#Fellowship in Critical Care

[fellowshipprograms]

A Fellowship in Critical Care Medicine is an intensive and comprehensive training program designed to prepare physicians to handle the high-stakes and complex environment of ICUs. It provides advanced training to physicians, typically spanning 1 year, to develop expertise in diagnosing and treating life-threatening conditions.

[cerificatecoursegma]

The curriculum of a Fellowship in Critical Care Medicine is meticulously crafted to offer a holistic understanding of critical care principles and practices.

[medvantagesolution]

Optimizing Critical Care: A Comprehensive Guide to Enhancing the Assessment for Standard ICU Patients

Fellowship in Critical Care is one of the most important courses in India as it teaches about the general flow of assessment for a standard ICU patient who is intubated with an arterial line and is on multiple drugs. In a clinical setting your assessments need to be based on the patient’s presenting problem and current condition. So first we introduce ourselves to the patient and if present the family as well. Then slowly and steadily start to explain what you are going to do; this should be done regardless of the patient’s level of consciousness. As with any initial interaction with a patient, ensure that you are following correct infection prevention and control policies with hand hygiene and appropriate personal protection equipment. Even during a potential short interaction, you will need to collect important information about your patient like is he/she awake and alert, does the patient focus on you when you introduce yourself, does the family appear stressed.

Fellowship Course in Critical Care Medicine guides you on how to do the basic neurological assessment of a patient that starts with consists of four components, level of consciousness, pupils, vital signs including pain and motor strength. These will be demonstrated for both the responsive and non-responsive patient. Its important to remember that the goal with the neurological assessment is to get the best possible response, which means whenever possible you should remove or reduce sedation prior to assessment. Relying solely on blood pressure or cardiac output to determine adequate circulation can lead to erroneous conclusions. General techniques to assess peripheral perfusion include as with pitot pulses capillary refill and edema and inspection where we look for modeling evidence of bleeding and cyanosis.

Fellowship in Critical care in India teaches the most effective and common techniques used for pulmonary physical assessment are inspection and auscultation. For inspection observe the general appearance and the state of the patient including color such as cyanosis, modelling, pallor, rate rhythm and pattern of breathing, symmetry of chest expansion and the shape of the chest. Thus, inspection should include state of nutrition, symmetry, and posture. Wasting and hallmarks of poor nutrition may indicate chronic disease, poor grooming or slack posture may suggest depression or low self-esteem. Then proceed to more specific examination of the skin, looking for redness or other signs of infection, hair loss, nail thickening, and moles or other areas of pigmentation and inquiries about any recent changes in skin lesions that could indicate early cancer. Inspection also should encompass, in particular, areas that the patient normally would not be able to see, such as the scalp, the back, and the buttocks. The nails and the skin are particularly important in making a diagnosis. Examination of the nails can provide important clues about systemic disease. Clubbing of the nails (broadening of the nailbeds, with curved and shiny nails) may indicate congenital heart disease, chronic obstructive pulmonary disease, bronchogenic carcinoma, or another cardiac or pulmonary condition. Pitting of the nails occurs in about 50 percent of patients with psoriasis. The skin should always be inspected for cancer, though it is sometimes difficult to differentiate a benign mole (nevus) from a cancer. That’s why doing a fellowship course in Critical Care by MedVantage is an essential need for every healthcare professional.

[doctorspork]

You're the dumpster fire extinguisher. Good luck.

my boss, when I said work was a dumpster fire today

[doctorweebmd]

am i an insane person for planning to apply for another fellowship next year 

[ramp-it-up]

Sugar, Cubed

Photo found on Pinterest

Summary: I revisited Sugar and the boys from the Sugar is Sweet séries, and let me tell you. Bucky and Steve sure have grown up from their college days. They are no longer playing around. And they are coming for you. How do you choose? And do you have to?

Word Count: 3.5K

Pairings: Steve Rogers x Reader; Bucky Barnes x Reader; boss Tony Stark x reader

Warnings: 18+ Only, Minors DNI. Not Beta’d. Read at your own risk. Roommate/Co-worker au, S MUT! Angst, little bit of slow burn. Main character injury, allusions to sex, sexual tension, indecent proposal, caught between two lovers trope, idiots in love, Tony being Tony, truth or dare, talk of voyeruism, possibility of group sex, eventual polyandry.

A/N: This is related to the Sugar is Sweet au, but can be read alone. This is part one, part two will be posted next week. I hope you like it. This is part of Falloween 2024.

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——

You met the two most hated men in your life while you were living together as recipients of the prestigious Stark STEM Fellowship at NYU.

There was an instant spark when you met James Buchanan Barnes and Steven Grant Rogers, best friends from childhood. They sarcastically named you Sugar because of your initial rudeness, but the nickname just stuck around after you warmed up to them.

In the Stark Fellows program, life was hard work and hard play. Soon it was down to just you, Bucky and Steve, and life was a dream with parties, booze, and almost anything you wanted, as long as you lent your minds to the work.

Tony Stark tolerated anything that would keep productivity high. He knew that all work and no play would make Bucky, Sugar and Steve dull scientists.

So he encouraged you three to play. And funded it too.

Steve and Bucky were so protective of you, their sweet Sugar. The sexual tension that came with living with them was heady stuff.

You basked in the glow of Bucky and Steve's attention, while observant of the lines of partners at their bedroom doors and the competitiveness between the football quarterback and lacrosse captain.

You swore that neither Bucky nor Steve would ever win you, no matter the plays they made. But they each had you sprung in different ways. And they were so damn competitive.

They both wanted your heart.

It was only a matter of time before you gave it to each of them.

You fell hard for Bucky first. And it was urgent and intense.

But after just a year together, Bucky accepted a position with Stark Labs in Bucharest for a term that stretched into two years as he completed grad school at Politehnica. It happened without warning. You were angry at his choice and trapped in New York by your own contract with Stark for graduate work. 

You and Bucky were over. And you were heartbroken.

Steve’s waiting arms were open, and it was effortless and freeing to realize that the golden boy was the one who truly loved you. And he’d always been there. Your heart healed. You thought.

According to social media, Bucky seemed to love his new location, extending his contract beyond the initial year-long contract to finish his degree. It seemed that all he did was work.

Not that you were stalking his IG or anything.

He didn’t communicate with you directly, and with Steve only intermittently. It was like he’d erased his best friend and his best girl from his life. 

It made sense, since his best girl was now his best friend’s girl.

Then, during his second year, Bucky's stay in Romania was cut short,  he came back to New York, although not in the way you imagined.

Bucky had been critically injured; losing a limb. Tony made sure he had the best care, flying with Bucky to Wakanda for experimental surgery and overseeing his recovery. 

You found out via a social media after Bucky was back in town, and not from Tony or anyone else.

You were livid.

You raged at Steve, who had lied to you that he had to go to London for two weeks for work when he was actually in Wakanda at Bucky’s bedside.

The betrayal ran deep.

You and Steve were done after that, although you continued to work side by side at the labs. You felt as if Tony was trying to drive you over the edge, having you work around the clock with your ex. But he didn’t care. He had some insane theory that the tension would yield better results.

Each day, you longed for the hour that you could go to your posh new quarters in Stark tower. Although it was lonely, at least your apartment was private, and you could unwind in peace. Your days were tense, but predictable.

Until they weren’t anymore.

——

One afternoon, the hairs on the back of your neck stood up as you stared into the monitor to watch the results from the latest compound analysis roll numbers across your workstation.

“Hey there, Sugar.”

You froze, looking up and out over Manhattan through the window above your station. You couldn’t believe it, but you saw a pale reflection of him in the mirrored glass.

