The Damaging Tunnel of Residency

I woke up today, feeling miserable and empty. Yesterday too. And the day before yesterday. It was all the same.And what worries me the most is that this wave of bitterness hits me every single day since my second semester of residential program. I've become easily irritated by the smallest things.

The number of snide remarks I throw is concerning, my patience grows thinner by each day passing. I'm constantly on edge and frustrated. All in all, I've become the passive-aggressive personality I always despise.It's because I know what awaits me isn't going to be easy.

I once read a post in Humans of New York that said:There's a strange culture in medicine. People are less friendly to each other than I imagined. I got an MD and a PhD in Neuroscience. I'm finishing my residency right now. I guess I thought that everyone would be compassionate, and would help each other, and would be nice to each other.

And don't get me wrong - I work with a lot of compassionate people. But the stress just erodes people. There's a lot of tension and anger. We're taught that 80 hours per week is normal and shouldn't be questioned. But at the same time, a huge amount of work that medical interns do is administrative.

It could be outsourced without affecting the quality of education or care. And the culture does real harm. I've had two friends commit suicide. One of them was studying anesthesiology at Yale and overdosed in a parking lot. The other jumped off the dorm building at NYU.

There's got to be a better way.

I don't know, maybe I'm just saying this because I'm stressed. I'm heading to the ER now. I'm almost at the end of my residency. I can see the end of the tunnel. But the tunnel is very damaging.This is the truth, and God knows I can not word it any better.Just a few months ago, one senior of mine - just started her third semester - filed a resignation letter.

Rumor has it, she couldn't bear all the tension of being a junior resident. I myself have been questioning my motive of signing up to this tunnel. I didn't even want to be a doctor in the first place, let alone to add a few more torturing years just because everyone expect me to.

But apparently life has funny ways to teach me lessons that 'I don't like' does not always mean 'I can not'. So here I am, joining the bandwagon.Indonesian medical school system is notorious for its feudalism. But I guess everywhere is just the same. Medical school, in a way, is very much similar to military.

They function based on chains of command, in which the higher rank you are placed, the bigger responsibility you are carrying. I called it 'safety nets'. We, juniors, are minions. We come to the hospital earlier than everybody else, do all the labor works (writing charts, printing journals, preparing slides for morning reports, drawing blood works, collecting sputum, etc), doing everything under supervision, reporting back to our seniors when something doesn't sit right with our patients, and (most of the time) in return, our seniors will teach us how to handle those situations. If you're lucky enough, your seniors will even back you up for those novice mistakes you make.

Sounds easy, yes?Well, no.

We were 'someone' before we join this league of residency. Some of us worked as directors of some fancy hospitals, some are the sons/daughters of VIPs/professors/people from higher echelons, some even have longer titles than their surnames. But once we enter the ground zero, we are told to strip ourselves off those labels, to grind our teeth and to keep our ego in check.

Because in order to be filled with water, you've gotta empty your cups first.A best friend of mine once said, "You're back to school now, so it is important for you to willingly accept to be shaped and molded by your system. Once you're in, you're committing yourself to a life-long learning.

So no matter how hard it's going to be, you, after all, are prepared to be a better, wiser physician."And then one day I got to meet a friend of mine, an excellent pediatrician. She told me that she was also on the brink of giving up when the tunnel got darker and darker the deeper she walked.

Indeed, residency is not a walk in the park. It consumes your energy and demands half of your life. Those who are managed to get to the end of the tunnel have gone through a voracious battle.

And no body stays the same after.

"Residential program is the place where you are forced to be mature," one of my favorite seniors said. Mature and realistic, I may add.I wish I had someone to hand me down the manual, to tell me how this journey was going to be and whether it was worth it. I wish I had someone I could talk to in times of doubt.

Sometimes I feel like the sole reason why I am in this tunnel is because I just want to see how far I can go without losing myself in the process.This suffocation that lingers tight on my chest, whether a slight depression or simply boredom, isn't something I can easily explain to anyone. People are often mesmerized by the shining white coat and the courageous act of saving life Grey's Anatomy style, or even the nobility and wealth that comes along, unaware of the ugly truth masking behind.

This profession of mine is truly one of a kind.And just like what I told a dear philosopher friend of mine: if I'm going to go through this hell, I might as well do this right.We all make our choices. I pray mine is a blessing rather than regret.

