Joined March 2013
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I see the announcements abt this/that person tested neg for COVID. And I wonder, why celebrate? You still have time to get it. 😒
Brande Harris (she/her/hers) retweeted
HELP PLEASE: Trump doesn’t want Americans to know that open enrollment begins November 1 and has stopped all advertising.
Millions count on this coverage & will find better premiums this year.
Consider helping get the word out.
Details are here. healthcare.gov/quick-guide/d…
Get you flu shot. Do it now. Don’t wait until November. My Healthy Toddler Died From the Flu Last Year & This Is What I Need You to Know thestir.cafemom.com/parentin…
Today we are posing alternative words to help the CDC w/the new “word” restrictions. For evidence based we have ... moron free, data driven research, politically untainted information, stuff that is proved by science.
This will be an ongoing process. @CDC_tweets #realscience
I am The Compassion Collective. I Stand With Love. Will You Stand With Me? ctt.ec/4iJey+ #IStandWithLove #TheCompassionCollective
Part of being a caring physician is not signing off when the care gets difficult and the case gets complicated.
Recommendation: Decrease PIP to assess for comfort with hypercarbia, dec rate to assess for tolerance of rate. Each as stepwise. #hpm15
Recommendation: turn down FiO2 to assess for comfort and meds titration before extubation. #hpm15
Pentobarbital and haldol are good adjuvant comfort meds for compassionate extubation. #hpm15
In compassionate extubation, no neuromusc blockade at least 24 hours before. More time needed if renal/hepatic dysfunction. #hpm15
Early nerve block improves QoL and dec overall opioid use. And just seems more compassionate than current standard care. #hpm15
Many patients allow surrogates leeway in implementing preferences Terrry, J Clin Ethics 1999 #hpm15
In the process of getting the whole story, is it possible we are doing a really good family meeting? #hpm15
In resolving moral distress, we need to get "the whole story" from all sides, medical team AND family. #hpm15
Significance of moral distress on patients: inconsistent care, less attentive physical care, medication errors. #hpm15
With each "attack" of moral distress resolution of distress doesn't mean a return to baseline. There is new baseline of set. #hpm15
Most often cited source for moral distress is care that prolongs dying process or perception that patient is being tortured. #hpm15
Piers et al 2011. Inappropriate care inversely assoc w/factors indicating good teamwork #hpm15
@BrandeHarrisDO: Who get Moral Distress?
Everyone who cares for patients. We are all susceptible. #hpm15
Moral distress: occurs when an individual's moral integrity is seriously compromised + more. #hpm15