You slowly turned around.

Bucky looked good, his pale complexion not all the result of the blue gray skies over the Hudson. His face had grown more angular, his hair was shorter, and his eyes seemed older, but outside, he was the same Bucky. 

You didn’t know what you were expecting. 

Bucky Barnes seemed whole, except his left hand, the “golden arm” that was the pride of Bobcat football, was now black and gold metal. 

Vibranium. 

You stared at it as it reached for you.

“So I don’t get a hug?” 

Your eyes moved to his face while Steve cleared his throat and reminded you that he was there. You tried to forget his existence most days, but Bucky walking into your lab had erased him from your mind completely. For a moment.

“Sugar–”

You cut him off.

“Fuck you, Grant.” 

You looked back at Bucky with tears in your eyes.

“And fuck you, James.”

Despite your epithets, you threw yourself into his arms, sobbing with emotion.

“How could you…?”

You whispered it into his suit coat, your fingers digging into the material at his back as you cried into his shoulder. Bucky held you tight against him, and he felt harder, more solid. 

You realized that under all of the anger and hurt, you were mainly just relieved that he was alive.

Over two years of anxiety and unprocessed feelings were coming out, and Bucky rocked you as your body heaved. Steve came up behind you and hugged you both.

For a minute you relished the feeling, being held by the only two men that you ever had feelings for. You felt safe. But then you remembered the secrets and the lies, and anger flooded you again. You twisted out of their grasp.

“Don’t get any ideas, assholes.”

You moved away from them and wrapped your arms around yourself, suddenly cold.

“Do you know how worried I was? No one gave me any information. At all. I had to find out from social media. I felt like a fool, Bucky.”

You scowled at him.

“And you. You knew that, Cap. And you lied to my fucking face.”

You glared at Steve.

You looked from Steve to Bucky, who shared a guilty glance with each other. 

“That’s my fault, Sugar. I– I made Tony and Steve swear not to tell you.”

Your dark haired ex boyfriend looked at his shoes as he rubbed the back of his neck with his new hand. He held it up and looked at it and then at you.

“Didn’t know how you would feel about this.”

You ignored the uncertainty and hurt in his eyes.

"What do you want? A cookie? A pat on the head?  A tear? You are not going to make me feel sorry for you. Not when you let everyone else but me in on your secret."

You cocked your head and gazed curiously at the new appendage, then back at him.

“Bucky, I am stronger than you think. And I loved you.”

Both Steve and Bucky winced at the word ‘loved,’ but both for different reasons.

“I would have accepted you anyway you came. And I would have been by your side while you recovered. But you didn’t want that. But it looks as if you’re fine.” 

Steve sat back down at his workstation, resigned. You shook your head at him. If it wouldn’t have cost you a million dollars, which you didn’t have, you would have walked out of Stark Industries and moved across the world. But you had work to do.

“You’re interrupting our work here. You need to leave.”

You wanted him away from you like fire.

“That’s what I’m tryna tell you, Doll.” 

Bucky strolled over to the locker area and took off his coat, grabbing goggles and a lab coat.

“I’m reporting for duty. Tony assigned me back to the New York lab.”

—-

Tony leaned against the bar in his office, after he downed the drink that he’d offered you and that you’d refused. It was only 10:46 am. You were trying to hand in your resignation. Or at least ask for a transfer to a new location.

“And just where do you think you’re going to go, Sugar?”

You glared at your boss. Bolstered by anger, this was the least intimidated, and most angry, you’d ever been at him.

“Paris, maybe? Tokyo? Hell, even Des Moines. I’ll take anything. I need space.”

Tony shook his head. 

“I need you here. The productivity with Barnes back is about to be through the roof.”

You just stared at him incredulously.

“You’re not thinking with your brain. Your heart and what is pounding between your legs are in the way.” 

Your mouth dropped open.

“...But the tension between you Barnes and Rogers will make me a lot of money. I’ve studied you since your freshman year. I know what makes you tick, what motivates you to do your best work. And the numbers don’t lie. Being right in the middle of Bucky and Cap makes lots of money for Stark Industries.”

You stared out at the view of New Jersey, outraged.

“Besides. I have the exclusive contract over your mind, body, and soul for the next seven years. Might as well make the most of it.”

You sighed and took the drink Tony offered you this time.

—-

Bucky Barnes was the most infuriating man you’d ever met, second only to Steve Rogers.

Your brain was scrambled when you weren’t working, so you worked that much harder to stay in control. You hated when Tony was right.

Here you were, flanked by two gorgeous men whose work clothes only accentuated their powerful bodies. Bodies that you knew very well. Your tongue had traced every plane of each of them. Your hands explored their broad shoulders and taught, muscular frames. Your fists had clenched their throbbing cocks and you had accepted them inside you. 

No matter how mad you were at them, you couldn’t get them out of your mind.

Imagining Bucky crashing his lips to yours as he backed you up against a wall made your core throb. And dreaming about Steve’s hands around your thighs as he lifted you onto a lab table made your nipples tingle.

Working in between them in the lab was torture for your neglected body and soul. You were doomed to work in  between the two men who’d fucked you most thoroughly and recently.

You didn’t even want to think about your heart.

You ignored the lingering looks in their blue eyes, the way they gentled their voices when they spoke to you, and the way they tried to come in contact with you for no reason. The number of times fingers lingered over passed specimens, the way space became so tight that they had to squeeze behind you in the lab, and the uncomfortable number of times you ended up between them in the equipment closet made you lose your breath.

Steve and Bucky never pressed you for anything, and all you had to say was ‘excuse me,’ for them to move out of your way, but it was untenable. You would give neither of them the satisfaction of getting upset. You managed made it through work and home to your brand new vibrator every night after long days of fighting their pheromones in the lab.

After a week of forced proximity, you were experiencing the forced Stark Industries Happy Hour. As you waited for your drink at the bar, you thought it strange that Tony had never made them mandatory before Bucky came back. That was quite the coincidence.

You wanted to pace yourself with your drinking as you realized that you had to stay there for another couple of hours to get the bonus that came with attendance. The word ‘happy’ and the names Bucky Barnes or Steve Rogers did not go together, so you participated in each round to numb the desire that was plaguing you. 

For someone so smart. You were so clueless sometimes.

—-

As you rode the elevator in Stark Tower to your apartment later that evening, it seemed as if the elevator was moving extra slowly. You didn’t know if it was the tequila affecting your senses, or an actual malfunction, so you asked FRIDAY for analytics, but for some reason, she said you didn’t have clearance for the answer.

You were mad and mute for a minute, trying to clear your head for the security code. It was then that one of your fellow passengers, who you were trying to ignore, broke the silence.

“Okay Sugar, truth, or dare?”

You looked at him as Steve watched you both. 

“I said, truth, or dare.”

“Truth is Bucky, we’re not kids anymore.”

“So you pick truth. You don’t get to pick the question, though.”

Bucky ignored your ire.

“Which one of our cocks is better, mine or Steve’s?”

Your eyes widened and you gasped as Steve interjected,

“Buck…”

“What, Punk? Remember she rated them before she experienced them. Did that hold out? Or did she tell you that you were the 9.9 too?”

Steve rolled his eyes and went back to watching the floor count, mouth set in a thin line. You had not, in fact, told Steve that he was the 9.9. 

“Stop being a little shit, James.” 

You were rocked, memories flooding back, dysregulating your nervous system even more.

“So you’re saying you won't answer the truth?”

You crossed your arms and legs as you leaned back against the elevator wall. You looked up at the floor indicator lights, trying to stop the emotions from getting to you.

“You can pass. Or you can take a dare, Sugar.”

You huffed, fighting the urge to just say pass. Some lingering adolescent urge refused to let you.

“This is so fucking ridiculous.”

You spoke it outwardly, but you were talking to yourself, to your riotous body, which was reacting to these two men in this enclosed space in the most alarming way.

Bucky was watching you intently, but Steve hadn’t turned around, just replied in that voice of his.

“Those are the rules, Sugar. You should probably answer the question or take the dare.”

You closed your eyes and took a deep breath when you realized what this was. You were dealing with male egos and competitiveness. And they wanted to know the answer, hear you talk about their cocks when for some reason the agave gods were making you horny.

You had to get out of there. 

“You’re not making stupid bets and putting notches in the bedposts any longer. Bucky, we were together, and then you left. I thought it was something that it was not. Then Steve and I got together. I loved you both and in return, you both played me. You both won.” 

Steve turned around and faced you as Bucky advanced closer. He licked his lips and you wanted, no you needed, to run.

“You think I didn’t love you, Sugar? Shit, I worshiped you.”

The sensation of Bucky’s firm body crowding you in bed, taking up the mattress, leg wedged between your thighs while he delivered hot kisses and a slow grind against your clit came out of nowhere. You missed it. You wanted it again. But you lifted your chin as you straightened your spine, determined to resist him.

“You left me.”

“Stark made me!”

Bucky’s blue eyes were wide with emotion.

“‘S’okay Buck. She doesn’t believe I loved her either. Even though I always have. And I caught her when you were gone.”

You looked up at Steve and saw the hurt, and you were preparing not to care, but the feeling of Steve naked against your back, his hands roaming all over you, whispering assurances and praise as he rocked inside and made you come apart in his grip almost made your knees buckle.

You had to move, so you pushed at the rock hard wall of them and they let you move them to get to the elevator controls.

“Why. Won’t. This. Thing. Move!?!?”

You pushed too many buttons at once as Steve and Bucky tried to stop you. The only thing that stopped was the slow progress of the elevator. The small room jolted to a halt, and you stumbled, right into Bucky and Steve’s arms as everything went dark.

“Well now, Sugar. You should have just taken the dare.”

Bucky’s sass enraged you and you cursed and batted their hands away from you as you reached for your purse to find your phone.

—-

A half an hour later, you were all sitting on the floor, Bucky’s jacket beneath you and Steve’s jacket around your arms because the climate control was off. There was no telling how long it would be before someone would find you.

There had been silence since you realized you had not cell phone signal and cursed for 3 minutes straight. You were more than sober now.

God, you wished you were drunk.

“Answer the question. Or take the dare, Sugar.”

This time it was Steve.

“Your fucking competitiveness is so annoying, you know that? Can you two accomplish anything on your own, just for your own pride? Or altruism? Or shits and giggles?”

You could feel their eyes on you in the dark. You fought against them in the darkness, or you were just fighting the darkness, because the lack of sight was enhancing your other senses, and lord you didn’t really want to feel those right now.

“Truth. Or Dare?”

Bucky’s velvet voice was undeterred. You shook your head at it.

“Fine. If it will get you to leave me alone. Dare.”

“I dare you to give up control.”

The response was immediate, as if he were waiting for you to say that.

You groaned, a sound that sounded to sensual, even to your own ears. You were going for annoyed.

“Bucky, it’s late. I’m tired. I’m stuck in an elevator with my two exes. This is a nightmare. And you’re daring me to give up a concept?”

He chuckled.

“Not the concept of control. I think you know exactly what I mean. Give me control. One long weekend. It will be just like when we were roommates. But without the endless teasing and blue balls. This time you give us both that we deserve.”

“What the hell are you talking about, Bucky?”

Your head turned toward Steve, whose voice was on edge.

“I get to watch. You and Sugar, Steve. And direct. And participate…and we find out who is the best…”

“Hold on…”

You could feel Steve shifting in his position on the floor.

“Are you talking about….? Watching me and Sugar… what–?”

“Really Bucky? Do you have a metal brain as well?”

You wanted to fight, but them touching you was out of the question. Bucky was pure chaos.

“If we do this, what would that accomplish?”

“The fuck are you entertaining this nonsense for, Steve? Who the fuck–”

Bucky interrupted your rant.

“Well, you’ve entertained both of us, Sugar, haven’t you? Teased us. Toyed with us. Played us against the other. Wore our clothes and nothing else, slept between us in our bed. Teased us with that body well before we could really do anything about it.”

You dropped your head in your hands, exhausted, as Bucky continued.

“And then, when you finally granted us between your legs, one by one, there was always this spector hanging over the bed, or the floor, or the counter, or the lawn that we fucked on, wasn’t there?”

Bucky paused and you heard the bitterness in his voice. 

“The other one of us was always in the closet or the bushes, or in your head, weren’t we?”

"Don't blame me for your twisted predilections, Bucky."

“What about your predilections, Sugar? You’ve played us against each other long enough. Don’t forget. We both know what gets you off.”

Bucky’s voice wrapped around you in the dark, and you wanted to climb on and ride it as your clit began to pulse. You cursed your body’s reaction to him.

“We know what gets you off hard. Steve told me everything. And it was the same as with me. Your fantasies, Sugar…”

Steve spoke up.

“Bucky, this is uncalled for…”.

"Stop being such a boy scout."

“We know you, Sugar. What we don’t know is who you like the best. We deserve to know.”

“Bucky…”

“It would give us all closure, Steve.”

“You’re crazy, Bucky.”

“Put up or shut up, Sugar.”

Suddenly the lights came back on and you scrambled to stand up as the elevator started again, this time moving at normal speed. You looked between one man who was flushed red and the other who had a smirk on his face.

The elevator stopped and the doors opened, as you bolted out, you replied to Bucky.

“Why don’t you just fuck each other? That will kill two birds with one stone.”

——

Next part: Simple Sugar

Let me know if you like it! 😊

[callsign-dexter]

Big Brother to the Rescue

Summary: You, Y/N Rhodes, get really sick during the night and have to be taken to the hospital. You're dad is not around and Claire is out of town so you turn to the only person you trust, your big brother, Connor Rhodes.

Pairings: Connor Rhodes x Sister!Reader

Warnings: angst, fluff, cussing, inaccurate medical talk, fever, vomit, hospitals

Masterlist

You loved your brother, Connor Rhodes, to death and he loved you the same, maybe even more. You love your sister, Claire Rhodes, too but not as much as you loved Connor. They practically raised you. Your living situation was not good. Your father, Cornelius Rhodes, was a massive jerk and your mother passed away when you were young. You looked up to Clarie as a mother figure and Connor as a father figure. Connor was only 16 when you were born and he instantly fell in love with you and was proud to be the big brother and jumped at every chance to help out with you. He was the best big brother you could ask for. Clarie was the best sister you could ask for too but it wasn't a bond like you and Connor had. 

Growing up was not the most pleasant and it turned worse when your mother passed. When Connor turned 18, he tried so hard to get custody over you but it was quickly shot down even though he had a steady income and home but your dad was so powerful that he made it not happen. It also didn't help that Connor was going to medical school and wasn't home a lot but it could've worked, you still visited him often and had a lot of sleepovers with him plus it was a place for you to escape from your dad.  When your guys’ dad started to criticize him for his medical school he had enough and moved to a different state but that didn't stop you from contacting him all the time and taking trips, when you were allowed, down to see him in Guadalajara, Mexico. It broke your heart that he moved but your bond never weakened and when he spent his residency in Riyadh, Saudi Arabia, you weren't allowed to visit him but video calling was a daily routine. He hated that he couldn't bring you with him but he didn't have custody and it would be too much hassle to get you over to Saudi Arabia whereas Mexico was a little easier.  