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Ethicists, Hold Your Horses
By Fleur Jongepier (Assistant Professor of (Digital) Ethics at Radboud University Nijmegen) and Karin Jongsma (Assistant Professor of Bioethics at University Medical Center Utrecht). This article is loosely based on a Dutch article which previously appeared on the philosophy weblog Bij Nader Inzien. Translation by Radboud Recharge and the authors. The English version of this article was published on Open for Debate.If intensive care beds or ventilators run out, who should be saved? And how should such decisions be morally justified? These are horrible, indeed impossible, decisions that clinicians currently face, or may be confronted with in the (near) future. In Italy, clinicians were "weeping in the hospital hallways because of the choices they were going to have to make". These are also questions that ethicists have, for decades, thought long and hard about.It seems natural - so natural it almost goes without saying - for ethicists to engage right now, and to start a public debate about the moral justifications of the possible triage options. And they have. Julian Savulescu and Dominic Wilkinson, for instance, recently wrote an article entitled 'Who gets the ventilator in the coronavirus pandemic?' They outline five different approaches, but really only take the utilitarian approach seriously; in other words, that a clinician should act such as to save the greatest number. On the utilitarian view, if "one person, Jim, has a 90 per cent chance and another, Jock, has a 10 per cent chance, you should use your ventilator for Jim." We can call them Jim and Jock of course, but let's not forget that Jim typically represents the elderly or people with illnesses or disabilities, whereas Jock represent the young and fit.Similarly, in the Dutch context, colleagues Marcel Verweij and Roland Pierik recently stirred up debate on the opinion pages of the national newspaper. They proposed that in the event of extreme scarcity in the intensive care unit, priority should be given to younger corona patients. Verweij and Pierik are by no means the only ones defending this view. What's the reasoning behind this view?There are basically two arguments. First, young people generally recover faster, which means that giving priority to younger people will allow one to treat more people overall, thereby increasing the chance to save more lives. Verweij and Pierik provide a second, much more controversial, argument, namely, that the death of a young person involves a "much greater loss". Why? Because an 80-year-old will have already "had the chance to live their life".This is not an unfamiliar standpoint within ethics - it's known as the "fair innings principle" - but this doesn't mean it's uncontroversial. Here we are not principally concerned with the fair innings principle itself (though we have serious concerns on that front, too), but more fundamentally about whether now is the right time to have a public debate about whether it's morally justifiable to sacrifice the elderly to save more lives whilst the pandemic is raging on.An impossible burdenIn response to alarmed reactions by some readers, Verweij and Pierik wrote a second article, motivating their reason for submitting their article to the national newspaper. They give two reasons: solidarity and democratic, public deliberation. We believe both arguments are insufficient reasons, in fact we think on the grounds of solidarity and democracy one can come to the opposite conclusion, that we shouldn't have a public debate about the ethical foundations of triage decisions right now.Let's start with the argument from solidarity. We should have a public debate about the ethics of triage decisions because doing so is a way of expressing solidarity with clinicians. Verweij and Pierik write: "It's an almost unbearable responsibility to have to decide who should and should not be offered a chance of survival. Solidarity means that we should collectively bear the burden of the crisis as much as possible."Some have recently suggested to introduce a "triage committee" to remove "the weight of these choices from any one individual, spreading the burden among all members of the committee". Such a committee would also enable physicians and nurses to remain the primary caretaker and "fiduciary advocates" rather than simultaneously being the one having to decide whether their lives are to be saved at all, imposing on them an impossible double-role.A need for moral reassurance?But can ethicists - indeed, ethical theory - also help relieve the burden? In a sense, it feels right to stand firmly behind the clinicians, who are now making impossible decisions, and to tell them: You're doing okay, your choices are ethically justifiable.But it is not evident that clinicians are now actually helped by moral reassurances or for ethicists to 'have their back'. It is also not necessarily a good idea to pull clinicians into a reflective, deliberative ethical mode right now. This could slow them down or result in confusion and might actually increase rather than reduce the burden on them. Clinicians already have had their training and learned the moral theory; now is the time to act.A potential explanation for why ethicists are submitting op eds to the newspapers about triage decisions is that academic questions have become real life questions, plus academics are being told from every angle they need to get out of their ivory towers. As Verweij and Pierik write: "For us as ethicists, the question whose lives should be saved is obviously an interesting dilemma that we often discuss in our teaching and articles."Indeed, examples of triage decisions are widely used in education as thought experiments. But real-life triage is a different matter altogether. We firmly believe triage decisions are in safe hands with clinical (support) teams, and, in fact, not broaching the issue of moral justifications of triage decisions could now actually express more solidarity and support with clinicians than defending a specific moral stance. A more practical point is that clinicians in all likelihood will neither have the time nor the energy to read the opinion pages. It is therefore questionable whether one could reach them with articles in the newspaper, even if one would want to.You might say: in spite of the fact that clinicians indeed have had 'the theory' and in spite of the fact that we place great trust their decision-making capacities, actually having to make such decisions is another story. And this must indeed be acknowledged. The burden on clinicians is inconceivably heavy.Given the current burden on clinicians, many clinicians would perhaps welcome, or even explicitly request, guidance from ethicists. So here we want to make clear that this is not what we are against. Ethicists can and do contribute to ongoing triage conversations with physicians, respiratory therapists, nurses, and critical care specialists. To an important extent, then, a public debate which includes ethicists is already ongoing. What's less clear is just how 'public' a 'public debate' must be (more on this below). In any case, ethicists can help out - and express solidarity with - clinicians in other ways - more fruitful ways, we think - than defending utilitarianism or the fair innings principle in the media.Solidarity: a double-edged swordAs we've seen, one argument to have this public debate now is that this would express solidarity with clinicians. We've suggested that it is not evident that this would actually benefit them. Even if it did, though, an appeal to solidarity cuts both ways. After all, many members of the public were startled and hurt by the articles currently going around. That this has created unrest and real damage to some individuals was foreseeable. It was foreseeable that the message that the lives of some people would be considered less worthy than others' would linger primarily in the minds of the elderly, the already ill or people with disabilities.Obviously, the idea that some lives are more worthy than others is not the explicit or intended message of the articles which defend utilitarian or fair innings-based ways of making triage decisions. In the philosophy of language, however, a useful distinction is made between 'saying' and 'conveying'. You can say something explicitly, but you can also implicitly convey a message, be it intentionally or not. It is understandable that some elderly, ill, or vulnerable readers interpreted utilitarian and fair innings-based articles in ways that had not been explicitly said. For instance, it's understandable that many got the message that their lives were of lesser worth or that the elderly 'have already had their chance'. These messages were, no doubt, not meant to be conveyed. But that they were conveyed all the same was foreseeable.Here's the thing: an ethicist should not only reflect on moral rules, norms, and principles, and how they (fail to) apply to the real world, but also on what communicating certain moral views can bring about in the lives and experiences of human beings. How and when to communicate and reflect on ethical principles is an important part of ethics itself.Tragedy and the limits of ethicsAnother possible unintentional message of the article was that the aforementioned priority principle that Verweij and Pierik defended could be interpreted as a bona fide or 'sound' ethical principle. It is crucial to emphasise that triages in intensive care in crisis situations are examples of tragedy. Tragedies pose a challenge to almost all moral theories and principles (see also this piece written by Schaubroeck on the BNI website (in Dutch) and this blog from John Danaher).We generally consider moral theories, beliefs, and principles (such as justice, human dignity, non-discrimination, and so on) to be 'admirable' or the sorts of things we would proudly or wholeheartedly support. But this works differently in tragic situations. When a younger person is given priority and an older person dies as a result, we would not say that the underlying decision and principle was 'admirable'. We would not proudly stand by the ethical justification for such a decision. The choice involves choosing the lesser of two unspeakable evils; it was a tragic decision.Authors writing on triage decisions are well aware of this, of course. But the very act of defending, say, utilitarianism or the fair innings principle in public in times of crisis, and arguing what makes the approach justified, may have nevertheless convey a different message to some readers. It may convey that it is morally 'okay' to sacrifice the old or vulnerable in order to save the young. It's not.Given the likelihood that articles in which ethicists say how triage decisions ought to be made on the basis of moral theories and principles fails to reach or genuinely help its target audience (clinicians) and that another important audience (members of the general public) are likely to be harmed by its content, it's better if ethicists would not publish their takes on triage at this moment. Precisely for reasons of solidarity.A democratic discussionOne might rightly worry: isn't what we are proposing here anti-democratic? Shouldn't it be precisely part of a well-functioning democracy to discuss vital decisions, such as priority rules on intensive care units? Given the value of democracy and its connection to open debate, it seems discussing these matters with the general public is precisely what must be done. Even if people are startled, even harmed, as a result.We agree that having societal debates is vital. We even agree that we need to have an open conversation about the possible moral justifications of triage decisions. However, the 'argument from democracy', as we might call it, is not an argument for having that conversation now.Our worry about trying to aim for a 'public debate' where triage decisions are concerned, is that it will be neither a 'debate' nor strictly speaking 'societal'. After all, only about 50% of the (Dutch) population reads the newspaper. In those percentages, men are generally overrepresented and migrants are underrepresented. So, the public reached through (online) articles may well be ill-representing society at large. As for having a 'debate': an (online) article does not constitute a debate (not the sort of debate we need to have, anyway). It's one directional. This is particularly problematic when ethicists make it seem as if the theory or principle they defend (utilitarianism or the fair innings principle, say) is the moral principle.It doesn't need to be one-directional, and no doubt the ethicists who are engaging precisely hope and aim for readers to engage, too. And sure, readers could submit a two hundred-word reply, or say something in the comment section. But that's not nearly enough. Also, let's not forget these are likely to be individuals with time and energy on their hands, that is, probably not the ones ill or stressed out. That is: those affected most. If we want a genuinely public debate, we need to give the public a genuine voice. We need more than a handful of articles by ethicists to which citizens can respond in the comment sections. Having a proper public conversation is vital, but doing so now is, we fear, neither desirable nor possible.Against democracy?A recent statement from the Nuffield Council on Bioethics deals explicitly with questions concerning democratic governance in relation to COVID-19. The authors express serious concerns about the situation in the UK - and situations elsewhere are probably not dissimilar - that, right now, decisions are being made that "go to the very heart of what governments are there to do: to protect the freedom and well-being of their people". Yet public information is "limited and obscure" and no proper public discourse on any of the vital ethical-political questions has gotten off the ground. They plead for greater accountability and transparency, and ask the government to get public deliberation off the ground. We are "all in it together, we all need to know and all need to have a voice".The present article might be interpreted as being "against" initiatives like these. So we want to be clear: we very much share the overall pro-transparency and pro-democratic sentiment. But respecting and promoting transparency and democracy can be done in different ways. There's a difference, to begin, between accountability and transparency (we all need to know) on the one hand and public discourse (we all need to have voice), on the other. We wholeheartedly agree with the first point. It's crucial that governments make explicit the decisions they are making and make explicit their reasons (and empirical evidence, where available) for making those decisions.As for the second point: yes, we do "all need to have a voice". The question is: do we all have a voice? Are our voices at the same decibels? Do we all have a voice that will actually be heard? If we don't, then it may not be the best idea to engage in public discourse now but rather do so later, once we've had more time to also think about and are actually able to guarantee the diversity and inclusivity of the debate we need to have. Public debates are difficult, slow, and complex and it is unlikely that a consensus or otherwise strong supported triage criterion will be the result from public consultation any time soon.The alternative is a quasi-public debate, in which some members of the public are represented, and others (those most affected, we fear) aren't. This is perhaps the worse of the two options. The combination of "public debate" and "now" form an unhappy couple. Doing it properly later may be better than doing it poorly and half-heartedly now. If only because three or four op-eds and a half-baked survey filled in by healthy, abled, and childless individuals might create the illusion that we've all had a say when in fact we haven't at all.Being realistic or a coward?Our standpoint relates to an important distinction in political philosophy between ideal theory and non-ideal theory. Ideally, we