I worked with a new locum (agency/casual/temporary fill in) scrub nurse yesterday. He said there were more than 70 jobs listed for the day in Melbourne. He just went for the nearest and best paid option.
Think on that a bit…
70 gaps in theatre nursing position. Most nursing departments will first call their own staff to do extra shifts before looking to external agency to fill in (more expensive, unfamiliar staff)…
Think of the local staff that have to do more shifts. Think of the nursing managers that have to find staff daily. Local staff depleted. Money is way better as casual…
Surfers ear is not swimmers ears.
Inner ears is the cochlea and semicircular canal. What you refer to as inner ears is actually the middle ear anatomically speaking. Surgery ears and Eustachian tube dysfunction is unrelated.
Middle ear fluid has nothing to do with swimming.2/
Surfers ear is bony exostosis. Bone haemorrhoids of the ear canal. It’s not infection. It’s not blockage. It’s not inflammation. It’s just bony growth. Of course it can predispose to wax blockage or infection. But then just call it wax blockage or otitis externa. 3/
John Farnham, an Aussie legend, sadly has one of the many kinds of Head & Neck Cancer. Just like Michael Douglas, Sigmund Freud, Sammy Davis Jr, George Harrison and many others did.
A thread on Head & Neck cancer:
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2. Head & Neck cancer is a big group of cancer that arise from the Head & Neck region, involving the skin, inner lining of the airway & digestion, glands (saliva glands, thyroid), soft tissue, muscle, bone, sinuses, etc.
3. Depending on where they come from, they’re often squamous cell carcinoma, but they can be adenocarcinoma, adenoid cystic, acinic, papillary thyroid, follicular, sarcoma, etc. Not a single disease. Various kinds, types, locations, and degrees of aggressiveness.
12 Tips on surviving a hospital admission in COVID times.
1. Prepare to wait. Staff overworked, doing double shifts. Hospitals at full capacity. Be patient. 2. Bring a book, a computer, a phone and necessary chargers. 3. Come alone if possible or with only 1 support person.
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4. Bring small snacks if needed (free of nuts if possible) & drinks. 5. Prepare to be cancelled or have your plans changed. Cancellations are always last resort but sometimes there are no other options. 6. Summarise your health needs and history on a page. Staff exhausted.
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7. Bring all your meds. Hospitals may have supply issues and you may need to rely on your own supply. 8. Bring any previous health notes, history or results. Often the IT system is not perfect. 9. Have contacts of your next of kin and GP ready on paper too.
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Let’s talk about the journey of the facial nerve from brain to face.
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2. Here’s a schematic diagram from Grays with my additional labelling. This complex nerve meanders through really tight structures.
Facial nerve is also called Cranial Nerve VII (“seven” if you don’t do Roman numerals).
I love it and I spend hundreds of hours operating on it.
3. We start at the facial nerve nuclei in the brain stem (pons). The nerve then swims through CSF like a hanging bridge to get to a tight bony tunnel called internal auditory canal. It’s not alone here. The tunnel is shared with vestibulocochlear nerve (CNVIII). Schematically: