Apytele

@Apytele@sh.itjust.works

• ⁨Comment⁩ on ⁨I was diagnosed with early onset dementia and alzhimers. Is there safe guards I can put it up so I don't screw or kill anyone? Like who do I contact about being denied to own a gun?⁩ ⁨⁨1⁩ ⁨day⁩ ago⁩:

  Oh hi I’m a psychiatric nurse!

  Most important: Pick the three people you trust most in the world, put them in order of who you want making decisions for you the most, then talk to your doctor about what paperwork you need to sign for that. Then talk to those people at length about how you want to die and what would make you feel the safest and happiest day-to-day. Think about what things you do for fun / relaxation, what kind of music you like you listen to, etc.

  If you’re up to it, I also highly recommend Wellness Recovery Action Planning. It’s more designed for people who are more likely to recover, but it’ll give you a template to go off to communicate your day to day needs in a written format for your legal decision makers and healthcare professionals to make you feel safe and comfortable as you progress through these next few stages.

  And I can’t stress the music enough. It’s the part of your brain that’s likely to keep working the longest. Make two playlists, one to dance / have fun to, and one to relax / sleep to.

  Good luck and I really hope you’re able to find trustworthy people to make decisions for you because without them to actually carry out your wishes, literally anything else you decide on now is completely moot.

• ⁨Comment⁩ on ⁨Happy DB Cooper Day to those who celebrate!⁩ ⁨⁨4⁩ ⁨days⁩ ago⁩:

  Honestly it’s not even the CPR that particularly bothers me, it’s the intubation and the stuff after. I’ve worked with so many patients who don’t have a lot of working neural tissue left and their family just has them medically tortured for years because they want to see them blink occasionally. Next time I update my documents I think I’m going to add that if my family wants something to happen to me that I have to be held down for, they have to be in the room. If they can’t stand to watch / listen to me while it happens, they’ve no right signing off on it.

• ⁨Comment⁩ on ⁨Happy DB Cooper Day to those who celebrate!⁩ ⁨⁨5⁩ ⁨days⁩ ago⁩:

  um. yeah. they do that after regular surgery too. a shitton of sedatives will do that. ect is somewhat associated with temporary memory loss but it wears off just as quick as with a regular seizure.

• ⁨Comment⁩ on ⁨Happy DB Cooper Day to those who celebrate!⁩ ⁨⁨5⁩ ⁨days⁩ ago⁩:

  there is actually a huuuge overlap between anticonvulsants / antiseizure medications and anti-manic agents (mania being the opposite of depression).

• ⁨Comment⁩ on ⁨Happy DB Cooper Day to those who celebrate!⁩ ⁨⁨5⁩ ⁨days⁩ ago⁩:

  Oh yeah electroshock therapy is actually something we still do. I’ve worked at two places actually who do it. They put the patient under full medical sedation like they would for surgery (they even have a little mini recovery and PACU in the ECT suite). In fact the only main difference between an ECT suite and an OR suite is that the actual procedure room is just clean, not fully sterile since they’re not actually opening the person. On the floor we have to observe all the same pre-op and post-op precautions, like NPO (nothing to eat or drink) after midnight, and changing them into clean clothes in the morning. We don’t have to do a chlorhexidine scrub (again not sterile) but showers are encouraged (sometimes the patient is too sick to tolerate even a bed bath though). Our only special precaution is that we have to stop all anti seizure meds the night before because the whole point is to induce a seizure.

  They just put electrodes on kinda like they would with an external defibrillator to stop an abnormal heart rhythm (except obvs they put them on the head, not the chest). Then induce a controlled seizure that lasts like 60 seconds or so, then use medications to stop the seizure if necessary. In fact it’s almost exactly like a heart defibrillator in that we’re turning their brain off and on again to get it to work! Funny that that works with organs like it does with computers! 😅

• ⁨Comment⁩ on ⁨Seals the deal, once and for all.⁩ ⁨⁨6⁩ ⁨days⁩ ago⁩:

  Yeah. It rubs me the wrong way to hear jokes about being attacked at night being a good thing. This is exactly why even if I do turn out to be a trans dude I’ll still probably never interact with “the trans community.” I’ve never encountered a group of people less willing to discuss how gender dynamics actually play out for me in the world I’m living in. I’ve had MAGA coworkers who are significantly more accepting of my evolving gender expression than other trans people.