agree: we need to have a public debate, we need to have it now, and we need to have it with all of us. But sometimes, pursuing the ideal can have counterproductive outcomes, and pursuing a non-ideal course of action (having the debate later), is to be preferred. Precisely because, paradoxically, the non-ideal course of action enables us to get closer to the ideal of all of us having a voice, and getting an actual chance of being heard.Maybe we're too pessimistic. When defending non-ideal solutions, one always risks slipping into cowardice. As the authors of the Nuffic statement acknowledge, maybe there is "no capacity now to open up a wider public discourse", which is what we fear, but they also add, quite rightly, that "capacity should not be an excuse". The solution must clearly then be not to accept the situation but to try and change the capacity. But can we? The real question is whether we can really get a public debate going that is legitimate and isn't going to harm more than it helps. We need to think about the empirical chances of public deliberation actually being successful. Because if the public is not ready, or able, or willing to engage in public deliberation, or if it turns out only a privileged subset of the public is, then that might be a reason not to do it now, in spite of the fact that, ideally, we should all be deliberating about this together, right now.Non-ideal circumstancesAnother obvious reason for not starting a societal debate now is that emotions are running high, there is a great deal of unrest, fear, misunderstanding and uncertainty. As far as we can see, there is now a need for articles about which specific action we should be taking in daily life (What are we supposed to do exactly when someone in our household becomes sick? Should we be making DIY masks or not?).Let's also not forget many members of the general public are currently being invaded by tent-building, pet-hunting offspring with Nutella-smeared faces. They may well have other things on their minds than the moral justification of implicit ethical principles for triage at the intensive care unit. They might well want to engage in public deliberation, but simply can't, at this moment. These are not ideal circumstances for a complex societal debate about the principles of who should be saved in these extraordinary times. We believe a public discussion would be more effective, less aggressive, and more inclusive, if we have it when the worst of this is over. We contend therefore that, precisely for reasons of democratic legitimacy, now is not the time.For the record: despite the title of this blog, there is plenty of constructive work that ethicists could do. For example, they could say something sensible about the currently emerging culture of 'shaming' and hostility; the difference between being alone and being lonely; how can we ensure ethically sound clinical research in times of crisis; how we should feel about the enormous influence of companies who sell ventilators and choose whom (not) to sell it to; how we should be dealing with digital social contact (and medical consultations) and how this differs or does not differ from face-to-face meetings. We are here specifically worried about whether ethicists can fulfil a constructive role when it comes to publicly defending certain moral theories or principles to justify ways of making triage decisions on intensive care units, or whether it's better to place our trust in clinicians and/or triage committees.The ethicist's role in times of crisisBut isn't this an ethicist's job? Isn't it their responsibility to publicly discuss uncomfortable moral principles and considerations, also in crisis situations? We realise that our standpoint is quite controversial, but we would say: no, not necessarily.Indeed, it is the ethicist's job to reflect on the ethical challenges and issues in society. Where possible, it is also their job to share their expertise with doctors when they undergo crisis training and learn about triage decision-making. At the moment, this is already going on. It's not like ethicists are not consulted or asked for their views - the contrary. But it's not enough for an ethicist to share their knowledge of how certain moral theories or principles are understood in ongoing debates in applied ethics. In their expert capacity, their responsibility also extends to taking into account what the articulation and defence of certain moral principles may lead to. This includes unintended messages. Especially utilitarians, who appear to have the loudest voice in current triage discussions, have every reason to include this factor in their calculations.Isn't it strange that we are engaging in public debate in order to say we shouldn't be having this public debate? Yes, it's strange, but these are strange times. For this reason, we ultimately decided that we would not send a (much) shorter version of this article to the newspaper, since that would be hypocritical. We decided it may be right to engage on a more reflective platform, without scarcity, and that allows for longreads. Though the irony of it all does not escape us.We believe that now that there are actually real ethical dilemmas, this is, paradoxically perhaps, the time for ethicists to hold their horses. We should now be relying on the expertise - and by this we specifically also mean the moral expertise - of clinicians and their support teams, who face incredibly difficult decisions at the intensive care unit. We believe that this trust is more supportive towards clinicians than a reflectively substantiated ethical article that, no matter which way you look at it, raises questions about the decisions clinicians have to make. Applied ethicists are, ideally, good at ethically reflecting on 'real life' situations. Clinicians are good at acting in 'real life' situations.To put it simply: fellow ethicists, now is not the time.·RELATED QUESTIONIs there is any side effects of not sleeping in a medicated bed?I don't think so! if you are not a medical patient, you can sleep in any bed you feel comfortable with.But for medical patients, it is necessary to sleep on a medicated because it has so many movable parts that offer comfort to them and for their treatment.If you want a high-quality medical bed at your resident, you can easily get a free demonstration on the same day you will contact one of the best reliable online platforms which is Adjustable beds.They will provide you what ever you need in your medical bed. If you want to take a full experience of their medical beds, then you can use their free no obligation home service that will allow you to use their products at your own home.
The Medical Center Foundation Announces More Than 2.3 Million Raised Through W.a.T.C.H. Employee-Giv
The employees of Northeast Georgia Health System (NGHS) are going beyond the bedside and into their wallets to show their commitment to improving the health of the community in all they do.Nancy Colston, president and chief development officer of The Medical Center Foundation, announced that NGHS employees raised $2,388,048 through a recent campaign conducted by its employee-giving club, called W.A.T.C.H. (We Are Targeting Community Healthcare)."By pledging more than $2.3 million, NGHS employees have set a new record and made an inspiring leap into our campaign," said Colston. "This is a tremendous milestone in the history of The Medical Center Foundation and one that has a direct impact on the health care of our community."Employee fundraising efforts were led by tri-chairs: Heath Gurr, RPh; Ivan Moore, RN; and Jennifer Stoeckig, RN; who were supported by a team of nearly 40 employee volunteers throughout the Health System. Pledges were made by more than 3,400 employees during 100 presentations held across the organization this summer.W.A.T.C.H. members have given more than $7.8 million since the first W.A.T.C.H. Campaign began in 1999 to support numerous projects such as Hospice of Northeast Georgia Medical Center, community walks, nursing and allied health scholarships, a mobile simulation unit and a future wellness walkway to be constructed at Northeast Georgia Medical Center Braselton.Learn more about W.A.T.C.H. and how you can support The Medical Center Foundation at www.TheMedicalCenterFoundation.org.In This Picture: The total dollar amount raised through a recent campaign conducted by The Medical Center Foundation's employee-giving club, called W.A.T.C.H., is revealed to W.A.T.C.H. Committee members.Originally published at Gwinnett Magazine·RELATED QUESTIONIs there is any side effects of not sleeping in a medicated bed?I don't think so! if you are not a medical patient, you can sleep in any bed you feel comfortable with.But for medical patients, it is necessary to sleep on a medicated because it has so many movable parts that offer comfort to them and for their treatment.If you want a high-quality medical bed at your resident, you can easily get a free demonstration on the same day you will contact one of the best reliable online platforms which is Adjustable beds.They will provide you what ever you need in your medical bed. If you want to take a full experience of their medical beds, then you can use their free no obligation home service that will allow you to use their products at your own home.
Buy Hospital Beds in New Jersey and Philadelphia Area
Hospital beds are of different types and different beds have different kinds of usage. Each has a specific purpose and not every hospital has all the types. The choice depends on various factors and also on the prices of different beds. Let's have a look at some of the most common types of hospital beds:Gatch BedProbably the oldest hospital beds that one can see even today. Gatch beds are usually found in nursing homes and medical facilities that are not economically well-off. They do not run electricity and have three cranks present at the foot just below the mattress. One crank lowers and raises the whole bed, one the head of the bed and the final one lowers and raises the foot of the bed.Electric BedAn electric hospital bed is what can be seen most commonly. The side rails have buttons that need to be pressed in case the head needs to be raised or lowered. The patients can do these themselves ensuring more comfort and convenience.StretchersThese are the beds that are generally present in the hospital emergency rooms. These offer ultimate mobility and can be easily transferred from 'place of accident' or house to the ambulance and to the emergency room. These come with folding legs.Low BedsThese, as the name suggests, have a low height and used for patients who have a tendency to fall off from the bed and sustain injury, in spite of the side rails. The height can be adjusted in some of these and is usually in the range of 8 inches to 2 feet from the ground. However, in most cases, only the head and foot can be raised and lowered.Low Air Loss BedThese come with special cushions and are for burn and skin-graft patients. The bed come with special hospital bed mattress having sacs where air can be blow into. This bed is meant to keep the patient cool and dry. Often patients with serious ulcer problems are given such beds.Circo-electric BedThese look like a hamster treadmill and can rotate. These are used for patients with severe spinal injury or skin conditions that needs to be turned frequently and cannot move.To buy hospital bed in New Jersey and Philadelphia, Goodwill Home Medical Equipment is a reliable name. They even supply a wide range of medical supplies, incontinence products, mobility aids and home medical equipment. Please visit or call 609-337-5506 for more information.Buy hospital bed in New Jersey and Philadelphia, Electric Hospital Bed, Patient Hoyer Lift for Sale, Hospital Bed Mattress·RELATED QUESTIONIs there is any side effects of not sleeping in a medicated bed?I don't think so! if you are not a medical patient, you can sleep in any bed you feel comfortable with.But for medical patients, it is necessary to sleep on a medicated because it has so many movable parts that offer comfort to them and for their treatment.If you want a high-quality medical bed at your resident, you can easily get a free demonstration on the same day you will contact one of the best reliable online platforms which is Adjustable beds.They will provide you what ever you need in your medical bed. If you want to take a full experience of their medical beds, then you can use their free no obligation home service that will allow you to use their products at your own home.
Beds That Heal You
Beds are meant for sleep. Sleep is essential for healthy living. Healthy living is only possible if you keep healing the wear and tears life causes. That's a fact!Hospitals and their capacity to attend patients have a direct proportional relationship with the number of beds they accommodate. In the words of Groucho Marx- A hospital bed is a parked taxi, with the meter running!A hospital bed by name is meant for a patient. The bed ensures comfort and well being. Not only for the patients, but the hospital bed is also designed for the health care staff, so that they can perform their duties properly. Some common features are· Portability of the bed.· Adjustable height of the bed.· Side railings on the bed for safety of the patients.· Buttons to operate the bed.UsageBy name it is not only suited for the hospitals but also can be kept at other locations where an ailing has to be taken care of. These can be listed as nursing homes, domestic health care, old age home etc.The varietiesGone are the days when a hospital bed was manually operated by a pulley that was moved clock wise or anti clock wise in order to adjust the bed height. Now we have fully and semi-automated beds that operate with push buttons or remote controls.Now the beds are further fragmented to operate on particular areas like the head the foot or the body. Manufacturers of hospital beds have flooded the market with variety that suits the purpose.Some featuresWheels- Beds are attached with wheels so that they are movable. These wheels are blocked for safety reasons when not in use.Elevation-The beds are elevated for the ease of the patients. Beds can be raised in the head section or the foot section or the entire body section depending on the need of the hour.Safety features-Despite the side railing these days the beds are fitted with exit alarms that raise an alarm the moment the bed gets empty. These alarms are meant for the older people who have a falling off tendency and people with memory impairment.·RELATED QUESTIONIs there is any side effects of not sleeping in a medicated bed?I don't think so! if you are not a medical patient, you can sleep in any bed you feel comfortable with.But for medical patients, it is necessary to sleep on a medicated because it has so many movable parts that offer comfort to them and for their treatment.If you want a high-quality medical bed at your resident, you can easily get a free demonstration on the same day you will contact one of the best reliable online platforms which is Adjustable beds.They will provide you what ever you need in your medical bed. If you want to take a full experience of their medical beds, then you can use their free no obligation home service that will allow you to use their products at your own home.
Design Scheme of Multi-channel Voltage Measurement Based on Stm32
Design Scheme of Multi-channel Voltage Measurement Based on Stm32
