crisis in Pakistan 🇵🇰 : indushospital.org.pk/donate/ Here is a specific story about a particular doctor in Pakistan that shows you the horrific state and urgency of the situation: kzbin.info/www/bejne/oWaUnH2elriee5Y (🚨⚠️*WARNING!!!*: there is a graphic photo of multiple pieces of cloth/sponges that were taken out of the patients’ body, they are bloody and all together in one ball) Here is a resource for the humanitarian crisis in Yemen 🇾🇪 : www.islamic-relief.org.uk/yemen-emergency-appeal/ Resource for Syria 🇸🇾 : www.islamic-relief.org/category/appeals/emergencies/syria-crisis-appeal/ Resource for Iraq 🇮🇶 : www.islamic-relief.org/category/appeals/emergencies/iraq-emergency-appeal/ Resource for Rohingya: irusa.org/asia/myanmar/ Resource for Uighur Muslims: www.saveuighur.org/donate/ Resource for Kashmir: www.islamichelp.org.uk/emergencies/kashmir-emergency/ Share The Meal is a great system where the UN donates 3 meals to every child for just 80 cents US. You can donate from wherever, whenever, and there’s an app: sharethemeal.org/en/index.html Freedom Bakeries works hard to free people from hunger, and focuses on places like Pakistan, Gaza, and Yemen: freedombakeries.org May Allah AZW grant help and relief to all these countries and free them from all injustice and corruption, and grant them peace and relief forever, Ameen 🤲🏼✨🌙 دول حول العالم من فضلك لا تنس البحث في الموارد الخاصة بك للمساعدة ، وكذلك البلدان الأخرى ، والاطلاع على محتوى إعلامي ومفيد آخر! لمقاطع الفيديو ، هناك موارد في الوصف وكذلك في قسم التعليقات. مجانًا 🇮🇶 🇾🇪 🇸🇾 🇮🇳 🇨🇴 🇵🇰 (علم الأويغور) إليك مقطع فيديو بواسطة Jay Palfrey يتحدث عن عدة بلدان وماذا يحدث هناك 🇮🇳🇨🇴 إلخ.: ‏ kzbin.info/www/bejne/qJK4p5SifKl-jMU هنا مرجع للأزمة الطبية في باكستان 🇵🇰: ‏ indushospital.org.pk/donate/ إليكم قصة محددة عن طبيب معين في باكستان توضح لك الحالة المروعة وإلحاح الموقف: kzbin.info/www/bejne/oWaUnH2elriee5Y (🚨⚠️ * تحذير !!! *: هناك صورة بيانية لقطع متعددة من القماش / الإسفنج التي تم إخراجها من جسم المريض ، فهي ملطخة بالدماء وجميعها معًا في كرة واحدة) هذا مصدر للأزمة الإنسانية في اليمن 🇾🇪: ‏www.islamic-relief.org.uk/yemen-emergency-appeal/ المورد لسوريا 🇸🇾: ‏ www.islamic-relief.org/category/appeals/emergencies/syria-crisis-appeal/ المورد للعراق 🇮🇶: ‏ www.islamic-relief.org/category/appeals/emergencies/iraq-em Emergency-appeal/ الموارد للروهينغيا: ‏ irusa.org/asia/myanmar/ مورد لمسلمي الأويغور: ‏ www.saveuighur.org/donate/ الموارد لكشمير: ‏ www.islamichelp.org.uk/emergencies/kashmir-emergency/ ‏ Share The Meal هو نظام رائع حيث تتبرع الأمم المتحدة بثلاث وجبات لكل طفل مقابل 80 سنتًا فقط من الولايات المتحدة. يمكنك التبرع من أي مكان وفي أي وقت وهناك تطبيق: ‏ sharethemeal.org/en/index.html تعمل مخابز الحرية جاهدة لتحرير الناس من الجوع ، وتركز على أماكن مثل باكستان وغزة واليمن: ‏ freedombakeries.org وفق الله عز وجل العون والإغاثة لجميع هذه البلدان ، وحررها من كل ظلم وفساد ، وسلمها وعونها إلى الأبد ، آمين 🤲🏼✨🌙 .

[@jrmckim]

That was 1 long comment.

[@amartummapudi6656]

Means Infectious Diseases is the best?😅

[@Nealetony]

Mmmm Flomax for kidney stones sucks when I work 14 hour shifts

[@paty2216]

Genius

[@OrthodogAllen]

this is poggers

[@o.o7120]

🤣 so true

[@goodenurseV]

Gah. Most. Accurate thing. Ever.

[@tanyand]

Bahaha... stop checking trops!

[@MoOutdoorsandReviews]

wont accept this patient until you call several consults, (every internist I have ever talked to)

[@HeavyProfessor]

You forgot rheumatology, they are the best

[@tonyw.3210]

Steroids 😝

[@HeavyProfessor]

@@tonyw.3210 Yes, even in 90 year year old for pseudogout

[@wholeNwon]

"Cannot definitely exclude lupus."