—------

When Connor finally came back to Chicago, you were 12, you were ecstatic you finally had your father figure back. You caught him up on everything and while he was away. Claire resented him for leaving but she could never be mad at you. She would do everything to protect you, if you had girl questions or boy problems you were going to her. Your dad couldn't give a shit about you, sure he fed you and gave you a roof over your head but he didn't want you and he could care less about you. So, when Connor came back and started working at Gaffney Chicago Medical Center for his fellowship for trauma surgery fellowship everything went back to normal. Your daily meetups, sleepovers, and going to him for problems and medical issues started right back up like he never left. He still tried to get custody but it failed every time but he wasn't going to stop fighting for you, they wouldn't let him have you even if you said you wanted to live with him.

—------

When you were 13 you had gotten really sick like hospital sick. It was a night that Connor wasn't working and you were just in agony. Claire had moved out and your father was at a charity thing leaving you home alone. It started in the middle of the night waking you up from a dead sleep. You desperately tried to call your dad but it just went to voicemail so you tried one more time and he answered 

“Dad, I don't feel good.” You told him. 

“What's wrong?” He asked and this gave a you some hope. 

“My stomach really hurts. I feel like I'm going to throw up. I feel hot.” You said

“Suck it up. There is medicine in the cabinet downstairs.” He said and hung up and you let out a sob. 

You pulled yourself off your bed and dragged yourself to the steps and took painful steps down the steps. You sobbed the entire time. You finally got to the kitchen and opened the cabinet and grabbed the painkillers and you took them. Almost immediately as it touched your stomach you were throwing up everywhere. You were so weak. So weak that you just ended up collapsing onto the kitchen floor just barely missing your throw up. Thankfully you had grabbed your phone and slowly and shakingly grabbed your phone, your vision blurring. You unlocked it and pulled up your contacts and hit one you knew all too well. It rang not even once and Connor's voice came through.

“Y/N/N? It's 3 AM. What's wrong?” He asked in a voice full of concern.

“I... I... I don't feel good.” You said your teeth were chattering because despite your temperature, you were freezing.

“Where's dad? Did you tell him?” He asked and you could hear him rustling around.

“He's at a charity event. I... I called him and told him but he told me to suck it up and take the medicine in the cabinet in the kitchen. I'm in so much pain, Con. I took the medicine and immediately threw it up.” You told him the feeling of the cold floor was nice.

“Bastard.” He murmured “I'm on my way. You stay put.” He said. 

“I'm hot but so cold.” You said letting your eyes droop. “So tired.” You added.

“Hey, stay on the phone with me. Why didn't you call Clarie? She lives closer.” He asked

“She's gone out of town.” You said and you could hear him get into his car and the engine start. 

“Son of a bitch.” He said and started to drive as fast as he could while still obeying the speed limit. He kept talking to you but you stopped responding and that scared him. He hung up when he arrived at your guys’ family home. He was quick to jump out and run to the front door and grab the key under the mat and opened it.

The house was dark but he knew where you were at. “Y/N/N. It's me.” He yelled out but got no response. He walked into the kitchen and saw you lying there. “Fuck.” He murmured to himself and ran over to you missing your vomit. He kneeled down and touched your forehead and retracted his hand “Damn, Sis. You're burning up.” He said. He walked over to the drawer and grabbed the thermometer and thankfully it was on that stuck in your ear. He put it there and waited for it to beep and when it did, he cursed and read it aloud “104.3. Fuck I need to take you in.” He said and started to try and wake you up. “Y/N/N, Sweetheart. It's me. Your brother. Can you open your eyes?” He asked as he pressed two fingers to your neck. “Damn, pulse is way too fast.” He said and him talking must've started to rouse you.

“Con?” You asked and he smiled softly. 

“Yea it's me. Can you open your eyes?” He asked and you cracked them open until they were open. “There we go.” He said.

“Tired.” You said and started to close again.

“No. Hey, keep those eyes open. I'm going to take you to Med, Ok?” He asked and you nodded.

“Ok. Go see Will?” You asked and he smiled. Will has become a favorite of yours and he doesn’t know why.

“Yes. We'll go see Will.” He said as he started to stand you and your legs shook like a newborn foal's standing for the first time. “Can you walk?” He asked.

“I don’t know.” You said in barely just a whisper and you tried to take a few steps and all but collapsed into his arms.

“That is a no.” He said and then he was scooping you up into his arms and walking out of the house and to his car. He got you in the passenger side seat and then him in the driver’s seat and he was off heading to Med as fast as he could. He continued to talk to you to keep you awake and before you knew it you were pulling into Med. He parked and turned the car off and got out heading to the passenger side seat. He quickly scooped you up and shut the door hastily. He rushed you into ED where he saw Maggie. “Mags.” He said and she looked up at him and quickly rushed you into a bay. “She wants Will.” He said and she nodded. She walked out of the room and went to get Will not even a second later he was rushing into the room.

“Connor? What is going on?” He asked

“She called me saying she didn’t feel good and when I asked her what was wrong, she told me she was hot but so cold. She said she took some medicine but once she took it, she immediately threw up. When I got there, she was passed out on the floor next to a pile of vomit. She was burning up to the touch, she had and still has according to the monitor a temperature of 104.3 and her pulse was fast, way too fast.” He explained as they could see from the monitor “She also said she was really tired. I woke her up and had her stand and she shook like a life, she tried to walk but she collapsed into my arms and then I quickly got her in the car and rushed her here.” He finished.

“Why isn’t Cornelius here instead?” Will asked

“He is at a charity event. Left her by herself. She called him and told him she was sick but he told her to suck it up and take the medicine in the cabinet.

“Bastard.” Will said

“That’s what I said.” Connor said

“I want to get an ultrasound done on her stomach to rule out appendicitis.” Will said and Connor nodded.

“I agree.” Connor said and soon Will was calling in the ultrasound machine and he got to work with the help of a nurse. “So, it is not appendicitis.” Connor confirmed and Will nodded.

“I want to run some tests on her. Swab for flu and viral infection and take some blood as well.” He said and Connor nodded. Throughout this entire process you had been out and now that you were in the hospital you were allowed to sleep. “I want to get some fluids running to help with her temperature and get some IV children’s Tylenol on board as well.” He said and again Connor nodded. As the nurse was preparing everything you started to wake up. 

“Will?” You asked and he smiled and looked over at you.

“Hey, Sweetheart. We’re going to get you feeling better, ok? I just want to run some tests.” He said and you nodded.

“Ok.” You said and then you saw the needles “Con, no.” You said and shook your head but that was a mistake because it hurt your head.

“Hey it is ok. I’ll be here the entire time. Ok?” He asked and you nodded and then he nodded at the nurse and Will and everyone got to work. Soon blood was taken, fluids were hooked up, and swabs were taken.

“Get those tests going ASAP.” Will told the nurse and she nodded and they were out of the room. Will had to tend to some other patients and you both understood and they let you go back to sleep. With the fluids going your pulse was starting to come up and it was steady since you were sleeping and your temperature was starting to come down and the IV children’s Tylenol helped with that. 20 minutes later Will was coming in.

“So?” Connor asked

“She has a really bad viral infection and she has a really bad case of the flu. I want to get her admitted and keep her here for a few days.” Will said

“This had to be going on for a few days.” Connor said

“Did she not tell you anything about it?” He asked and Connor shook his head.

“No, she didn’t look sick when we met up a couple of days ago.” Connor said, sighing and Will nodded.

“Let’s get her moved.” Will said and so they did.

The next time you were waking up, 3 hrs. after coming into ED, you were waking up in a room. “Connor?” You asked sluggishly.