This design proposes a design scheme of multi-channel voltage measurement based on STM32 chip, and the measurement range is between 0-10V. The built-in A / D of STM32 samples the multi-channel voltage values to obtain the corresponding digital quantity. Then the corresponding analog voltage value is obtained according to the proportional relationship between digital quantity and analog quantity, which is displayed by TFTLCD display equipment, and the multi-channel collected data is stored in SD card.1. IntroductionIn recent years, data acquisition and its application have attracted more and more attention, and data acquisition system has developed rapidly. It can be widely used in various fields.Data acquisition technology is one of the important branches of information science. Data acquisition is also a process of obtaining object information from one or more signals. Data acquisition is an important link in industrial control systems. It is usually realized by some single chip microcomputer systems with relatively independent functions. As an indispensable part of the measurement and control system, the performance characteristics of data acquisition directly affect the whole system.Voltage measurement is the most universal. It is of great significance to study and design methods and instruments to improve voltage measurement accuracy. In the design of voltage measurement, single chip microcomputer as controller is the core of the whole design. In addition, there must be an analog-to-digital converter (ADC) in the design. ADC is used to directly collect analog voltage and convert analog signal into digital signal. It directly affects the accuracy and speed of data acquisition.2. System overviewThe microcontroller of this design adopts STM32 single chip microcomputer.STM32 Series MCU is designed based on the Cortex-M3 core of arm company. Its clock frequency reaches 72mhz. It is a high-performance product among similar products. It has the advantages of high performance, low cost and low power consumption. It is a good choice in embedded application design. The A / D converter in the design adopts STM32 built-in ADC. STM32 ADC is a 12 bit successive approximation analog-to-digital converter.It has up to 18 channels and can measure 16 external and 2 internal signal sources. The A / D conversion of each channel can be performed in single, continuous, scanning or intermittent mode. The conversion results can be stored in the 16 bit data register in left or right alignment. The maximum input clock can reach 14mhzThis design can measure the voltage value of 8 channels, the measurement range is 0-10V, and the display error is ± 0.001V. LCD displays the voltage value and waveform in real time, and microSD card synchronously stores the data. The system principle block diagram is shown in Figure 1.Design scheme of multi-channel voltage measurement based on stm323.3 LCD control circuitThe LCD used in this design is 2.4 inches, 320 & times; 240 resolution. The LCD module is controlled by the FSMC interface of STM32.FSMC (flexible static memory controller) can be changed into static storage controller. It is a unique storage control mechanism of STM32 series high storage density microcontroller with internal integration of flash of more than 256Kb and suffixes Xc, XD and Xe. By setting the special function register, FSMC can send corresponding data / address / control signal types according to different external memory types to match the speed of the signal, so that STM32 series microcontrollers can not only apply various external static memories of different types and speeds, Moreover, it can expand a variety of different types of static memory without adding external devices, so as to meet the comprehensive requirements of system design for storage capacity, product volume and cost.In STM32, one end of FSMC is connected to core Cortex-M3 through internal high-speed bus AHB, and the other end is an external bus for extended memory. After the access signal of the kernel to the external memory is sent to the AHB bus, it is converted into a signal conforming to the communication protocol of the external memory through the FSMC and sent to the corresponding pin of the external memory to realize the data interaction between the kernel and the external memory. FSMC acts as a bridge, which can not only convert the signal type, but also adjust the signal width and timing, so as to shield the differences of different storage types and make them no difference to the kernel.FSMC can connect devices such as nor / PSRAM / NAND / PC card, and has FSMC_ A [25:0] has 26 address buses and FSMC [15:0] has 16 data buses. In addition, the extended storage space of FSMC is divided into 8 blocks. Select the block of the operation through the address line. In this way, the LCD will operate as a memory with one address space.3.4 SD card drive circuitThe SD card used in this design is microSD, also known as TF card. MicroSD card is a very small flash memory card, which is mainly used in mobile phones. However, due to its small volume and the continuous improvement of storage capacity, it has been used in GPS devices, portable music players, digital cameras and some flash memory disks. The pin diagram of microSD card is shown in Figure 9.MicroSD card, like SD card, has SPI and SDIO operation buses. Compared with SDIO bus, SPI bus has simple interface, but its speed is slow. We use SDIO mode.MicroSD card has 4 data lines in SDIO mode.In fact, microSD has 1-wire mode and 4-wire mode in SDIO mode, that is, 1 or 4 data lines are used respectively. Of course, the speed of 4-wire mode is faster than that of 1-wire mode, but the operation is more complex. The 4-wire mode of SDIO is used in this design. The hardware connection diagram of microSD card is shown in Figure 3.STM32 MCU Chinese official websiteSTMicroelectronics / St / STM
How Does Temperature Affect the Speed of Sound?
How Does Temperature Affect the Speed of Sound?
As other answers show, the speed of sound is slightly influenced by temperature.Much more interesting is the influence of gradients in temperature! The usual distribution of temperature at different heights is: high at ground level, decreasing upwards. This profile, with slightly higher sound velocity at ground level causes wave fronts to curve upwards. Sometimes the temperature profile is inverse, from ground level to a certain height, in the order of hundreds of meters. This inversion layer acts as a reflector, causing sound to propagate over much larger distances.It is not the speed as such, but the differences in speed that have important influence on sound propagation.1. How to increase my running speed?No, leaping prime does now not make you a quicker runner. Speed is muscular so you will do whole frame paintings along side plyometrics, which can be exceptional varieties of bounding and leaping to construct explosive force. To get greater at going for walks you ought to run. If you are employed on lifting and doing the plyometrics you are going to have the groundwork to upgrade your going for walks. What form of going for walks are you running for? If it's soccer then you definitely will have to coach for brief bursts of velocity. If it's one other game you have got to appear on the distances required on your game. A huge aspect of velocity it response. That manner the begin. Whether it's out of the blocks in a race, or attending to a fly ball within the outfield. Speed is vigor so that you ought to be ready to loosen up rise up tall, maintain your elbows at ninety levels, swing them directly entrance to again, and now not throughout your frame. Land at the balls of your ft.2. Water flows through a 1.5 cm diameter pipe into a 275 liter bathtub, which it fills in 5 minutes. What is the speed of the water in the pipe?Mass of 275 litres of Water divided by 5 minutes x 60 seconds = Time of 300 secondsMass Flow Rate of 0.9166 litres per secondThis is excessive amount of water in Speed or Velocity to fill a bathtub in 300 seconds. See IPHE & CIBSE CoP & Technical Guidance on maximum flow rate for 15 mm smooth wall copper pipework. The water pressure is another factor is consider.Water flows through a 1.5 cm diameter pipe into a 275 liter bathtub, which it fills in 5 minutes. What is the speed of the water in the pipe?.3. Not getting the download speed I should be getting?you download a file to what ? a phone or a computer? ethernet or wirelessly ? you need to be more clear on how to ask a question, even with my godlike powers i cant read your mind4. Need help gaining speed/trimming fat?challenging task. browse in google. that will may help!5. Why are people so insistent that speed of light is constant for all observers