nexus

I trained at Bart's, London 1980 - 83. The pleated cap was worn by students and 1st yr qualifiers. Then you went on to the '5th yr cap'! The pleated cap was formed by taking a well starched rectangle of white linen, lay it on a flat surface with the long side closest to you, take a strip of cardboard, about the circumference of your head and about 5cms deep and match its edge to the edge of the cloth (in the middle of the length), then fold that side up and over the cardboard twice to form a smooth, supported, cloth-covered strip. For the next bit you need something round and hard - the bottom of a metal saucepan or as many of us used, a small, round shortbread tin. You form the strip containing the cardboard around the tin and secure underneath with a small, 1cm, safety pin. This leaves the rest of the material as a single layer sticking up. Working from one side to the other, you smooth the material down into 5 or 6 triangular pleats, then pin together the top of the strip containing the cardboard over the pleats trapping them between the two safety pins. You are then left with a 'tail' sticking out from between the safety pins which you fold up and smooth flat over the top of the cap. Way easier to do than explain, we taught each other! Caps were abandoned by the end of the 80s, deemed an infection risk and outdated frippery. :chuckle

I'm in the UK and patient controlled analgesia is used routinely for post op patients. Is this not the case in the US? It seems strange that patients are still left to suffer severe pain post operatively when all the evidence shows that PCA is best practice.

I love BST too even though I was off at the w/end and should have begrudged my hour less in bed. If the Scottish farmers want to put their clocks back again in October, let them! Why should we? We are a different country after all. But then I guess, BST would be GMT - very confusing.

On my unit in England, all patients are admitted under the care of the intensivists who then make treatment decisions. Their medical/surgical team may be involved in decisions but the juniors aren't allowed to change medication etc. Dee P

We use it as an anticoagulant during cvvhf when patients have HIT. I didn't know it had vasodilatory effects and we certainly don't take all the precautions you mention. What doses are you giving? Dee P

OK, not 'empty beds'. Ones that will become empty later when the patient has gone to the discharge lounge and home on the twilight transport. :)

I work in ICU and we say if the notes won't fit through the letterbox, we're not having the patient. (In our dreams)

I work in ICU and we have problems finding beds for patients that are well enough to go to the ward because the bed managers are saving the empty beds for A&E patients. We have even discharged patients home recently.