Same. I know it's an immoral thought, but when you realize that them clogging up the hospital system due to selfish reasons is going to cost the lives of people that genuinely need hospital support (like those with cancer), it doesn't feel exactly immoral.
Right now, junkies are being turned out because critically ill people get first priority in triage. No rehab beds. No psyche beds. Very limited trauma beds. No selective surgery. We do not have either staff or equipment or medications for the overflow. The same jackasses who howl about their "freedoms and rights" are the ones howling about how long its taking to get a bed or medication when they're sick.
Apley found out way too late what a moron he was. We are running out of medication to safely intubate. People have no idea what hell is with a big tube shoved down your throat is like completely conscious. Your hands tied down and restrained so you don't yank it out and rip your airway apart with the balloon that keeps it in place.
Agreed. I went into respiratory distress during a cardiac procedure (it was minor, I was awake) and not being able to breathe was terrifying. As I went unconscious I wasn't expecting to wake up again.
When I did wake up, I was disoriented and didn't know where I was. I couldn't talk because of this large tube in my throat, and immediately discovered my hands were strapped down. That was practically as terrifying.
Yup. It's just like a bladder catheter only bigger in a different place. The throat is highly muscular. You will try to expel something that your body thinks is blocking your airway. That's why people have to be restrained. They frequently try to yank them out.
I think they were asking if your field intubation was a combitube (aka King tube). They're a lot easier to place in the field, sounds like the kind you had.
They are the worst aren't they? I'm in the biggest medical center in the world. It's not a happy place, but it has got to the point that when we get word that someone particularly awful coded and couldn't be revived, we say something like, "Oh no... Anyways."
I freely admit I hate losing patients. I've beat on their chests trying to drag them back. That's one of the reasons this is so damn frustrating. I've had idiots attack me because of diagnosis they would not , did not understand or agree with. It's different with COVID-19. They are actually demanding garbage because a reality show fruitcake told them too.
I don't know if you've spent a lot of time in a trauma center, but after a shit ton of death, everyone starts to look like meat. The human mind has its limits, and you gotta roll out onto some other duty. The problem with covid is, there is no other duty.
I'm a combat medic veteran and medical professional. I've worked with doctors without borders before. I still would but I can't right now. That's why I have a gym in my house. I just got through beating a punching bag senseless after a long day. I can't punch patients. I won't drink myself to death either to deal with the frustration and death either. Idiots who refuse to take it seriously are exactly like drunks who drive or junkies who only thinks of the world revolving around them. They do not give a rat's ass about anyone except themselves. They do not care about the wake of devastation they are leaving behind.
Some people can take it. Most people can't. It is what it is, heh. I've got a bunch of staff that are on a pretty high dose of SSRI's or Benzos and they are still about to break.
Yup. I thought a resident had a piece of tape on his scrub pants. I yanked on it. He had a butterfly IV in his lower leg. So he could keep it open to inject drugs. He would steal narcotics from the nursing home he did staffing in. I had a nurse go batshit while taking care of an aortic balloon pump patient. She simply cracked up with no warning. I bounced my flight surgeon off his feet when he came into the ER with a beer and a 45. He had lost his wife suddenly and he was our only surgeon on call. He could not simply shut off his feelings. None of us can.
I'm not sure how this convo became "staff stealing drugs". I think it might have went off the rails. From my perspective I was talking about the legally prescribed drugs staff are on to deal with mental breaks, and the other guy was talking about dealing with addicts doing crazy stuff to get admitted since the bar for getting admitted is higher now.
Yup. I know. I've busted more than one doctor and nurse who turned into a drunk or junkie. I've known fellow medical professionals who turn their exhaustion on patients. Nurses who kill patients. Intentionally. Doctors who are code junkies. We are human beings. I have family too. Just like cops who see people at their most vulnerable and worst, then have to go home and forget it.
We've got a pretty good protocol for rolling people off services that we know are pretty emotionally damaging to mitigate this. The problem is that we can't really roll people off dealing with covid patients during these surges. It's all hands on deck.
I can see how you thought that was the topic of conversation since the other guy was talking about dealing with drug addicts. The points being made in this thread were about the amount of stress and emotional damage coming in, and SSRIs and Benzos are what staff have been prescribed to treat that emotional damage/mental trauma. I'm not sure why he kept bringing up drug addicts. My best guess is that it's just an additional problem he is dealing with in his hospital. Also a generalization like "Texans are fidiots" is typically the kind of thing a "fidiot" would say.
I understand. I posted about an impossible situation my mother is in. The staff are great. I’m not angry with staff. I’m angry with the government who demand our taxes but offer no protection from a real threat. Silly wars intervening in other nations demanding they treat their people better when we cannot take care our own.
I wish those who think this is a joke would suit up in full PPE for an hour. It’s hot. Sweaty. Cumbersome. Pretty awful. Turning patients. Running from one catastrophe to another for 10+ hours a day with no end in sight.
Yup, those that remain are at the end of their rope, barely hanging on, and this happens. You either laugh about it and become cynical, or you implode.