and is the maximum traveling speed?In special relativity, when the speed of light is constant for everyone, time can be different. When different travellers or observers have light remain constant, their time can change to allow for this. So try to wrap your head around the fact that different observers can have differences in time, and this allows the speed of light to remain constant for all observers.6. fur nice fan motor Polly have to be smaller to make the fan go faster?Motor pulley larger or driven pulley smaller will increase speed7. What are the technical factors in a processor that determine its speed?Clock Speed of the Processor and its primary cache size determines its speed in terms of throughput8. Is faster than the speed of light possible?well ist just a theory so it could be or couldnt be true.....einstien said if we could go the speed of light then we cold time travel...other people say it is still expanding....what i want to know is how can all of that crap fit into somthing the size of a pin head lol.9. How to train for faster picking speed on guitar?Assuming we are talking about alternate picking, there are basically two exercise methods for building speed.The first and the better known one is to start slow. Set your metronome to a comfortable tempo and play the exercise a few times. Then go up 2 bpms or so and repeat. Continue alternating between plus two and minus one. Back down some 10 bpm when you hit your limit and work your way up from there again. You can go up 10 bpm or so from time to time just to see how it feels. The second one is to practice in bursts. Start with two notes and play as fast as you can. Then add the third and continue from there. This method is not as well known as the first one but is every bit as useful. You can also start from the most difficult spot on the exercise and add notes on both sides.Practicing scales only is probably not the best way to go. There are specially crafted exercise sets to build speed that isolate common patterns. Troy Stetina's book Speed Mechanics contains one such set.In terms of technique, on your left hand, only apply enough pressure to avoid buzz. You will get tired very quickly if you exert more force than necessary. The lighter your left hand touch is, the easier it is to play fast. It's easier said than done but that's the whole idea of practicing.On your right hand, I would not worry that much about wrist vs. elbow unless you are aiming for Guiness speed record. Wrist movement is probably a bit better but there's nothing wrong with a combination of wrist and elbow. Guitarists argue about it all the time but there are superb guitarists in both camps which proves that both techniques are equally viable. Just avoid finger movement, it does not work for fast playing
What Is WiFi? Just Tell Me What It Is, and What It's Used For.?
What Is WiFi? Just Tell Me What It Is, and What It's Used For.?
Wi-Fi= wireless fidelity and what everyone else said1. i want to acess internet on my psp and my pc.i heard about this wifi link.i don't what a wifi is.plz help?you are not going to get free internet. if you want internet you have to pay for it. all Wi-Fi is, is you plugging a router into your internet connection, then the router transmits a signal.2. What WiFi router should I buy for my 800 SF apartment?Any wifi router provided by the internet provider will do and serve the purpose...An apartment area of 800 sq. ft is small enough which can easily be served by the company provided hardwares!You would not want to have a very strong signal that anyone outside your apartment can tap into!3. What is wifi and how do I know if my house has it?Wi-Fi is a wireless internet connection that things like laptops, wireless cards, and game systems use connect to the internet. If you do not have a wireless router, you do not have Wi-Fi4. What Wifi usb Adpter Is Better?Neither, they are both low quality. Buy from a reputable brand5. what is wifi actually? how does it works?it's a wireless connection. you can connect any computing device as long as you have a wireless nic enabled on that certain device. to access the internet you need to be in a "hotspot" that's the place where you can get your signal to connect to the internet6. How can I find out what Wifi networks my iPhone knows about?I think the only way is to actually be in range of the network that you want to get rid of. You can not actually see what networks you have stored, not that I know of, but if you want to get rid of a network.Settings > Wifi > Then select the blue arrow on the right of the network that you are connected to and click "Forget this Network".7. How do I find out what wifi chipset my phone has?I simply used the dmesg command in a terminal emulator and scrolled until I found anything named bcm432x... and wlan. Think thats it. I have lg p5008. I'm not entirely sure what WiFi is?Have a look at the wikipedia article. Usually you would get a DSL connection and set up your wireless network at home. The wireless network connection is also called W-LAN or WiFi, but in this context, WiFi has nothing to do with the ISP. Not sure if in your region any provider sells internet acces via WiFi, this is not a common thing to do.9. What is wifi and what does it do for a phone?If you have internet at home and have a wireless router you can connect wirelessly to it and get on the internet etc. on your phone. Hope this helps!10. 802.11 standards compliant methods of forming a LAN. Unlike Ethernet, data does not travel along a cable, but rather, wirelessly, at a frequency of 2.4GHz (802.11b/g) or 5.0GHz (802.11n and the antiquated 802.11a)11. What is "WiFi" and can you explain ,more about it? I'm GOnna buy a laptop.?well if you want wifi in your home you have to have an internet connection threw a modem..ex comcast, qwest, at&t. you will need to purchase a wireless router, its just another device that hooks into your modem. so no it is not free, but it is a one time charge because your ISP will not charge you to have the wireless router hooked up...and where you can use it is in your home. you can also connect to wifi at places like starbucks, and that is free as well.12. What WiFi router brands or models are considered to be secure? [closed]For cheap solution I use a wifi router well supported by dd-wrt alternative firmware. Here you can find supported models database.For more advanced, trouble-safe solution I use Ubiquiti UniFi - the AC-Lite model is really good.13. What is a bluetooth? what is WIFI? And what is a BLU RAY DVD?Bluetooth is a wireless technology for connecting electronic devices to each other. For instance there are Bluetooth Headphones, Bluetooth Cell Phone Ear Pieces, etc... If you want to be able to use the Bluetooth Ear Pieces with your cellphone, your cellphone must be Bluetooth compatible. WiFi is a method of connecting to the internet wirelessly. For instance many big cities may have "WiFi Hotspots". If you are in these WiFi Hotspots and you have your laptop or any other device that can connect to the internet wirelessly, you can surf the web wirelessly as long as you are in that particular area. And Blu-Ray is Sony's High Definition format disc. The difference between Blu-Ray and Regular DVD is that Blu-Ray can produce 1080p HD quality picture and Blu-Ray can hold more data. A Single Layer Blu-Ray disc can hold 25GB and a Dual Layer DVD can hold 50GB. A standard DVD can only hold around 8.5GB total. Basically if you have a HDTV, Blu-Ray would be the best choice for getting the best picture quality with clear, crisp viewing quality.
Which Is Better, WiFi Or ZigBee Wireless Technology
Which Is Better, WiFi Or ZigBee Wireless Technology
