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Posts ranked by engagement rate by followers. Pinned posts are shown because a reader will recognise them, but they sit outside the measured window and feed no average, rate or rhythm.
| # | Post | Date | Format | Likes | Comments | Plays | ER |
|---|---|---|---|---|---|---|---|
| 1 |  Ten things you look up on every shift. Most of us open a tab for at least six of them, every week, for years.
We put nine chapters of named guidelines in one file with a source tag on every number. For licensed clinicians, link in bio.
Which one do you still look up?
#hospitalist #residency #internalmedicine #meded #foamed physician medstudent nightshift attending clinicalpearls | 4 Sept 2026 | carousel Pinned | 133 | 5 | 90.79% | |
| 2 |  Read this handoff and try to find the error. There is none. Every line in it is true, and the night team is still going to be guessing at 3am.
The failures in a handoff are almost never wrong facts. They are absences, and absences are invisible when you proofread. No severity word, so the receiver cannot triage. No line beginning with if, so the covering doctor invents a plan instead of executing yours. A verb with no owner and no time, which is a wish rather than a task.
The trap is the instinct that follows: paste in the whole admission history so nothing is lost. Length is not safety. A longer handoff hides the three lines that mattered.
Which of the four does your handoff usually miss?
#handoff #patientsafety #hospitalist #residency #internalmedicine | 4 Sept 2026 | carousel Pinned | 26 | 0 | 17.11% | |
| 3 |  Stable overnight.
Four things happened on the night I wrote that line, and the record kept one of them. Not the worst one. The nurse called at 0140 for a heart rate of 118 and there was no order. Two liters went on at 0320 and nobody charted it as a change.
None of that is a documentation problem. It is the day team reading a word that says nothing happened.
What did your last stable overnight leave out? Tell me the hour.
Comment CHAPTER and I will send you the free sepsis chapter, the whole thing, no email. It is the same chapter that sits inside the paid file.
#hospitalmedicine #nursing #internalmedicine #residency #medicalstudent #patientsafety #handoff | 10 Sept 2026 | reel | 2 | 3 | 633 | 3.29% |
| 4 |  Eight words I wrote. Every one made somebody else stop and call me.
None of them is an error. As needed. Continue current management. Hold if unstable. Patient is refusing. Will follow. Improving. Per protocol. Discussed with family.
Each one is correct and each one is a phone call at 3 a.m. that somebody else has to make. The eight fixes are in the post, in the words I actually use now.
Comment CHAPTER and I will send you the free sepsis chapter, the whole thing, no email. Save it, because you will write one of these tonight.
Free chapter on the page in my bio. Same chapter that is inside the paid file.
#nursing #hospitalmedicine #pharmacy #casemanagement #medicalcoding #residency #medicalstudent #documentation | 9 Sept 2026 | carousel | 2 | 1 | 1.97% | |
| 5 |  Six clocks start when you order a restraint.
Every line here is the federal text at 42 CFR 482.13(e), not a hospital policy. Four hours for an adult, two for ages 9 to 17, one hour under 9, a face to face inside the first hour, and a new order after 24 hours that needs an exam first.
Your note usually records one of them.
The rest of what I look up is on the page in my bio. One chapter is free, no email.
#hospitalist #emergencymedicine #psychiatry #residency #patientsafety | 8 Sept 2026 | carousel | 1 | 1 | 1.32% | |
| 6 |  Eight medicines on this discharge list. I marked three.
Not because the doses are wrong. Because three lines do not say when they stop, how much is too much, or why two of them are both there.
Five lines are fine and I did not mark them. Three marks is the limit I keep. A list with eight marks gets read as noise and fixed as none.
The pass is three reads: stop dates, ceilings, pairs. Ninety seconds, and it is the last thing I do before I sign.
The rest of what I look up is on the page in my bio. One chapter is free, no email.
#hospitalist #pharmacy #residency #internalmedicine #medicaleducation | 9 Sept 2026 | carousel | 1 | 1 | 1.32% | |
| 7 |  Three of these change what you order tonight.
Eight questions your pharmacy answers in one call, and none of them is in an app, because every answer is local. Concentrations, who doses what, what is actually in the drawer at 2am. Three of them change what you order tonight.
Ask one, get all eight, and they remember who asked.