I hope you're doing better now. We've had an increase in gunshot victims in my area. We are having to leave them outside because our bays are crammed with people. We've had trauma victims of wrecks that had to wait because people have been fighting with us to get in because they got COVID-19. It doesn't matter if someone else is sick or dying, these people howl, I come first. In essence that's what they're saying because they refuse to take it seriously and work together to fight it. I understand people being afraid because they cannot breathe. I understand wanting to get your kids taken care of. Of getting your elderly parents seen if they can't breathe or are having a stroke. Unfortunately, we only have so much staffing, equipment, medication and beds.
Oh boy. You want people to use a glossary of acronyms you find easier to deal with. Addicts are junkies. Nothing changes that fact. Junkies are people who are seeking to escape pain or reality. For whatever reason. Physical, emotional, just wanna live in altered state of mind. Simply changing the acronym does not and never will change the fact. BTW. I sincerely hope you have found peace and an answer for your problem. Whatever caused it too
even in the retraction he is bullshitting about the 28k was slightly off and he is making it seem like it was the 3 day total when the 3 day total was 56K
ROTFLMAO. You must be joking. Junkies are not a HIGHLY CONTAGIOUS virus. Although unfortunately, they can transmit them. Usually by blood and fluids transmitted sexually. Not airborne.
Well, that's an age old question in ethics and morality. The trolly problem. One answer/justification is "whichever solution saves more lives", but ultimately the decision costs lives as well. It's not a decision I would make in a slapdash way. I'd at least warn people it was coming and give them a chance to reconsider.
Correct, but my addendum is to just tell the people saying it's a hoax. "You are free to believe that, but if you remain on these tracks, we are going run you over with that train you can see heading your way at about 120mph. Good luck."
It's more like there are people who have tied themselves firmly to the tracks and also to people who do believe in the train and want to get off, but they cannot because they are tied to the train-deniers.
If we could build train wheels that skip over believers and kill only deniers, then I wouldn't even touch the train's brakes, but we can't do that.
Yeah, but that is essentially the problem. Your first thought is, "Why are they on the tracks, why don't they just move, what the hell?" and your ethics prof just says, "they are there and won't move". Thus you could apply any narrative to them that you like to justify when they won't move and technically the one you described would fit the bill.
Except in this case you have one track where people fell on the track and thr other where people purposely jumped on the track saying "there is no trolly". I think if you have to pick a track, this one is rather easy.
Isn't that the trolly problem in a nutshell. When presented, the people are usually stupidly on the tracks and could easily move or just not fucking be on the train tracks. No one seems to point this out.
Most formulations of the trolley problem include some excuse for the people to be on the track. My teachers talked about an evil villain, or some vague, undefined confluence of circumstances. The point of the thought experiment isn't to nitpick details like that, it's to examine what sort of actions you would be okay with morally, and whether you have a consistent justification across formulations. You seem to have missed the point.
I've always either heard the "tied to the tracks" version or the "railroad work crew" version, I dunno what this "vague, undefined confluence of circumstances" version is but it sounds really existential.
"Due to a concatenation of events, six humans' lives have lead up to a moment in which they all find themselves on the tracks ahead of an out of control trolley. Whether or not you pull the lever to switch the track the trolley goes down, can any of us be truly said to have any actual control over the outcome of our existence?"
I think if you have to pick and choose who lives, which we do here, then the lives of the people choosing to endanger everyone else out of selfishness and negligence are worth less than everyone else.
Maybe. We are also throwing up covid tents, so we might not have to actually "choose" between who lives and dies. Instead we choose between who goes in the tents and who gets to go inside, heh
It's not immoral. Option 1) Deny healthcare to anti-vaxers: only they die. Option 2) Let them have healthcare: they kill potentially themselves and others who can't get care. More people die with option 2.
I get what you are saying, but in an ethics class you'd have the counterargument of choosing who lives and dies as being its own moral issue, and by letting the selfish simply choose to take up bed space and thus kill others, it is they who were free to make the immoral choice, so you didn't have to. Morality is a moving target. In our righteous anger we think, "fuck these selfish and evil creatures." I get it, I think it too. But then we stop and think, "What's to stop someone else from deciding something I'm doing is selfish and evil and they should get to kill me? Sure their opinion is wrong, but I opened the door to make it okay for a person to decide if I get to live just based on their moral judgement of my choices." Sucks. It's the same issue with how our gov got rid of small pox and polio. People leigt fought against it to. The gov went full authoritarian and said, "fuck you, you are getting the shots" which worked out, but there is nothing that could stop them from being authoritarian and doing something evil with that power. It's a rock and a hard place without some benevolent immortal king saying, "fuck it, I'm just going to make all the moral choices from now on."
It's the same issue with how our gov got rid of small pox and polio.
