Ask MetaFilter questions tagged with clinical

New job selling laboratory equipment, but have no lab/science experience

AMWKE1984 — Fri, 08 Feb 2013 06:40:32 -0800

I recently accepted a sales position within a company that sells laboratory equipment. (i.e. centrifuges, GC's, HPLC's, Thermal Cyclers, etc) I have no previous lab or science experience, so learning about a myriad of highly technical products/methods is a quite challenging. My main challenge comes from the fact that I need to engage in conversations with scientists, chemists, biologists on a daily basis. With no previous lab experience, I've been having a hard time talking to them on technical level. My biggest fear is asking about their work, and then sounding like an idiot for not knowing what the heck goes into carbon testing or any other lab procedure. (my B.A. is in marketing), so the sales part is not an issue.

Most of the other salespeople here come from lab backgrounds, or have degrees in the sciences. There are a few who are in my age/background who are doing well without the science knowledge.

What I'm looking for is a resource to better understand the flow of a lab. For example, if a lab is doing blood work, how do I know what pieces of lab equipment they are already using, and to maybe help understand the bath that a sample takes. I know I'll never be able to learn what someone has learned in 4-8 years of school/lab work, but I know I have the intangibles and the drive needed to succeed by learning whatever is necessary.

To summarize, what is the best method for me to understand the inner-workings of a lab, in order to at least have an idea of what their equipment needs are. I've found that science types like to talk a lot about the work they do, instead of me just asking if they have any equipment needs.

Thank you so much for the help!

Data Driven Clinical Care - Dynamic Graphing Website

rosswald — Wed, 16 Jan 2013 13:56:00 -0800

I would like advice on creating a dynamic graphing website to display clinical data on a intranet website to better aide clinicians. What my superiors are seeking is a "Data Mall." My programming/server-admin. experience is minimal, but my Linux-hobbyist mentality hates the MS Access solution that is being built. The scene:

So, our administrators have fallen in love with a concept that they have seen at a conference where clinicians could quickly and easily see a short list of their patients who have certain 'abnormal' clinical values/conditions, or to rank themselves amongst other providers according to certain metrics. Etc. Some call it a "Data Mall."

Our senior data coordinator has done a great job of leveraging an MS Access database (pulled from our true clinical database) with a VB front-end to be accessed by all providers. But, it still kind of sucks. It takes a long time to load, and is just unwieldy to ask clinicians to use the Access front-end.

Me, and where I have gotten so far:

I have previously setup my own LAMP CentOS server running MediaWiki just for fun, and was basically able to create a similar setup on a Windows PC using "EasyPHP", on top of which I installed Mediawiki and found a script for making calls to "Ploticus" from Mediawiki. I was able to display the simplest-of-simplest pie-charts on my wiki.

The heart of the matter:

The problem is that this solution seems complex, especially since my PHP and SQL knowledge is limited. Would the best solution just to be to dig in and master this option? Any recommendations for starting points?

Or is there another tool, method, etc. that I should be looking at?

I realize that building this could almost be a full-time job, but like I said, part of me is just intrigued by the challenge, and part of me wants to impress the higher-ups. Still, maybe it is best left to the pros...?

Clinical lab paper

marsbar77 — Wed, 12 Dec 2012 08:51:57 -0800

I need to write a paper for my clinical laboratory sciences class, but being that the teacher was unclear in her instructions, I'm not sure what qualifies as a separate laboratory and what doesn't. Something like " the hematology lab" is very broad. Can I focus on JUST histology, for example? Is there such a thing as a histology laboratory, even if it's under anatomical sciences? Or does that refer to a technique. What to do here? How would you structure this paper? Any advice is appreciated. The prompt is as follows: (3-4 pages)
Introduction: tell me about a particular clinical laboratory of interest to you.
Body of Paper: tell what tests are done there, what technology/instruments may be in there,and what possible diseases are being diagnosed or ruled out in that lab.
Sumaary: End with how this laboratory area may monitor certain conditions and diseases as patients are being treated with various therapies. And/Or tell me what new technological advances may be in the near future in that particular lab (heme, micro, chemistry, etc.)
References: Please provide at least 4 references with at least one being from a scientific journal.

How can I help deal with my girlfriend's depression?

