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I have 0 kids and want them to have a good education because I find interacting with stupid people to be exhausting.

There’s been articles written about it actually. Google “health insurance ghost networks” for more info but the short version is that you know how the only utility of a middleman is to provide convenience? They get to keep more money every time you can’t figure out which doctors they actually cover. They actually get MORE money for being WORSE middlemen.

Also executive dysfunction (fancy word for the motivation and planning it takes to do complex tasks like navigating bureaucracy) is a symptom of pretty much every mental illness ever making them the easiest population to collect a premium from then bury in paperwork and by doing so never actually have to pay out for services. When you add in having the government cut a check perr poor person to insurance companies to provide state benefits it basically becomes an infinite money glitch that churns faster the more people you force into poverty.

…I mean I don’t wanna be that guy but… yeah that’s HCA alright. Iirc a while back they acquired a hospital in North Carolina that subsequently unionized in record time in a part of the country that is NOT union friendly, at which point HCA suddenly pulled out and took their funding. Pretty sure it was a critical access hospital too (critical access means the only hospital for miles around, usually rural). HCA is basically synonymous with capitalism in Healthcare. Even personally they once tried to illegally charge me for emergency mental health services. I’d rather quit nursing entirely than ever work for them. They are sooooo sketchy.

The details don’t match exactly but I’m thinking this is what I’m remembering.

Oh and by the way, remember how capping travel nurse wages was a big thing around that time? So typically when nurses strike they give notice then the hospital has to fill those positions, usually with travel nurses from around the country, who they have to pay to travel, get travel accommodations, get local licenses and certifications, get new uniforms, the whole 9 yards. Then their wages are also high for going to all that trouble plus a cut for the travel agency that’s helping to arrange it all. So yes, the hospital is hiring scabs, but one of the things that made that work out alright in the end is that those scabs will bleed the hospital dry pretty quickly. “Capping travel nurse pay” is an anti-union / anti-strike dogwhistle (I think I’m using that term correctly here).

My only question is how to best handle children having sex with each other. Do you ban it / try to prevent it from happening at all? Do you set limits on how different they can be in age? Is there an even younger age when it’s never ok but it’s ok if they’re both older AND of similar enough age? Is age not even the right way to do it and more importantly is there a better way? Should you have to pass a class where you can prove you know how to apply a condom and obtain consent from others??? I don’t have any good answers to any of these questions but I do think they’re important to ask and talk about. The more common discussion I wind up in is juvenile substance abuse (should you let kids do drugs as long as they’re in your house so you can keep them safe? Are kids who are raised where everybody 14ish and older can have a glass of wine at the dinner table more or less likely to develop alcoholism due to the increased daily presence but decreased taboo?) but this discussion reuses a lot of the same concepts.

Well you do gotta give Cesar back what he done minted.

I feel like that would be the depression version of sadness but idk what the equivalent would be for the depressed intensity of happiness. Honestly from going through a thesaurus (a hobby of mine) “complacence” has almost the exact connotation but an imperfect denotation.

Like the others said, it’s the exact right word for that exact level (a state of overall mood intensity that allows for anger, sadness, and happiness, but that doesn’t often go to the extremes of rage, despair, or euphoria) and I couldn’t think of a less clinical term for that exact state.

It’s not forgetting, it’s measuring with your heart.

Well the downside to the “you break [the virginity] you buy it” mindset (aside from the literal objectification) is that having to formally marry the child also means the child is formally married to (and stuck with) the pedo. At least the informal version is probably less legally complicated to flee from.

Relying on emergency services only wastes soooooo much money. Waiting until problems are acute and they HAVE to be treated under EMTALA means doing way more expensive treatments and clogs up emergency services. Not to mention that not vaccinating or treating bacterial infections results in a bunch of cooties getting spread around the community. And when they’re getting those emergency services they can’t pay for them so the cost has to get absorbed into the bills of the patients who can pay either directly or through insurance.