Except the US government has actually hindered the getting rid of polio. It's because of the actions of a US government agency (the CIA) that polio still hasn't been eradicated from the world:
I think it's important to note that I'm not disagreeing with you on what feels right / righteously justified. It's the ramifications of giving in to that feeling and where it might lead us. Essentially it would end up being one of those things were some rouge staff would have to do it "for the greater good" then all go to prison for it, so no one else got the bright idea to do something similar from their fucked up perspective.
Not really. Slippery slope goes to an absurd place. This is basic hypocrisy avoidance at worst, and common law at best. If you make it legal to do something the same exact action (but for different reasons) is also legal. This is something you must consider. Slippery slope is like when someone says, "If we let gay people get married then people will start marrying dogs!" Clearly you can see the difference between that and "If we make it okay to let people die because we find their choice reprehensible, then other people can let others die because they find their choice reprehensible,"
People do this all the time. In times of war, generals will order platoons or companies to certain death, in order to fake out the enemy and attack them from a different angle.
You are playing sophist games.
And who gives a f about ethics classes. They are so far removed from reality, it's not even funny.
there is nothing that could stop them from being authoritarian and doing something evil with that power.
Yes, the tired slippery slope argument. It's always trotted out. The government is a representative government where we elect officials to work on our behalf. We are the board of directors, the politicians are our employees.
Yes, someone can always take over and become a dictator, as Donald Trump tried to do with his demagoguery, and probably came so close to doing so.
But that would happen despite the vaccines. Because that is his personality, and that is the personality of those who elected him. So, yes, things can always go sideways, but that has nothing to do with what you are talking about.;
Yes, occasionally someone does have to make the tough decisions.
Most people would say that if someone breaks into your home, they have a gun or cattle prod and intend to do you and your family harm, you have the right to shoot and kill them.
But, I can see that you would trot out your slipper slope arguments even with something like this.
My mom is vaccinated. She doesn’t (well idk about now) have COVID but had a stroke two nights ago. I live in another state. I’m the eldest and the therefore saddled with responsibility for my parents. I headed to the airport to jump on a flight 2hr 10min flight away.
I had to board a flight jam packed with people who did not need to travel. I had a N95 (fitted)and a shield on. It was infuriating. Then I finally see her and head to her place to sleep after seeing her in the hospital and whatnot.
I kid you not that my mom called me this morning even though she cannot see well (the stroke affected her vision) telling me staff was donning and doffing infectious disease PPE outside of her room. They kept leaving her door open as well. She asked if COVID patients were on the floor. This is the Neuro ICU. Shifty eyes. Nurse told her she couldn’t disclose others diagnosis’s. Wtf? I’m so angry.
My mom is hooked up vital medications and is still under observation. I’m sick. Sick to my stomach. I performed her hygiene care (demoralizing as I am her daughter)and brought her an actual medical N95 and sanitizer. I even brought my own rapid COVID test (I know they are unreliable and must be verified with a PCR) expecting some kind of check? Some kind of rules? Nothing but hygiene theater that clocks out and leaves the entry to the hospital unmanned.
This is in a major city in the United States. Im disgusted. I feel betrayed by my country. Bonus: I saw children arriving to emergency in poor shape. Extra bonus: I was asked if I was there visiting someone on comfort care. FYI comfort care is not always end of life care but it is more often than not. Again, wth?
I’m upset. I think I have a right to be upset. I need to get my mother out and transferred where? Another hospital with more of the same? How can you ethically put COVID positive patients on a neuro ward with medically fragile patients. It’s wrong.
Yup, it's a shit show. We have "covid positive" people presenting with neuro problems too. It sucks, but what choice do we have. "Sorry bro, you have covid, so you're just gonna have to walk that aneurysm off."
I hear your point and agree with the thought emotionally. I just try to hold back that part of myself that wants to go all "vengeance on those that hurt society" since in my own mind I am determining what is "right" and in their own fucked up heads they are as well. If I give in to that emotion then I can't fault them for doing the same. Basically, if I don't want to be a hypocrite when I call them out for "taking matters into their own hands" I need to make sure I don't justify doing the same.
Not really. I work in the largest medical center in the world. We are rolling mandates across the whole system, but we didn't just flip the switch all willy nilly. We did incentives first to increase compliance, and kept increasing it until it was just a handful of people that wouldn't vaccinate. Then we mandated, and even more people complied. We've had to let go VERY few people. That said, we do have a mixed bag happening right now with shortage. We have a lot of people that are out taking care of family members that have some sort of chronic or terminal illness that can't go to a hospital. We have a lot of staff that are traumatized from the last two waves and have just said, "I can't" and have filed for FMLA and are on mental leave. We also have people that tried to just deal with it, but were met with a ton of people just being assholes about it, and they said, "I can't not help these people and let them die for their selfish behavior, but what I can do is just fucking not work anymore. I'll be back when it's over." We've got a nice new batch of fresh outta schoolies that are just trying to figure it out, and quite a mess of travel nurses. That's the picture though. I get crazy/stupid people want to drive some narrative that mandates are causing the shortage, but you'd have to be a pretty stupid to make a comment like that and not actually work in the system.
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