Yesterday had an infuriating situation where someone who should have known better messaged a patient about their new surprise serious diagnosis when I specifically told them to call. Today found a new breast cancer diagnosis dumped in my inbox as if it were nothing with note “patient unaware.” NOT FOR LONG THEY AREN’T, the results automatically release, what the fuck is wrong with you? If you’re the provider who ordered the test and it’s positive, call the patient and set up the urgent referral, don’t wait THROUGH THE WEEKEND. Jesus Christ.
yeah… my patients who have mychart and are with it find out what they have before i see it in Epic. i’ve had multiple pts in for other things see “concern for malignancy” or “probable metastatic” in their radiology report and ask of they have cancer. and then i have to explain as a nurse i’m not allowed to interpret scans, and its not in our computer yet so the doc doesn’t know yet.
for the love of god, if you order something you think will have bad news in it, check manual release and not immediate release. please.
We literally can’t anymore.
Oh yeah at our place we explicitly asked to set the EHR settings so the doctor can actually review a test result themselves before a test result gets dumped unreviewed into the patient’s inbox….we were told no, because test results MUST be released within 72 hours, even on a weekend or when the doctor is out. We have no control over release time at this institution outside of genetics results. Why? Some fucking MBA-assigned metric, I’m sure
(And before asking “just make sure to look at and respond to every test result in 3 days no matter what” we have over 800 patients each, the spirit is trying but the flesh cannot work 24/7)
In our state I don’t even have 72 hours. It releases to patients immediately. No options. We were told it’s because of a new-ish legal mandate.
In the last month I’ve had three patients find out they had cancer before I did. It’s horrible, and we can’t stop it, and it’s happened because somebody never released a cancer result, I’m sure of it.
I was in the ED this week, and this is the message I received every time a result was released, often before the provider had seen it.
Apparently any sort of delay or hold is considered “blocking” the patient’s access to the health records, and they’ve recently increased fines for hospitals not complying:
Okay I fully recognize that I’m a minority here but I do think this is an important thing to recognize is true of more than zero people you might be working with:
If I found it that my doctor intentionally withheld information about my medical testing results from me until they could first call me on the telephone, when it was mechanically possible to provide that information to me instantly and digitally, I would immediately and completely lose trust in that doctor. I would want to leave and get a different doctor. I would have to try really hard to be a mature grownup member of civilization and not scream at that doctor until my voice gave out.
That information is MINE. You are not my mother. You do not get to decide for me whether I am emotionally prepared to handle it or by what communication method I should receive it. Unless I have specifically requested this service from you (and I’m sure it’s very valuable to the people who want it! I have great respect for the no doubt horribly stressful process of it being your job to have to call people on the phone and gently tell them they have cancer!), you do not have the ethical right to decide I need it anyway.
What I need to emotionally handle alarming medical news is to read it in text, so I can be sure I didn’t hear it wrong, and then be alone for a bit to process it, and then figure out what I want to do given this information, AND THEN, AFTER THAT, to talk to my doctor about what they recommend. If my doctor insisted on hiding the info until she could call me she would be badly hurting me. Please do not try to do this to people without checking whether they want you to.
You are right and you should say it.
If don’t want to get bad news via MyChart, I can just not look, and wait to talk to my doctor.
I can’t do anything much about not being contacted about worrisome results because I don’t know that is what is happening. I think everything is fine because “don’t worry, we only call if something is wrong”. Then weeks later I get my GP asking if the specialist ever followed up with me about the weird thing they found on my CT scan.
I would much rather talk to a person. Unfortunately, I can’t trust that a person will call me.
I really hope this thing in my lung isn’t, like, dangerous. Now I unfortunately cannot trust that if it is, I will be notified.
So I binged the entirety of How To Build a Sex Room last night and this one scene just cracked me up
The designer’s at a western leather/tack store looking for supplies to make a rustic-style sex swing and turns to one of the store employees for advice, which initially goes about as amusingly as you would expect
So then she pulls up some pictures to give him an idea of what she needs
And don’t think your situation is going to be “so sad that it’ll pull on their heartstrings” and make some insurance company do the right thing.
Unfortunately they’ve heard it all before. They’re desensitized and it’s just going to sound like whining. Maybe, just maybe, people in the US shouldn’t NEED to rely on their heartstrings to get medical care.
I would be the worst spy of all time because on one hand I overshare like hell, but on the other hand I also have THE shittiest memory so it’s really a lose/lose scenario for everyone involved.
guy interrogating me: What’s the passcode?
me: Ah fuck. I think it might be 792…..4?
me: Actually no I think it starts with a 2.
me:
me: Yeah I usually just rely on muscle memory for it. Do you think you could get a keypad in here? That might be faster.
guy interrogating me: who do you work for?!
me: Okay, so this is super embarrassing. I know he told me his name when we first met but I forgot and at this point it would be weird if I asked him for his name again, right? So I just kind of go with “sir” whenever I have to talk to him. It might be David though. He looks like a David.
me, after being extracted: bad news guys, I totally blew Dave’s cover.
my boss: Wait, what?
me: Yeah, like they had knives and shit and it was kind of stressful so I just told them that my contact’s name was David Johnson. Really sorry about that.
boss: We don’t have a David Johnson working for us. Are you thinking of James?
me:
me: Good news, guys, I did not blow James’ cover!
Enemy 1: So, how did the interrogation go?
Enemy 2: We got nothing. All they did was ramble on about their childhood trauma for two hours.