The rest of what I look up is on the page in my bio. One chapter is free, no email.
#hospitalist #pharmacy #residency #internalmedicine #criticalcare | 8 Sept 2026 | carousel | 0 | 1 | 0.66% | |
| 8 |  Not every page needs a trip.
Three numbers decide before you move, the vitals right now, what changed since the last set, and the last dose with the time it went in. Two of the three are already at the desk. The third one is usually your answer.
The rest of what I look up is on the page in my bio. One chapter is free, no email.
#hospitalist #nightfloat #residency #internalmedicine #clinicalpearls | 8 Sept 2026 | reel | 0 | 1 | 90 | 0.66% |
| 9 |  Eleven entries between 10pm and 7am. Three of them get read again.
Months later nobody can change what happened. They can only see whether three times are in the chart: when somebody first wrote that something had changed, when the person who could change the plan was told, and when the plan actually moved.
Ordered, sent and given are three different clocks. The one that gets read is the last one.
Three lines, twenty seconds, and they are the three that get read.
The rest of what I look up is on the page in my bio. One chapter is free, no email.
#hospitalist #residency #internalmedicine #nursing #medicaleducation | 9 Sept 2026 | carousel | 0 | 1 | 0.66% | |
| 10 |  Your note is timed. It is timed wrong.
42 CFR 482.24(c)(1) asks for entries that are legible, complete, dated, timed, and authenticated by the person responsible. Every system I have used puts the signature hour in that field, and every one of us lets it.
Seen at 1410. Written at 2140. Both hours belong in the note, and only one of them is in mine.
Which hour is in your last note?
Comment CHAPTER and I will send you the free sepsis chapter, the whole thing, no email. It is the same chapter that sits inside the paid file.
#hospitalmedicine #healthinformation #medicalcoding #nursing #residency #compliance #patientsafety | 10 Sept 2026 | reel | 0 | 1 | 30 | 0.66% |
Top Reels by plays
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Separate population from the audit sample · 12 Reels with a published play count · 6 Sept 2026 – 10 Sept 2026 · includes 7 Reels older than the 10-post content window, excluded from every metric above.
The best discharge summary is three lines. 42 CFR 482.24(c)(4)(vii) asks for outcome of hospitalization, disposition of case, and provisions for follow up care. That is the list. The other two pages are for the chart, not for whoever sees the patient next. Twelve phrases free, no email. Link in bio. #hospitalist #dischargeplanning #clinicaldocumentation #internalmedicine #transitionsofcare
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Stable overnight. Four things happened on the night I wrote that line, and the record kept one of them. Not the worst one. The nurse called at 0140 for a heart rate of 118 and there was no order. Two liters went on at 0320 and nobody charted it as a change. None of that is a documentation problem. It is the day team reading a word that says nothing happened. What did your last stable overnight leave out? Tell me the hour. Comment CHAPTER and I will send you the free sepsis chapter, the whole thing, no email. It is the same chapter that sits inside the paid file. #hospitalmedicine #nursing #internalmedicine #residency #medicalstudent #patientsafety #handoff
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Nobody approved this phrase. Your order set went through medical staff, nursing and pharmacy before anyone could click it. 42 CFR 482.24(c)(3) spells out four conditions. The phrase you built yourself went through you, once, on a night shift. I am not against saved phrases. I am against the ones nobody has read since the day they were written. Twelve of my phrases are free, no email. All 68 are $10. Link in bio. #hospitalist #internalmedicine #clinicaldocumentation #residency #patientsafety
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A complete note. Zero facts. No acute distress. Reviewed and agree. Pending at this time. Teach back completed. Four lines that pass every audit and inform nobody. I counted in my own twelve published phrases: four of the twelve are one line long, and those four are the ones everybody already types. The other eight name a person, a time or a date. That is the whole difference. Read the twelve free, no email. All 68 are $10. Link in bio. #hospitalist #residency #internalmedicine #clinicaldocumentation #patientsafety
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A longer consult note is not a clearer one. The consultant reads one line and it is usually not the one you spent the paragraph on. Four questions that get answered the same day, each with a date in it and a decision waiting on the answer. The rest of what I look up is on the page in my bio. One chapter is free, no email. #hospitalist #internalmedicine #residency #consults #clinicalpearls
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