*lostatsea* — Mon, 22 Oct 2012 10:33:17 -0800

How can I help deal with my girlfriend's depression? I have been dating my girlfriend for a while and she is awesome. She struggles quite heavily with depression. I also struggle off and on but it is never nearly as severe as her's. Dating her has been eye opening for me and I now understand depression on a much larger scale than before. I know it isn't something the depressed can just 'snap out of'. It is a disease that millions struggle with. She goes through phases. She may be happy for a few months, and then slips suddenly into an extremely depressed state for a few months.

I know a lot of people will say that she needs to seek a professional for help, but she and I are wary about that route. She has tried counseling with no success. I also have a friend who struggles with the same thing. He is medicated now and the meds are seriously affecting his chemical balances in a permanent way. I have also noticed his whole aura shift dramatically. I like my girlfriend the way she is :)

I am trying my best to be supportive and understanding. Struggling with depression myself makes it a little hard because I am not taking care of myself and do not have the support that I am giving her 24/7.

What should I do?

How to Deal With Someone's Clinical Depression

Anonymous — Thu, 19 Apr 2012 08:09:14 -0800

After I blew it, how do I now help a clinically depressed good friend who prematurely ended treatment that was working? I have a friend ("they/them") who has suffered extreme, extended bouts of clinical depression that required electric shock therapy in the past, serious meds, and hospitalization. Over several decades I've been able to support this friend just by showing up regularly as part of the swat team of friends they've needed on site so they wouldn't kill themselves, and to assist exhausted family members.

Always, I just knew to listen to their "crazy talk" without ever denying that these thoughts were as real to them as the color of their eyes. The most I would offer were words about change, e.g. "Nothing stays the same, even this." As part of the help team, I gently guided this person to eat and to get outside even though they didn't want to do anything but sleep. I wrestled with what to say about ECT and meds because this person is an alternative treatment believer big-time, and the conventional treatments are brutal. However, they were the only things that worked, so that put me on "that side" since they know I'm an evidence-based person as is pretty much everyone on the swat team.

Eventually, the episodes would end, the dawn came, and this charismatic, creative wonderful spirit emerged from the cave like a colorful butterfly. The rest of us were grateful, but exhausted, especially family members who had to hear that it wasn't the "bad" Western treatments that ended the depression but this or that potion, expensive quack, etc. Maybe it was all of the above.

Anyway said friend had the longest, most awful bout of depression last year, which lasted six months. Finally, they agreed to some new meds, which seemed to have started working within a few weeks. Whatever it was, the friend stopped taking them. "I feel so great, I don't need them," while the rest of us looked at each other askance. Within weeks, another profound crash followed. The friend blamed everything but the premature cessation of the conventional treatment.

I said nothing about this unwise decision during a recent, difficult conversation. However, I let my squelched frustration out in other ways. Instead of just listening as in the past, I tried to talk them out of their own feelings, using reason and my ingrained practicality to "get them to see" the irrational things they were saying and thinking.

I hate myself for this. I have since apologized. Understandlably, they are now on the defensive, trying to explain, via e-mails since I'm not nearby this time, why their thoughts are rational. Yes, they are . . . to them. This is what they feel. I have to honor that, but I'm faking it. I'm faking it while I listen to the new quack therapies they want to try.

What can I say or do from now on to regain this person's trust in me while they are still depressed? They want to call me to explain how they feel. How do I respond to their paranoia and guilt without the impatience I exhibited? How do I deal with their complaints about (actually stalwart, patient) family members and helpers who aren't helping, according to this very, very depressed person? I usually just say: "Being a caregiver is tough. They're doing their best."

If you've suffered such profound depression, tell me what to say and how to proceed kindly and helpfully.

I should have just gone to med school

pintapicasso — Tue, 21 Feb 2012 13:36:51 -0800

Calling all nurses and non-nurses: I hate clinical, what do I do? Hi, everyone. I feel really silly posting about this. As you can see from my previous questions... school is tough for me.

I'm in the midst of the first year of a two year nursing program. I already have a bachelor's degree and previous to the nursing program I was managing a restaurant. My program is set up so that after our first year we are LPNs and after our second year we are RNs.

I wanted to go into nursing because: I like being hands-on with people, I like working with elderly people, I like being on my feet, and I like being busy. We have had a rotation at a nursing home which I really enjoyed.