“Hey, Sis. I’m here.” He said coming over to you as he entered the room with a cup of coffee. 

“Where am I?” You asked and he smiled and came over and sat next to you.

“In the hospital. You have a really bad case of the flu and a bad viral infection. Will is taking care of you and has you on antibiotics.” He said and you nodded and you were struggling to keep your eyes open. 

“Dad?” You asked

“Not here.” He said and to be honest he didn’t want him here. He hadn’t even thought about him since you arrived here and boy was, he going to have some words for him. “Go back to sleep.” He said and you nodded and were out like a light and he could tell because your heart rate slowed. Now it was time to have some words for his father. He made sure you were asleep before pulling his phone out and stepping out of the room where he saw Will. “Hey, I need to make a phone call. Mind staying with her?” He asked and Will smiled.

“Of course.” He said and walked into the room with you and Connor walked into the doctor’s lounge and dialed his dad’s phone number and he rang 5 times before he answered. Cornelius didn’t even have time to say hi before Connor started to rail into him.

“Do you know where your daughter is?” Connor asked

“No, but she has made a mess in the kitchen she needs to clean up.” Cornelius said and Connor saw red.

“She’s in the hospital because she has a bad case of the flu and a bad case of a viral infection.” Connor said venom in his words.

“Well, she needs to get home now and clean the mess up.” He said 

“She will be doing no such thing. Not anymore.” Connor said

“And why is that?” Cornelius asked

“Because she is coming to live with me. I was the one that found her when she called and told me what was going on while you were too busy at a charity event. She told you she was sick and you told her to suck it up. You told her to take the medicine in the cabinet and she instantly threw it up. She was running a 104.3 fever when I found her and she couldn’t even stand or walk. She was so weak. I’m filing for sole custody of her and you’re going to sign it because you are not fit to be a father let alone a guardian. You will not be coming to see her. You will not see her at all unless she is with me or have contact with her. That is final.” He went off on him. Cornelius was silent by the time he was done.

“Fine. Keep the bitch. I don’t care. I’ll have her stuff packed and waiting for you to pick it up.” He said and then hung up the phone. Connor was relieved now he needed to start the paperwork. He let out a sigh of relief.  

Connor walked back to your room and saw you wake and sitting up talking to Will. You looked over and saw him. You still looked tired but you were awake. “Where were you?” You asked.

“I was on the phone with dad.” He said

“I’ll leave the two of you alone. I will be back in a few to check on you.” Will said, directing that last sentence to you. You and Connor nodded and Will left. 

“Is he coming?” You asked and he shook his head.

“No.” He said and you looked relieved “I have good news though.” He said and you perked up.

“Oh?” You asked curious and he nodded.

“From now on you will be coming to live with me and you won’t see him or talk to him.” Connor said and your face brightened.

“Really?” You asked and he nodded.

“Really.” He said and you squealed in excitement. Your wish was finally coming true. You were going to be living with your big brother. You then started to go on about all the things you two could do together and he smiled and nodded. You suddenly stopped talking and looked at him and smiled. “What?” He asked.

“I love you, Con.” You said and he smiled.

“I love you too, Y/N/N. Now and forever.” He said and he leaned over to kiss your forehead.

“Now and forever.” You confirmed. Your wish did come true and you couldn’t be happier.

Tag list:

@kmc1989

@els-marvelvsp

@atarmychick007

@nyx2021

@grandstrangerphantom

@angenu01-blog

@talesofreading

@callsign-revenge

[dangermousie]

I have never seen a drama (or a show from anywhere) convey the feeling - emotional and psychological - of what it is like for me to read a truly immersive high fantasy this well before. I am a 12 year old reading about the Fellowship fighting in Khazad-dum, feeling as if I'd glimpsed another, more saturated reality. I am a lot older than 12, reading Sanderson and feeling pulled into the pages. It's high fantasy and a dark fairy tale and a meditation on humanity. GJM has his scripts/plots criticized (especially his endings which are admittedly always ???!!!) and I get that but for me, it never matters because the emotion I feel when watching his stuff is like a hit of serotonin, it absorbs me so much that I genuinely don't care about the plot.

His stories are flawed plot-wise. Not gonna argue there. But his visual storytelling, his sense of place, and his ability to direct his actors (he's making mediocre actors incredible and terrible actors decent), combined with the fact that he likes to explore themes I find interesting (among others, has anyone noticed his fixation on brothers who are not biologically brothers - TJR and CL in MJTY, FSF and MTY in Ice Fantasy - he did not direct but it's his story - and what he's setting up here) basically means that I, never a plot watcher or reader anyway, genuinely do not care about narrative flaws. It's an equivalent of reading a stylist so good that I don't care about the narrative per se. I am a poetry reader after all.

But anyway, back to the drama. I loved ZY's last ditch attempt not to discuss it.

The way it melds into the past, and his carrying her after her master's murder...

The way it melds into her present face...and what he said AAAA

I also got to say that another thing this drama gets which a lot of supernatural stories do not is not just how Other he is, but how it informs everything. It is very much a spirit that was around during her young adulthood (and childhood?) as a friend of her shifu and someone who helped her that is now around and the relationship is fluid and changing and may turn romantic or not but it is never like one between a human man and a human woman.

Oohhhh and the way it melds again...

[villain-crown]

heart | @jegulus-microfic | words: 855

* I’m running late on the prompts whoops

critical care, part 6 (part 1, part 2, part 3, part 4, part 5, part 7, part 8, part 9)

a Jegulus nurse!AU

“Wow, he’s mean.”

“I’m meaner,” Regulus replied and holy shit James believed him.

He could picture it now: Regulus, a relentless, demanding little thing on top of him, sinking onto James’s cock with a vicious hiss and riding him until he was spent. He would be so small but a force of nature all the same, wrapping James’s heartstrings around his little finger like a leash.

Bloody hell, he’s going to look amazing on our Christmas cards.

“Were you just waiting for me to get angry?”

“I was waiting to see if you could,” Regulus corrected, licking a bit of cream from his spoon. James watched the pink tongue dart out, give a good, long lick and disappear past plush lips once more.

I’m not meant to survive this lunch.

“So you and Riddle used to…?”

“Used to,” Regulus replied carelessly.

“What happened?”

“He asked Sirius if he could fuck the both of us at the same time. Not a good look.”

James gaped at him, thoroughly distracted from his lascivious thoughts. “What!?”

Regulus set his spoon to the side. “It was before Sirius got together with Lupin. He was sleeping with half the hospital and every now and then one of his conquests would decide they wanted the matching set. So now Sirius loses his shit at anyone that looks at me sideways and I get the pleasure of sneaking around behind his back like this.”

That… made a lot of sense actually. James had just assumed that Sirius was being baselessly paranoid but there was something a bit bittersweet about it now. Sirius loved Regulus more than anything or anyone. He must have felt very guilty for putting his little brother in that position.

“I’m sorry.”

Regulus frowned. “Why? It’s not your fault.”

“It’s just… what you say.” James cleared his throat, switching topics. “But why did you want to see if I could get angry?”

“I wanted to make sure I wasn’t wrong.”

“About?”

“You manifesting the right attitude to fuck me.”

Even though James had very blatantly been hoping for it, the direct statement made him choke hard. “What!?”

“I like it rough,” Regulus explained calmly, making James work hard to will the beginnings of arousal away. “With teeth and nails and words. I don’t see anything wrong with it, but I understand that not every guy can deliver.”