• ⁨Comment⁩ on ⁨Current state of the internet⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  I shudder to think where Epic EMR is in all this. It’s got to be a disturbingly large part of the market share at this point but it’s by far the single easiest to use EMR I’ve ever touched. Like at least omni is drafting behind pyxis. Cerner is waaay behind epic and we don’t even talk about meditech. Epic is just so easy to use. The flowsheets literally link to an outline of a person where you can literally mark the person’s lines, drains, and wounds and just click them to see the flowsheet for each one, add a new entry, etc. But I worry sometimes that it’s such a big part of the market now that if some fundamental flaw brings a large portion of it down it’s gonna hugely impact the health system. There are baby ICU nurses exiting their new grad years barely knowing how to titrate a weight-based drip because they’re so used to epic linking to the pump to calculate and titrate the drip automatically. I hate to give one to the ED nurses but at least they’re used to just eyeballing their coworker’s bag running on gravity out of the corner of their eye from the room around the corner.

• ⁨Comment⁩ on ⁨Seals the deal, once and for all.⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  I’ve had several trans women tell me it’s gender affirming to be harassed / belittled by men and I can’t decide if that’s a fetish or just a really fucked up toxic coping mechanism (or toxically coping by developing a fetish).

• ⁨Comment⁩ on ⁨So now that it's that time of year again in the US, what are some tips and tricks for dealing with that one relative who goes on about the same bullshit for hours and won't shut the fuck up?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  I’ve been working inpatient psychiatry for almost a decade now and here’s how we talk people out of delusions…

  …you don’t. Confronting the delusion directly helps their brain practice protecting the false belief system and strengthens the neural links / pathways. It’s like the ruts made by a wagon wheel, the more the wagon travels the path the deeper they get. All you can do is send the wagon somewhere else and wait for the ruts to erode on their own.

  So if you really do love this person and want to bring them out of it, do your best to send the wagon somewhere else. Just glaze over for a second while they rant, then change the subject. Try to connect over knitting or gardening or woodworking or music or old movies or sports or whatever other hobby or social activity / discussion you can use to connect with them over that’s reality based.

  That’s how COVID sucked them into all this. It broke up the knitting groups and gardening clubs and cooking classes and all anybody had left to socialize with was Facebook conspiracies. If we want out, we need to focus on rebuilding those communities.

• ⁨Comment⁩ on ⁨Amazing⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  I mean. There was also 0025, 0125, 0225… It’s actually fallen on 25/25/25 20 times now…

• ⁨Comment⁩ on ⁨apparently, the T button dosent exist for some people⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  I felt the same way about the person with the third person pronouns. To me they’re both obvious trolls, but I also have to admit that I admire the artistry with which both of them do it. They’re not hateful. They don’t abuse anyone. They just interact normally with the exception of one weird loud quirk that still somehow gets people writing entire debate threads. Both Diogenes and Horace De Vere Cole would be in awe.

• ⁨Comment⁩ on ⁨First snake to be covered in vegan butter?!?⁩ ⁨⁨1⁩ ⁨week⁩ ago⁩:

  Look at that big dumb adorable baby with her big dumb adorable head. Look into those adorable little eyes on top of that blunt little snoot. That is a empty head. 0 thoughts. Give her a boop for me.

• ⁨Comment⁩ on ⁨Anyone?⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  Honestly they don’t even read like honest speculation. They read more like an inside joke the same way you’d ask what blackmail material your shitty coworker has on the boss to somehow never get fired.

• ⁨Comment⁩ on ⁨The moment we've all been waiting for: you now can have targeted ads on your 2k smartfridge⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

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• ⁨Comment⁩ on ⁨I knew it⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  People be shaming others for connecting with a community that supports a regular routine of both daily, weekly, monthly, and annual routines with at least a small amount of support for illness and poverty and which bfocuses on a concept larger than any one of their single personal existences then wondering why they’re depressed. Like I struggle with joining a major organized religion or even a secular social community like a sports team or knitting group but at least I know that’s why I’m depressed. And the Muslims also specifically have a faith that supports strict hygiene practices, which I admire greatly.

• ⁨Comment⁩ on ⁨How do you beat post-work floppiness?⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  It’s funny that this is about work life balance because I’m trying to catch some sleep before my fourth twelve in a row and my acute psych nurse brain just went nooo nooooooo oh noooooooooooo but assuming you never experience significant mania, psychosis, or delirium, I LOVE that for you.

• ⁨Comment⁩ on ⁨[deleted]⁩ ⁨⁨2⁩ ⁨weeks⁩ ago⁩:

  I wanna know where the other social supports are. If neither of you have family that give a fuck where are her mom friends and where are your dad friends so you guys can pool childcare? (There are also other configurations, the gendered model is just the most common).