Wireless replacing wired has become an irreversible trend, which can also be said to be a new industry. At present, there are two technical camps of ZigBee and WiFi in the field of smart home, and WiFi and ZigBee have their own advantages in wireless technology. Among the most popular wireless technologies in the industry, WiFi technology and ZigBee technology are the most worthy of competition. So which is more advantageous, WiFi or ZigBee? Who will become the mainstream in the future? This is worth discussing.WiFi: WiFi technology is the fastest transmission technology at present. The product cost is low and it is more popular in current life. However, the devices that can be connected with WiFi are limited. The actual scale of adding WiFi network to devices generally will not exceed 16. In the development of, the number of switches, lighting and home appliances will certainly be far more than 16, so WiFi has its advantages, but it has great limitations, Limited development.ZigBee is a two-way wireless communication technology with low complexity, high security and short-range transmission. It has the characteristics of strong scalability and can be embedded in various household devices. ZigBee also has advantages in security.1. The future smart home network will be a smart network, which can sensitively perceive the changes of data and traffic of each node; Be able to intelligently allocate, repair and deal with network resources; It has the attribute of "self-learning and self-organization".. However, in the practical application of families, switches, lighting, curtains, anti-theft devices, etc. will not move after installation.2. ZigBee supports up to 65000 nodes, but can WiFi connect more than 100 devices? The answer is No. So large capacity is good.For example, LVMI smart home, that is, Xiaomi's smart home brand, basically supports ZigBee protocol.When it comes to LVMI, I recommend their smart gateway. The smart home market is very messy. Sometimes we are excited to buy it and find that it does not support it. Therefore, when we buy it, we should see what the device supports or does not support. Of course, the best thing is to buy a gateway with high compatibility. LVMI's gateway product not only supports ZigBee protocol, but also is compatible with homekit. This product supports 32 aqara devices of green rice, which can be connected with Apple's "home" app. After that, it can control the associated devices on IOS devices and Siri directly. I think most young people now use fruit machines to compare prices. In this way, it is still very friendly to most IOS users. For fruit powder users, the biggest advantage of this product is price. At present, the smart home products supporting homekit on Apple's official website are very expensive. Even a simple smart socket costs 295 yuan. Through the aqara gateway of LVMI, the cost of access equipment can be reduced.Well, comprehensive comparison, WiFi is relatively more convenient, but ZigBee will be more stable and support more devices. If you only want to use one or two smart devices, WiFi can be used. If you want to create a complete set of smart home ecological chain, it is obvious that ZigBee is more in line with your requirements. Xiaobian is more optimistic about ZigBee. After all, home is developing towards the trend of comprehensive intelligence, Technology with multiple devices can ensure this. No matter what kind of technology, we hope to constantly update and improve, and making our products convenient is the king.
Smart Home Promotes Building Intercom into Thousands of Households, with Large Stock and Incremental
Smart Home Promotes Building Intercom into Thousands of Households, with Large Stock and Incremental
In the large densely populated cities of Beijing, Shanghai, Guangzhou and Shenzhen and the rising second and third tier cities, the housing demand is increasing year by year. The huge floating population not only promotes the rapid development of low-end real estate resources in the first tier cities, but also extends the complex industrial chain around the buildings. In particular, the development slogan of "smart city" put forward by the state in recent two years gives hope to the market that lives on security products around buildings in addition to real estate developers.Smart home promotes building intercom into thousands of householdsAt present, more and more building intercom manufacturers begin to go deep into the field of smart home and combine building intercom system with smart home system. This is reflected in the construction of "digital building" and "smart home industry ecosystem":Combined with the smart home system, in addition to the traditional intercom unlocking function, the building intercom also integrates many convenient functions such as SMS notification, mobile app remote control, security alarm, indoor monitoring and viewing, elevator call, home control, information home and so on.Building intercom and smart home complement each other, further improving the value-added space and cost performance of both, thus bringing huge space for function expansion.In the future, it is expected to take advantage of the upsurge of smart home to develop rapidly in the wave of home intelligence, and will carry more home control functions.Smart community derived demand brings new business opportunities for building intercomIn addition to the smart home, the building intercom system, as the entrance of the smart community, realizes the extension of multiple functions such as identity confirmation, access control, security monitoring, human-computer interaction and so on by combining AI technology.The consumer demand derived from the smart community can be said to bring new business opportunities to the building intercom industry. In the process of continuous promotion of the smart community, many building intercom enterprises see the future business opportunities and begin to make corresponding layout and planning on products and solutions. Using information means, Internet and Internet of things technology, develop community oriented Internet of things system and information platform, and provide real-time, fast, efficient and low-cost Internet of things, interconnection and intelligence for the community on this basis. For example, it launched smart community management, smart life services, smart travel and other related solutions, and continued to pay attention to the field of community and personal security.High, middle and low-end take all stock and incremental market space is largeAs an upstream industry of real estate, building intercom has significantly increased the demand for medium and low-end building intercom products under the condition that the state vigorously promotes the construction of affordable housing and indemnificatory housing.With the implementation of smart city construction, the demand for high-end building intercom products is also increasing day by day. The application of high-definition visualization and face recognition in the field of building intercom is accelerating.At the same time, after more than 20 years of development, many communities equipped with building intercom in the early stage are facing problems such as disrepair and backward configuration. Therefore, the equipment renewal demand of old communities has also become a new round of market growth point of building intercom system.Overall, China's housing market will continue to develop. According to the relevant development strategies of the State Council, China will build 10 billion square meters of housing by 2020. For building intercom enterprises, there is a large development space for building intercom related products in both stock market and incremental market.Conclusion: in a word, opening up the integration and docking with comprehensive life service platforms and community operation platforms such as third-party payment, smart city, video surveillance, community o2o e-commerce, smart home and community elderly care, that is to provide overall solutions for communities and families, which has become the future development trend of deepening reform, transformation and upgrading of building intercom enterprises. Moreover, with the gradual improvement of community infrastructure, building intercom enterprises also need to change from the role of product provider to the role of supporting service provider.
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