James suddenly pictured a naked, sweating, panting Regulus on all fours under him with James’s teeth digging into Regulus’s smooth, warm shoulder as he took him from behind in harsh thrusts. It wasn’t James’s usual style—he liked looking at his partner; liked a bit of connection. But he was only human and what else was he supposed to do but agree if Regulus wanted a little pain with his pleasure?

There was something else that concerned him, however.

“Do you think Riddle’s angry enough to tell people?”

Regulus looked disinterested. “Riddle doesn’t scare me. He understands that the only power he has over me is whatever I decide to give him. If he turns me in to HR, I’ll turn him in too.”

“Mutually assured destruction.”

“No, actually, because I can get another nursing job tomorrow. He’s in a competitive program that lasts two years. He can’t afford to get kicked out. He wouldn’t get another cardiovascular fellowship with a sex scandal on his record. If anything, he’ll try to protect me to protect himself.”

Gorgeous, vicious little thing, James thought admiringly.

“I’m not being unreasonable. If he doesn’t want any problems, he just has to keep his mouth shut. It’s not that hard.”

“And you’re good at that sort of thing, are you? Keeping your mouth shut?”

Regulus just looked at him. “I make a much better impression with it open.”

“I bet you do.”

“So?” Regulus picked up the spoon again, idly pressing it against his tongue. “I already know you’re interested, so let’s not kid ourselves there. The real question is if you’re too scared of my big brother to fuck me the way you obviously want to.”

And that really was the question, wasn’t it? Sirius would lose his mind if he found out, that was a given. If he didn’t take a hit out on James, he’d at least refuse to ever speak to him again.

Objectively, this was a very obvious choice.

He should be running away screaming at the very suggestion of engaging the Slytherin like that.

…But fuck, Regulus was fit.

Like, expensive fashion magazine meets dirty wanking material fit.

This is really sort of Sirius’s fault, he tried to convince himself. The way Remus had told it yesterday when James had struck up a very ulteriorly-motivated conversation on the subject, Sirius had practically raised Regulus and had no spine whatsoever when it came to denying him anything.

“He’s never even heard of the word ‘no,’” Remus had concluded with a fond roll of his eyes. “Sirius spoils him rotten.”

And James would be out of his fucking mind to say no to him too.

“…You know what? Fuck it. I’ll fist fight Sirius every morning in the parking lot for the rest of my life if I have to. We’re doing this.”

[noctivagantpodcast]

I Live On Stolen Land

Consider donating to one of these wonderful charities dedicated to preserving the cultures, livelihoods, rights, and dignity of Indigenous peoples.

First Nations Development Institute. Information taken from their 'Our Programs' page: Grantmaker dedicated to addressing financial inequality and its many, many negative impacts. In additional to financial aid, FNDI provides job training and participates in policy-making and advocacy, often focusing on environmental concerns, food insecurity, and tribal sovereignty. Some examples of current projects include "Fortifying Our Forests" AKA restoring and protecting sacred land in partnership with the Forest Service, Native Language Immersion Initiative AKA ensuring the survival of Native languages, and Native Farm To School AKA connecting Native youth with traditional means of growing and harvesting food.

Native American Rights Fund A registered non-profit that provides legal representation in matters of Native interest, be that a single individual or an entire tribe. Since their inception, they have won cases that made critical contributions to the advancement of Native rights in the United States. Their efforts have helped uphold tribal sovereignty, compelled museums, universities, and other institutions to return the remains of Native ancestors, and protected the voting rights of pretty much everyone.

Redhawk Native American Arts Council This organization's primary focus is on the preservation of Native American arts through educational programs. We can also thank them for granting scholarships to Native students seeking higher education, and for running a youth program which aims to help Urban Indigenous youth connect with their heritage through the arts.

Seventh Generation Fund A "fiscal sponsor" for smaller community groups that are run by and for Native tribes/individuals, with the focus of preserving heritage and defending tribal sovereignty, as well as continued survival post-genocide. One example of their work is the Flicker Fund, a disaster fund dedicated to supporting Indigenous communities during times of crisis, be that a pandemic, extreme weather, or a severe drought. Another is the Traditions Bearers Fellowship, which provides financial support to tribal community members who carry on pre-colonization traditions.

Quiluete Move To Higher Ground Stephanie Meyer committed a serious of egregious acts of cultural appropriation and exploitation, and made a very large fortune off a very real tribe. This very real tribe now finds themselves living in a tsunami zone and unable to afford a move to a safer area. As of 2022, the move of the Tribal School, the most important phase, is complete, but there's much more work to be done.

Indigenous Women Rising Abortion Fund A fund to provide Native individuals and family access to abortion care, menstrual hygiene supplies, and midwifery. Here are two separate articles verifying their status as the ONLY indigenous specific (and Indigenous led) abortion fund. For more information on how the destruction of Roe V Wade has negatively impacted Indigenous women, look here and here.

South Dakota Historical Society Foundation So, this isn't a Native led or Native specific organization, but, they work closely with Indigenous communities in South Dakota to preserve their heritage alongside the state's history. I recently had a lovely conversation with one of their representatives about the Ghost Shirt their society is sheltering until such a time as the tribe it rightfully belongs to can house it safely. Article about the shirt's repatriation with some cool info on the shirt's history is here.

[all-pacas]

alternately: never does the show say in-dialogue that chase is an intensivist. so what if he never was? almost everything we see him doing is stuff that a surgeon would be able to do.

doing surgical training and then taking a fellowship wherin he doesn't need to do any surgery is not NOT in character for chase.

Unfortunately, they do say it a couple of times in S1:

Maternity:

HOUSE: Chase, you’re the intensivist. How many [blood tests] could we do before we risk exsanguinating the kids?

Socratic Method:

HOUSE: I have a headache. It’s my only symptom. I go to see three doctors. The neurologist [looking at Foreman] tells me it’s an aneurysm, the immunologist [looking at Cameron] says I got hay fever, the intensivist… [looking at Chase] can’t be bothered, sends me to a shrink, who tells me that I’m punishing myself ‘cause I wanna sleep with my mommy.

(btw, I do love that little line. Cameron and Foreman will spend time diagnosing, but Chase is way too busy. He even makes a face like "good point, House.")

Additionally, in S1 in particular, Chase is always the one stuck with the critically ill patients, like the babies in Maternity or the teenagers in Poison, which isn't really surgical care but, you know, intensive care. That said, I absolutely agree with you that taking a fellowship that has no use whatsoever with his training does seem in character for Chase. Hell, I can imagine that diagnostics could be useful in an ICU setting, but most of the time he's going to know what's going on with his patients already working there. It still might be just for fun.

[fellowshipprograms]

Want to upskill in critical care medicine but don’t know where to start! Join online fellowship program

Fellowship in Critical Care Medicine is a specialized field that focuses on providing intensive care to patients with life-threatening illnesses or injuries. It requires a unique set of skills, knowledge, and dedication to deliver optimal care in high-pressure situations. Within this challenging environment, the significance of fellowship in critical care medicine cannot be overstated. A fellowship program offers aspiring intensivists an invaluable opportunity to develop expertise, collaborate with multidisciplinary teams, and ultimately, make a meaningful impact on patient outcomes. This medical stream is in charge of treating hospitalized critical patients and giving them the life support they require to survive. You will be in charge of treating patients who are critically sick or in need of acute care as an intensive care physician.

Ways to improve your skill in fellowship in critical care medicine:

A critical care medicine fellowship acts as a transitional period before an intensive care physician can start practicing on their own. Fellows receive extensive training during this time to hone their clinical abilities, increase their knowledge, and be exposed to a variety of critical care circumstances. In addressing complicated medical diseases like sepsis, acute respiratory distress syndrome (ARDS), severe injuries, and post-operative care, they get practical experience.