We have clinical two or three days a week: a full 7-3. Previous to the shift we have to do a lookup on medical dx, meds, labs, etc. It takes me 4-5 hours. At clinicals we do everything independently except for giving meds (we each only give them 1 out of 4 shifts, with our teacher) and things like inserting or removing a catheter, which we do with our teacher. Most of our day is spent taking vitals, checking blood sugars, giving bedbaths, toileting, ambulating, charting, etc. We kind of take over the CNA's job, but we take on LPN tasks as well.

All this is to say that I am SO STRESSED OUT at clinical. We rotate between three hospitals and just started a new one last week. After spending forever looking up my patient the day before, I hardly sleep and get to the hospital sooo anxious. Once I am there I feel like a complete idiot. I feel as though I'm a chicken with my head cut off and like it's a giant scam that I'm even there in the first place.

Here are specific things I would like advice on:

-How do little things become second nature? Like, today I was helping someone into the shower and I forgot to wrap their cast in a bag until the patient told me! Little things like that just aren't stuck in my brain, but I had never showered someone with a cast before. I don't know when I will again. How long does it take?

- A big source of anxiety are the staff nurses. I am going to sound like a baby but many of them are so nasty and unpleasant to us. I know that they are incredibly busy. I am very un-assertive so I hardly ever ask them for anything and I think they appreciate that and help me when I do ask. However, I see them snap or yell at my fellow students and it makes me so mad! But I can't do anything about it. When you are a staff nurse, does it get better? Are the nurses like this to new nurses? (I am NOT trying to be mean to nurses. Some of them are very nice)

Some of the other students in my class are sooo into clinical; they say that they love it and they want to take their patients home with them. Is this a learned attitude? I don't think I will ever feel this way. I want to shoot myself at around 0800 each day. I want to throw up and cry multiple times a day. It is getting a little bit easier but not much.

Despite this I get very good evaluations in clinical but I feel like I'm playing a giant trick on everyone. Each time I take a blood pressure or listen to lung sounds I'm thinking "I CANT BELIEVE YOU TRUST ME TO MAKE SENSE OF THIS."

Many nurses I've talked to say it's a good idea to work on a med/surg floor straight out of the RN year to get experience. The idea of prolonging this stress terrifies me. What's strange is that I am normally very even-keel; I have really chilled out about the rest of our classes. They are difficult but I study my butt off and do very well without worrying about it. Clinical is a whole 'nother beast, and deep down it makes me worry that I don't want to actually be a nurse. I do enjoy my one-on-one time with patients, but it's overshadowed by the stress.

Please, give me some insight, words of encouragement, anything. My fiance has to deal with me crying multiple nights a week and my friends don't seem to get how difficult it is. Some of my fellow students are right there with me and we comiserate, it's literally the only thing that makes me feel better. I'm considering taking a year off after June and working as an LPN at a clinic or nursing home, just to get my feet wet and regroup. Any advice?

I realize this is all over the place but I'm in the middle of another lookup and feel like a robot. Oh, and I'm on sleeping pills.

Psychotherapy: can a therapist be right about progress and the client not see it?

y6t5r4e3w2q1 — Sun, 08 Jan 2012 08:03:13 -0800

Psychotherapy: can a therapist be right about progress and the client not see it? We often hear from people who are in psychotherapy and are in disagreement with their psychotherapist about whether they are making progress. When is the psychotherapist right? We often hear from people who are in psychotherapy and are in disagreement with their psychotherapist about whether they are making progress. When is the psychotherapist right?

The psychotherapist claims to see progress. The client claims to see no progress.

The most obvious are scenarios are:
The usual answer on Ask MetaFilter is that the client is right and the psychotherapist is wrong, but is this always the case?

Assuming that the therapist is not an out-and-out charlatan who knows the client isn't making progress, here are my questions:

What things or categories of things could a psychotherapist be seeing -- or imaging they see -- that are real and worthwhile but invisible to the client?

If it's ever the case that the psychotherapist's perception of progress is more accurate than the client's does the client ever come round to seeing the psychotherapist's point of view?

I would particularly like to hear from people who are psychotherapists and have had that experience or from people who have been in psychotherapy and retrospectively saw progress where at the time they could not see it.

There's lots and lots of discussion about psychotherapists being ineffective but I'd be interested to hear explanations or discussions of whether or how they can be obscurely effective -- effective without it being apparent to the client.