Enemy 1: Hmm. maybe lower the dose of the truth serum next time.
To call WT’s actions “antics” would be reducing the severity of what they’re doing to creators. This is unacceptable behavior and it should be all the more reason for creators to start exploring other career paths outside of WT. For years they’ve been meticulously crafting an environment where people believe that WT is the only path to success, where WT controls the degree of success creators can achieve, from the manipulation of the promotional system to the lack of tagging and proper search functions on the app. Now that they’ve boiled the frog to this point, they’re cashing out by flooding the platform with cheap imports, implementing AI tools, and of course, trying to use their contracts as a way to trap creators and keep them from owning their own IP’s and maximizing on their own success.
I said it before and I’ll say it again - Webtoons is planning to go public with their IPO this summer, so it would be a real shame if creators spoke up about the underhanded tactics used by WT to keep them from finding success in their own works. At the very least, it should serve as a reminder to all of us that companies like these can’t amass billions without exploiting people along the way.
We can’t even use “they’re creating jobs for comic creators” as a reason to want to see WT succeed in spite of their flaws anymore because they’re literally ruining people’s careers, cutting them off before they’ve even started. That’s not the platform being “flawed”, that’s the platform and the system it’s built on being broken, full stop.
morally grey/evil scientist characters are always like biochemical engineers or nuclear physicists or whatever but the people want VARIETY give me a story about a fucked up geologist for once
My face is having uncontrollable spasms. Great. It hurts really, really, really bad.
I think part of why I have trouble explaining pain to the doctor is when they ask about the pain scale I always think “Well, if someone threw me down a flight of stairs right now or punched me a few times, it would definitely hurt a lot more” so I end up saying a low number. I was reading an article that said that “10” is the most commonly reported number and that is baffling to me. When I woke up from surgery with an 8" incision in my body and I could hardly even speak, I was in the most horrific pain of my life but I said “6” because I thought “Well, if you hit me in the stomach, it would be worse.”
I searched and searched for the post this graphic was from, and the OP deactivated, but I kept the graphic, because my BFF does the same thing, uses her imagination to come up with the worst pain she can imagine and pegs her “10″ there, and so is like, well, I’m conscious, so this must be a 5, and then the doctors don’t take her seriously. (And she then does things like driving herself to the hospital while in the process of giving birth. Probably should have called an ambulance for that one!)
So I found this and sent it to her. Because this is what they want to know: how badly is this pain affecting you? Not on a scale of “nothing” to “how I’d imagine it’d feel if bears were eating my still-living guts while I was on fire”.
I hate reposting stuff, but I’ll never find that post again and OP is deactivated, so, here’s a repost. I can delete this later, i just wanted to get it to you and I can’t embed images in a chat or an ask.
This is possibly why it took several weeks to diagnose my fractured spine.
Pain Scale transcription:
10 - I am in bed and I can’t move due to my pain. I need someone to take me to the emergency room because of my pain.
9 - My pain is all that I can think about. I can barely move or talk because of my pain.
8 - My pain is so severe that it is difficult to think of anything else. Talking and listening are difficult.
7 - I am in pain all the time. It keeps me from doing most activities.
6 - I think about my pain all of the time. I give up many activities because of my pain.
5 - I think about my pain most of the time. I cannot do some of the activities I need to do each day because of the pain.
4 - I am constantly aware of my pain but can continue most activities.
3 - My pain bothers me but I can ignore it most of the time.
2 - I have a low level of pain. I am aware of my pain only when I pay attention to it.
1 - My pain is hardly noticeable.
0 - I have no pain.
It’s also really important to get this kind of scale to people who have chronic pain, because chronic pain drastically lowers your perception of how “bad” any kind of pain actually is, and yet something like this pain scale is extremely user friendly.
For example, if someone asked me how much pain I’m in at any given time, I’d say hardly any, and yet I’m apparently at a chronic 2.5, and it only goes up from there depending on the day.
1 - Everything is a-okay! There is absolutely nothing wrong. You’re probably cuddling a fluffy kitten right now. Enjoy!
2 - You’re a bit frustrated or disappointed, but you’re easily distracted and cheered up with a little effort.
3 - Things are bothering you, but you’re coping. You might be overtired or hungry. The emotional equivalent of a headache.
MODERATE
4 - Today is a bad day (or a few bad days). You still have the skills to get through it, but be gentle with yourself. Use self-care strategies.
5 - Your mental health is starting to impact on your everyday life. Easy things are becoming difficult. You should talk to your doctor.
6 - You can’t do things the way you usually do them due to your mental health. Impulsive and compulsive thoughts may be hard to cope with.
SEVERE
7 - You’re avoiding things that make you more distressed, but that will make it worse. You should definitely seek help. This is serious.
8 - You can’t hide your struggles any more. You may have issues sleeping, eating, having fun, socialising, and work/study. Your mental health is affecting almost all parts of your life.
9 - You’re at a critical point. You aren’t functioning any more. You need urgent help. You may be a risk to yourself or others if left untreated.
10 - The worst mental and emotional distress possible. You can no longer care for yourself. You can’t imagine things getting any worse. Contact a crisis line immediately.
These are so important! SO SO IMPORTANT SHARE THIS AND SAVE IT TO SHOW YOUR DOCTORS!
This is the first time I’ve seen the fatigue scale, and HOLY MOLY that’s a revelation!!! These should be on all hospital and doctor office walls.
I’ve never seen the mental health one! or the fatigue one! I printed out the pain one and gave it to my GP.