Fellows are taught to interpret diagnostic tests, monitor vital signs, deliver life-saving therapies, and make critical decisions in a hurry under the supervision of experienced mentors. They become adept at using cutting-edge technologies like mechanical ventilators, hemodynamic monitoring equipment, and renal replacement treatment. Fellows receive the in-depth training necessary to meet the complex difficulties that emerge in critical care settings.

Global insight:

● 15 million people are admitted to ICU annually worldwide

● India has just 4,500 specialists who can work in ICUs and need more specialist

● Annually ICU mortality in india is 729/4038 (18.1%)

Patient Care Through Collaboration:

The exposure to a collaborative atmosphere is one of the critical care fellowship's most important benefits. Teams of doctors, nurses, respiratory therapists, pharmacists, and other healthcare workers collaborate in intensive care units (ICUs). The value of clear communication, cross-disciplinary teamwork, and consensus decision-making is taught to fellows.

Critical care medicine programs encourage a comprehensive approach to patient care in this environment. Fellows learn to appreciate the many viewpoints that the team members bring to the table, which enables them to create an all-encompassing treatment strategy that takes the patient's physical, emotional, and psychological requirements into consideration. Everyone contributes their skills to improve patient outcomes in the collaborative atmosphere, which encourages a culture of ongoing learning.

Most common cases in critical care unit:

1. Heart attack

2. Stroke

3. Poisoning

4. Pneumonia

5. Surgical complications

6. Trauma from road accidents

7. Burns

8. Allergic reactions

9. Sepsis

10. Respiratory failure

11. Cancer-related critical care

Benefits of enrolling in fellowship in critical care medicine:

The COVID-19 epidemic has shown us that our existing medical system is lacking in personnel capable of running an intensive care unit. A fellowship in critical care medicine is necessary to close this gap and provide patients with improved critical care and efficient ICUs.

The physician will be equipped with all the skills necessary to handle critical patients and end-stage illnesses after completing this intensive care medicine course. An ICU doctor is a lifesaver for the patients since here is where the sickest hospital patients are housed.

Benefits of fellowship program in critical care medicine:

1. Gain an advantage in the demanding healthcare sector-Your career options as a qualified doctor will expand after taking a course in critical care, and you can work as a specialist in the area at several multispecialty institutions.

2. Expand your clinical knowledge- Following MBBS, a doctor might not have the knowledge and abilities necessary for practice or employment in a hospital. This kind of training will provide you with the practical skills and in-depth information you need to become an authority in the subject area and stand out from the competition. It will increase the physician's self-assurance and credibility.3. Improve soft skills- Your soft skills, including research, critical thinking, and communication abilities, will improve if you pursue a fellowship in intensive care medicine or a certificate degree in that field. You will gain valuable clinical experience while doing the course, which will help you advance your expertise. A program like this will also enable you to expand your network and meet other business gurus.

4. A chance to get expertise from professionals- Online Critical care course are created and taught by teachers who are specialists in their field. As a result, rather than merely theoretical or bookish information, one has access to clinical and case-based knowledge.

Conclusion- Fellowship in critical care medicine is a life-changing experience that shapes future intensivists into highly competent and caring medical professionals. It provides a special synthesis of practical instruction, group practice, chances for research, and networking that equips fellows to deliver extraordinary care in life-or-death circumstances. By encouraging knowledge, cross-disciplinary cooperation, and a dedication to lifelong learning.

[cerificatecoursegma]

Fellowship in Critical Care: A Career Booster for MBBS Doctors in India

The medical profession is highly respected and demanding, and India has a significant shortage of critical care specialists. As a result, the need for skilled healthcare professionals in critical care has grown exponentially. For MBBS doctors in India, pursuing a Fellowship in Critical Care can be a significant career booster. This postgraduate program offers numerous benefits and opportunities for doctors, enabling them to make a substantial impact on patient care, broaden their horizons, and advance their careers.

Addressing the Gap in Critical Care Expertise:

India has been grappling with a scarcity of well-trained critical care specialists. This shortage has been particularly evident in the wake of the COVID-19 pandemic, where the demand for critical care professionals soared. Pursuing a Fellowship in Critical Care equips MBBS doctors with the skills and knowledge needed to bridge this gap effectively. They become adept at managing critically ill patients, which is a crucial aspect of healthcare delivery.

Enhanced Patient Care:

Critical care is a specialized field that deals with patients who are severely ill or injured, often with life-threatening conditions. A Fellowship in Critical Care provides doctors with a deeper understanding of the intricacies of treating such patients. The training emphasizes early diagnosis, effective intervention, and continuous monitoring, resulting in better outcomes and increased patient survival rates. MBBS doctors who complete this fellowship are better equipped to save lives and provide the best possible care to critically ill patients.

Diverse Career Opportunities:

Pursuing a Fellowship in Critical Care opens doors to a wide range of career opportunities. Critical care specialists are in high demand not only in hospitals but also in nursing homes, trauma centers, and even in pre-hospital care services. They can also explore academic and research positions. This diversity of career options allows MBBS doctors to follow their interests and shape their careers to match their aspirations.

Improved Earning Potential:

With specialized skills and knowledge in critical care, MBBS doctors can expect to earn significantly higher salaries. Hospitals and healthcare institutions value critical care specialists, making them well-compensated for their expertise. This can be a motivating factor for doctors to consider pursuing a Fellowship in Critical Care, as it not only enhances their professional skills but also their financial well-being.

International Recognition:

The skills and knowledge acquired through a Fellowship in Critical Care are internationally recognized. This enables MBBS doctors to explore job opportunities and further studies abroad, broadening their horizons and enriching their professional experiences. The global recognition of this specialization can lead to international collaborations, research opportunities, and participation in medical conferences and workshops.

Career Progression and Leadership Opportunities:

A Fellowship in Critical Care can fast-track the career of an MBBS doctor. The specialized training and expertise gained through the program can open up leadership roles within healthcare institutions. Doctors may take on positions like Head of the Intensive Care Unit (ICU) or Director of Critical Care Services, where they can influence policies, procedures, and standards of care.

Personal Satisfaction and Fulfillment:

Working in critical care can be emotionally and mentally challenging, but it is also highly rewarding. MBBS doctors who choose this path often find a deep sense of satisfaction in saving lives, providing comfort to families, and making a real difference in the lives of critically ill patients. This personal fulfillment can be a significant motivation to pursue a career in critical care.

In conclusion, a Fellowship in Critical Care is undeniably a career booster for MBBS doctors in India. It equips them with essential skills, enhances patient care, opens diverse career opportunities, improves earning potential, provides international recognition, offers career progression, and brings personal satisfaction and fulfillment. As the demand for critical care specialists continues to grow, this specialized training not only benefits the doctors themselves but also serves as a vital contribution to the healthcare system and the well-being of the nation.

[medvantagesolution]

The Significance of Online Fellowship Programs in Enhancing Patient Survival Rate in Emergency Situations

A Multi focal Medical Perspective by MedVantage In the realm of healthcare, the ability to provide timely and efficient critical care in trauma and emergency situations is paramount. These situations often arise suddenly and require swift, expert intervention to maximize the chances of patient survival rate and recovery.

1.Expedited Medical Evaluation: The first step in providing critical care in trauma and emergency situations is a rapid and accurate assessment of the patient's condition. Healthcare providers must quickly identify life-threatening injuries or illnesses and prioritize interventions accordingly. The primary survey (ABCs: Airway, Breathing, Circulation) is essential to ensure that the patient's vital functions are stable.

2.Hemodynamic Control and Maintenance: Once the initial assessment is complete, the focus shifts to stabilizing the patient's condition. This may involve interventions such as securing the airway, providing oxygen or mechanical ventilation, controlling bleeding, and administering medications to support blood pressure and heart function.

