I like the witches who tell people to buy carbon monoxide detectors. One time I told a patient with abusive auditory hallucinations that her nighttime zyprexa was gonna shut the stupid bastard up and she was welcome to ascribe whatever spiritual interpretation she liked to that.

Dude needed to goon.

Pretty sure I'm going to find myself in some kind of mass migration by highway, get identified at a checkpoint as politically unacceptable in some way, then get moved to a large empty sports stadium with about 1-2 hundred other people, then get marched out onto the field and shot. I saw it very vividly in a dream that did not fade after waking up.

The other day a patient came up to the new nurse I'm orienting to awkwardly request "Vaseline and... idk. Something else I guess?" And she, in complete seriousness, asks if he needs toothpaste or deodorant maybe? Meanwhile me and my less new coworker are making prolonged and intense eye contact, each of us daring the other to break first. The patient eventually settles on socks (I would likely have suggested a washcloth or tissues, but I digress), which my oblivious coworker goes and grabs for him. Afterwards, due to both this and some other instances, I was just like. "Girl. Are you ace?" and she was like "omg how can you tell? ...I'm missing subtext again aren't I?" She's not even a new nurse, she's just new to us. It's like she has so low of a drive personally that she can't even register horniness as a possible motivation for other people.

My brain decided to read all of these in Cunk's voice.

Honestly it's probably way closer to the true neolithic diet that humans evolved to eat than scheduled meals are. And you're even describing the right things to eat that way, nuts, berries, a lil jerky. There's a lot of cultural variance too but honestly what our comes down to is that humanity's biggest strength that has allowed us to become as powerful as we are is our fundamental versatility.

Even just in terms of food: koalas can't even recognize the leaves of the one plant they eat their entire lives if they're not on a tree but humans can walk to the other side of the planet and look at a plant or animal and be like "wonder how I'm gonna cook that." That is AMAZING and you're saying you think that's bound by a schedule? You think humans spent time on the migration path going "nah I'm gonna skip that berry cuz it's not lunch yet!"

there's really no "right" way to eat other than daily / weekly balances of carbs / fat / protein / vitamins / minerals / water.

3 square meals is more like a pre-osha workplace safety thing for people doing manual labor since the meals need to be packed into a neat little meal break so they can get back to work, but the calorie requirements are so extreme that they need to get packed in thiiic during that meal break. Basically if you were a self respecting foreman of an old timey construction site you made sure the workers were eating "three square meals a day" to make sure they'd be working at peak productivity.

if you're not building a railroad or stonework or skyscraper or carrying a roof up a ladder then grazing or intermittent fasting are fine as long as you're getting the right balance of micros and macros. and when it comes to weight loss, gain, and maintenance, different people have different relationships with food that are often managed better with one strategy vs another, in ways that vary a lot from person to person.

looooooooong boi

Majestic AF

LLM promoting skills are becoming the new google research skills. My nursing school taught me how to google and look for the CDC page or the drug monograph or the manufacturers YouTube account. Now we're having to learn to ask the llm to fuzzy match the most likely relevant sources and follow the links to fact check from there. Wasteful sure but we're losing google as fast as it came in.

i suspect they are referring to this user having what reddit used to call a "cake day" referring to the anniversary of them making their account. that or theyre trans and just came out (closeted trans ppl are often called eggs) but I think it's the first thing since that profile does have the lil cake today. and idk that it's cringe (another comment) it's probably nice to be that recognizable (although anonymity has benefits).

I'm going to mostly focus on the more legitimate answers since you already seem to know some of this was possibly / probably oversight / neglect and that they should have given you more.

a) the big one is pressure from regulatory agencies to prescribe less narcotics. Some of this is legitimate; a lot of the opiate crisis was started by pharma companies lying about how habit forming their medications are and intentionally encouraging dependency through overprescribing to sell more, but a lot of it is also just straight up puritanical and part of efforts to disrupt minority communities that are more affected by illicit drug use. In the end though, even if they don't share the stigmatizing view of it, there's little individual prescribers can do about it.

b) there's huge pressure in institutional environments to do ANYTHING to prevent falls. In addition to getting stingy with sedatives that might make you dizzy there's also pressure to have 1:1 care where people watch the patient in the bathroom and we used to even restrain old people to keep them from falling (although thank goodness that's finally falling out of favor). To get rid of that we'd have to accept that sometimes people just fall and crack their head open and die and that's life but we're just not there yet as a society. In the US everything needs to be someone's fault and if the doctor prescribes a sedating med and I give it and you fall, it's partially considered my and the doctor's fault. If we do ALL the environmental AND don't give sedating meds, it's considered less our fault.

c) There's legit specific medical reasons sometimes. If you had a bowel obstruction opiates are actually specifically contraindicated since they're the medications MOST likely to cause constipation. Now if surgical intervention was the best option it might make sense to give them anyway, but there may have been some waffling on what the best option was and they couldn't un-give you the meds if the final decision was to have you pass it with medication / enemas instead of surgery. And bowel surgeries have a huuuge possibility of sepsis and having to parts of the bowel removed and having to get regular vitamin shots for the entire rest of your life (once had a bypass patient so iron deficient she stated hallucinating) so that's not a decision to make lightly.

d) insurance in the inpatient environment likely didn't interfere with the medication prescription directly. they probably DID interfere with the surgical decision which may have interfered with the medication decision (see above). but the bigger issue is that insurance agencies in general do something waaay more insidious than just avoiding paying. they create and fill a psychological need to find someone to blame for things. every time something bad happens in the US we immediately try to figure out who to blame so we know who's paying for it. this is your health but also to your house and your car. the insurance is there more than just to pay but also to pay court fees if the blame isn't immediately placeable. if I give you a sedating medication and you fall, the insurance doesn't pay for it they make the hospital pay for it. So as a result the hospital pressures me to not give you that medication so you don't fall and leave them with the bill. to truly be rid of insurance companies in general we would have to fundamentally move away from blame culture. we would have to shift to a mindset of, wow that's horrible but we as other humans are going to take care of you. and like I said, we're just not there yet (but universal healthcare is definitely a step in the right direction; that kind of change can't start with individuals struggling to make rent).