• ⁨Comment⁩ on ⁨Anon has had enough⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  OK you have a point that I will only grant because I’m so used to finding the lid left up despite my best efforts.

• ⁨Comment⁩ on ⁨Anon has had enough⁩ ⁨⁨3⁩ ⁨weeks⁩ ago⁩:

  So there’s this really cool trick:

  1. Face AWAY from the toilet with the heels of your feet close to the base.

  2. Un-button/tie/velcro/zip the whole waistband (not just the fly) such that you can-

  3. Lower your entire pants to the floor.

  Now this part can be a bit tricky and does take some practice to keep your balance but

  4. Bend your knees down into a squat while leaning ever so slightly backwards (you can put a hand on a nearby solid object such as the sink or a wall to steady yourself. They also make raised seats with handles on either side if you need help with this).

  5. Situate your buttocks firmly on the seat.

  6. Separate your thighs such that you can

  7. Point your penis down between your legs towards the toilet bowl.

  8. Proceed to urinate.

  9. Hygiene is the same as peeing using other techniques.

  This technique is all but foolproof; it is almost impossible to miss the toilet bowl.

  Hope this helps!

• ⁨Comment⁩ on ⁨THIS JUST IN: FBI suspects Kirk was likely targeted, more info to come⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

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• ⁨Comment⁩ on ⁨Anon is an artist⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  I fucking love @booboosenchan

• ⁨Comment⁩ on ⁨Who is the enemy?⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  As a psych nurse I hate food and housing instability and the death of thirdspaces

• ⁨Comment⁩ on ⁨Darling⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  I’m still waiting for my strattera to hit and my brain just went “oh my darling oh my darling, oh my daaarling, tangeriiine……wait”

• ⁨Comment⁩ on ⁨Why do narcissists have such fragile egos?⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  Tbh I think creating new terms just muddles medical records over time because now when you go into a field you have to learn not just a disorder, but also everything it’s been called throughout the last 50-100 years in case you’re going through the records of a patient older that 50-70 years old. I think the public needs to be better educated on these things.

• ⁨Comment⁩ on ⁨Percy Jackson lore is unhinged⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  My favorite comment was that he’s the only Greek god that’s faithful to his wife and doesn’t fuck with random mortals for no reason.

• ⁨Comment⁩ on ⁨BLUD⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  I have a study Notebook on esoteric spirituality that includes choice quotes. This is the quote for the reversed Knight of swords.

• ⁨Comment⁩ on ⁨Anon is a fact checker⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  Yeah when they fixate on sex it generally results in a bunch of behaviors and personality traits that make them unpleasant to be around and often make other people (particularly women) dislike or even fear the idea of sex with them.

  I also honestly think a lot of it comes down to homophobia. I think there’s a lot of closeted or Kinsey 3+ bi men that are prevented from being happy with a male partner and even more commonly it keeps straight men from pursuing platonically fulfilling emotional intimacy from other men. I often deal with sexual transference behaviors put of male patients and it can be difficult to both find a male staff member to model appropriate nonsexual emotional intimacy to them and to get the patient to accept the healthier experience.

  TLDR there’s a lot of things I would like to do to help solve the male loneliness epidemic because it’s a very real thing but I’m AFAB and NB at best and 90% of the work needs to be done by men helping other men, so I’m functionally helpless to do so.

• ⁨Comment⁩ on ⁨Big 5 Personality Traits - Cambridge Analytica's Means of Profiling⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  I just googled it. Super creepy:

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• ⁨Comment⁩ on ⁨ultra high iq⁩ ⁨⁨2⁩ ⁨months⁩ ago⁩:

  Oooooh that’s why they tested me for that. They told me I was faking for drugs because I got a 140 something but I panicked and failed the left right thingy really badly and my MSE results suggested dementia (and I was like, 20). I did finally find a doctor who listened and I’ve been very functional on Strattera for many years now (which is ironic because it’s not even a stimulant / it’s functionally useless recreationally). I can’t even take simulants because I have too much anxiety.

• ⁨Comment⁩ on ⁨Evolution: 🖕⁩ ⁨⁨3⁩ ⁨months⁩ ago⁩:

  honestly the best posture advice I have ever gotten is to sit like I have a tail (you would have to tilt your hips forward and stick your butt out behind you to put the tail up behind you rather than curling your tailbone under such that you’d be sitting on the tail).