3.Medical Team Coordination: Effective teamwork is crucial in trauma and emergency care. A multidisciplinary team, including physicians, nurses, paramedics, and other healthcare professionals, must work together seamlessly to provide the best possible care. Clear communication and well-defined roles are essential.

4.Medical Imaging for Diagnosis and Evaluation: Diagnostic imaging, such as X-rays, CT scans, and ultrasounds, plays a vital role in assessing and diagnosing trauma patients. These tools help identify injuries, fractures, and internal damage, enabling healthcare providers to make informed decisions regarding treatment.

5.Medical Hemostasis and Bleeding Management: Hemorrhage is a leading cause of death in trauma cases. The prompt control of bleeding is essential to prevent further deterioration of the patient's condition. Techniques like direct pressure, tourniquets, and hemostatic agents are used to manage hemorrhage.

6.Pain Control and Analgesia: Trauma and emergency patients often experience significant pain and discomfort. Effective pain management is essential to reduce suffering and improve patient cooperation during procedures and treatments.

7.Fluid Resuscitation: Intravenous fluids are administered to maintain blood pressure and ensure adequate perfusion of vital organs. The choice of fluids and their administration rates must be carefully tailored to the patient's condition.

8.Surgical Intervention: In some trauma cases, surgical intervention may be necessary to repair internal injuries or fractures. Surgeons may need to perform life-saving procedures, such as exploratory laparotomy, to assess and treat intra-abdominal injuries.

9.Critical Care Units: For patients with severe trauma or those who require ongoing intensive care, transfer to a specialized critical care unit, such as an ICU or a trauma center, may be necessary. These units are equipped with advanced monitoring and life-support equipment.

10.Rehabilitation and Long-Term Care: Once a patient's condition stabilizes, the focus shifts to rehabilitation and long-term care. This may involve physical therapy, occupational therapy, and psychological support to help the patient regain function and quality of life.

In conclusion, providing Fellowship in Critical Care, helps in trauma and emergency situations is a complex and multifocal endeavor. Swift assessment, efficient stabilization, and a coordinated approach are essential to improve patient outcomes. Healthcare professionals in these settings must be well-prepared, trained, and equipped to deliver life-saving interventions to enhance our ability to save lives in these high-stress situations.

[doctorspork]

Dropping by after literal months of not being on this website to announce that job searching is terrible, I am extremely qualified for the job I am trying to do, seriously please just give me a job so I can actually study for my 2nd of 3 sets of boards and continue doing my current job

[biblically-accurate-pirates]

tips for writing law as a surgeon in a modern AU

the US medical system, and especially medical training, is a mess of incomprehensible rules and timelines. surgery training ESPECIALLY. and accurate information can be weirdly hard to find! so without further ado, here's a list of random factoids that i thought would be vaguely useful to have in one place

Some basic terms: 

Attending: boss doctor, fully trained and certified. Often intimidating. 

Resident: worker doctor, still finishing training. They usually do the majority of the actual work in surgeries, especially as they advance. 

Intern: first-year resident. Their schedule is slightly different because every intern in every specialty has to meet a few requirements. They’re also limited in what medications they prescribe until they take a big test (usually at the end of the year).  

Junior resident: first 2 years of training. They do more of the paperwork (writing notes, calling other doctors, admitting patients) and floor work (changing wound dressings, seeing new patients, checking on old patients if there’s an issue)

Senior resident: 3+ years of training. They check on the juniors to make sure they’re doing everything right, and generally do more operating and interacting with the attendings. 

Chief resident: resident on their last year of training/just out of training. In many specialties there’s only one, but usually, every 5th year surgical resident is a chief. Treated as attendings in many cases, they also build the schedule for the other residents. 

Fellow: fully certified doctors doing additional training in a sub-specialty. Common surgical fellowships are trauma/critical care surgery, colorectal surgery, surgical oncology, and cardiothoracic surgery. 

Service: a team of doctors from one specialty who admit, operate on, and follow up with patients for one specific problem. 

On service/off service: “on service” residents are working on the team within their own specialty (a surgical resident who’s working on the general surgery team this month). Off-service residents are on a team outside of their primary specialty (an anesthesiology resident on the general surgery team). Anesthesiology, urology, plastic surgery, transitional year, and sometimes family medicine residents have to rotate through surgical teams. These residents pretty much never operate and only handle paperwork and floor work.  

Please, for the love of god, forget everything you saw on Grey’s Anatomy

I’m begging you. It’s so inaccurate.

Scrubs is decent tbh  

Dating patients is a HUGE no-no, especially for surgeons. Surgeons and psychiatrists are the two specialties where it is a top-tier ethical violation to ever date anyone who has ever been your patient. With other specialties (especially in rural areas) it’s generally okay, though still a little frowned upon, to date someone who’s a former patient, but you also can’t ditch someone as a patient just to date them. 

Also: surgeons deal with poop so much more than you can imagine. Would you, a normal person, ever want to date someone who wakes you up at 5am to ask you very seriously if you’ve pooped yet, press super hard on your still healing incisions, and leave? No. You would not. 

Surgical training is long AF. in the US you need to get through a bachelor’s degree (3-5 years), a MD/DO degree (minimum 4 years, often longer), general surgery training (minimum 5 years, up to 7 pretty regularly if people do research), and maybe fellowship (about 2 years). That’s a minimum of 12 years of training, after graduating high school at 18 years old. If you’re writing law as an attending (boss doctor) he’d need to be at least 30 years old, and if you’re writing him as a specialist he’d need to be 32. 

Attending schedules vs resident schedules: 

Residents work around 80 hours a week, often more. They switch services every month, and work all over the hospital. The work year starts in July and ends in june. Residents get either new years or christmas off, never both. residents have to get an average of one day off every week, and having both weekend days off is called a “golden weekend”. Also, most surgeries are at seven AM, so residents get to the hospital around 4:30/5am to see patients, write notes, and get ready for the surgeries. 

Attendings have more control over their schedule. Surgeons still work over 40 hours a week, more if they’re on a busy inpatient service. Generally, when they’re not covering the inpatient service, they’ll have 3-4 days a week of operating, a day of clinic, and a day of administrative work or research if they’re doing other projects. Attendants also take calls, which is when they supervise residents and do emergency surgeries for 24 hours straight. If they’re lucky they don’t actually spend the full 24 hours awake and working, but they’re rarely lucky. On some services, (especially trauma) there is Q3 or Q4 call, which means the surgeons work 24+ hours every 3 or 4 days. It’s brutal. 

What certain specialties actually do:

This is very Law specific and one of my pet peeves. “Heart surgeons”, who are cardiothoracic surgeons, are kinda boring imho and don’t fit the law's vibe. (all cardiothoracic people will, of course, disagree with me). They do some very cool, very intense open-heart surgeries, but they also do pretty much everything inside the chest cavity. So that means things like repairing a hernia in someone’s esophagus, or messing with the diaphragm. But that’s all pretty controlled surgery and they’re very limited in what else they can do. 

Trauma surgeons, on the other hand, are “emergency room surgeons”. They’re the ones who handle all of the super serious surgical injuries that come into the emergency department. They’re the ones who will fix someone if they have a gunshot wound and are bleeding out, or stabilize someone who was hit by a truck and broke all of their bones, or will open up someone’s chest cavity and use their hands to physically squeeze a heart to make it start beating again. They’re wild. They’re also usually chronically sleep deprived and have a thick veneer of “i give no fucks”. Very law.

anyway WOW that got long but i hope this was helpful to someone!!!