“I don’t wanna pay for other people’s Healthcare!”

You already are, just in the least efficient and most expensive way possible.

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People act like me not getting off the raised republican train until my early 20s is really slow but that’s when as a female child they allowed me to leave the house regularly for things other than school or church.

Eeeeh. I kinda get why it fell out of favor. For context, the weird thing about the nursing perspective vs the MD perspective is that you don’t get as much of the benefit of large studies, but you also aren’t as sensitive to big pharma marketing studies either which… good AND bad. Like for school I had to take a class on evaluating the validity of drug trials and one of the studies mentioned was taking advantage of the fact that there’s basically no equivalent doses between different antipsychotics but you can also look at the doses from an experienced clinician perspective and be like huh they’re saying this drug has less side effects compared to 20mg of Haldol daily, but literally ANYTHING has less side effects than 20mg of Haldol daily; that dose is insane. The nursing perspective also tends to be more sensitive to variations in the needs of local populations, you’ve lived in an area and worked within that specific demographic and environmental setting for a few decades vs the doctors main body of knowledge often even includes studies from across the world. Just giving some background as to the upsides and downsides of my perspective.

So back to my point, I can tell you I associate lithium with being a last resort med for really sick patients who nothing else cuts it for. I associate it with horrible side effects including crazy weight gain and thyroid problems as well as fluid and electrolyte balances, and depakote and tegretol aren’t gonna cause that last one at all and also do have that advantage of blood level monitoring. I don’t see tegretol prescribed as much but depakote is probably what I see as the most prescribed med even before lamictal. Now lamictal I completely understand why I’m not seeing in the inpatient setting; you can’t rapidly titrate without risking the death rash (SJS/TENS), and the objective of inpatient care is always rapid stabilization with tweaking to occur in the community. And also maybe I’m associating lithium with all these horrible side effects because I’m seeing it used for patients suffering from both the direct effects of severe mania, especially those with the cumulative effect of multiple manic episodes over time, as well as all the other horrible things those episodes put them at risk of such as homelessness, substance abuse, and general increased risk of injury and illness due to decreased capacity for self care.

I guess the TLDR is, it wouldn’t shock me if the inability to patent salt was the reason lithium isn’t preferred, but I also associate it with being a pretty old-school heavy hitter like thorazine is for psychosis, and while my perspective has the advantage of being more experiential, that comes at the disadvantage of being less empirical (but its also often difficult to tell how empirical some studies are due to the influence of capitalism on the development of pharmaceuticals).

Yeah the line between adhd and bipolar is thinner than ppl wanna admit. Lemme find The Infographic.

I am absolutely awestruck by the amount of bravery and critical thinking under stress that it must have taken to understand that you needed to sign a DNR for your 7 year old. Most parents in your situation would barely be able to add up 2+2, let alone comprehend enough of what the doctor was saying to make that kind of decision.

I’m also so happy for all of you that you wound up not needing that DNR. I hope she’s adapting well to her life with those limitations, but often children that age have enough neuroplasticity to work it out. She’s also certainly got parents who know how to put their own emotions aside and make sure she gets the care she needs, so under the circumstances she’s got a lot going for her. <3

The nurses and nursing assistants all have to wear trackers that track to see if they go near a hand sanitizer station or sink within 30 seconds after entering and 30 seconds before leaving a room. It’s to check for handwashing compliance but in addition to being a narrow and error-prone window it also doesn’t account for other common situations like poking your head into a room to check on someone while on the way to something else and not touching anything or anyone. It creates a situation where you’re better off just breezing through and ignoring a patient calling to you because if you go over there to acknowledge them but don’t have time to set down whatever you’re in the middle of, it’ll hurt your metrics. They might just need a cup of water you could grab and drop off on your way back in the other direction but fuck 'em, admin says you need to make a whole entry and exit ceremony of asking them what they need to keep your numbers up, so they’ll have to wait until you have time for that.