We'd like to be better at working with older adults.

two lights above the sea — Wed, 02 Nov 2011 09:22:00 -0800

I work in a research lab that is transitioning from working with young adult populations to working with 60 year old and up adults. Most people in the lab who don't have experience with older adults (myself included) are finding the transition frustrating and difficult at times. Can you recommend some resources to help us work better with older adults? I'm really looking for any information you can provide at this point, but I'm not really looking for very specific anecdotes. Books, articles, papers, websites, anything! Even your personal experience working with seniors in a medical or research field would be helpful. As it stands now, I think we are doing a "good" job, but I think we could be a lot better and saner at the end of the day. If it matters, we are doing psych (memory) research, with little to risk to the patient/participant.

Thanks in advance!

I'd like to start a clinical psychology doctoral program in 2012. I wasn't a Psych major. How do I prepare?

jander03 — Fri, 18 Mar 2011 04:00:23 -0800

I'd like to start a clinical psychology doctoral program in 2012. I wasn't a Psych major. How do I prepare? How can I overcome the following barriers... I know that some of these are a web search away, but I'd like to hear answers from real people.

1. I haven't done research or worked in a clinic!
Should I do one of these? How would one go about it outside of college?

2. A friend says that in the medical world there are "bridging programs." Any thing like that for clinical psychology?

3. I've heard a lot about matching my interests to individual professors. I have NO idea how to do that. How does that even work? Is there an article that explains all of this?

4. How can I keep up with what's happening in the field?
I keep up on only the most mainstream happenings in psychology - the types of things that appear in Psychology Today or a Malcolm Gladwell article. Is there a free/cheap clinical psychology research journal? A trusted blog?

5. In the real world of practitioners, what is the difference between a Psy. D and a Ph. D?

Possibly Relevant Details:
My GRE score and undergraduate GPA is comparable to the average at most clinical psychology programs I've seen.
Since leaving my alma mater, I've taught in underprivileged schools and coached teachers for a few years.
I have a minor in psychology, but no real research experience.
I have experience manipulating large pools of data.

Quick - need a good, simple DSLR for $1500!

tristeza — Fri, 19 Mar 2010 13:56:38 -0800

Your boss gives you 24 hours and $1500 to buy a simple DSLR camera for use in a clinic so the docs can take digital pictures of skin lesions and other pathologies, for future use in trainings (PowerPoints), websites, handouts etc. What do you do? I have not much experience with cameras, and basically no time to research. I need a simple to use DSLR that will take quality close up and/or macro photos in normal office lighting.

These are not professional photogs, so the camera has to be relatively easy to use (as in, many many automatic functions).

I know there are a million places to research this stuff, but as I said, I'm on a very tight deadline to spend this money...so, if you had about $1500 bucks to throw at a camera for this kind of use, what would you pick?

(Supplemental - if you think a DSLR is not even a necessity, I'm all ears, a point and shoot that could handle this is fine, too, I guess. The main point is good photos of gross skin stuff, taken by non-professionals.)

Thanks, gang, as always.

Applying to Clinical Psych program before undergrad

Genco_Olive_Oil — Mon, 27 Apr 2009 14:16:03 -0800

Does anyone know if you can apply to a clinical psychology Phd program before finishing your undergrad, or do you need to have experience before applying? Also what can you do to best guarantee your chances of acceptance?

Clinical information database design questions

sevenless — Mon, 30 Mar 2009 17:07:51 -0800

I've been tasked with making a large amount of clinical research information we have easier to search and maintain. I have some questions about the best way to organize a database to do this, and in so doing see how much of my time I've wasted so far. First off I'm using Access 2000--that's what our organization provides. Second, my database skills are marginally more than basic. I know how to make tables, form, queries, etc with Access. I have some idea about how to design relatively simple relational databases, but I'm having trouble determining if what I've done so far with this one is reasonable or if there's something better.

The data I have consists of clinical information for a number of research subjects. The data consists of things that are simple observations (e.g. temperature, weight, etc.) but also things that are more complicated like blood electrolyte measurements that contain many parts for a single "observation." In addition to observations there are also treatments like drug or fluid injections. The data as I get it is basically a list of observations and treatments for each subject organized by day. It's more or less a diary for each subject. A big unsearchable diary.

What I've done so far is to create a number of tables to sort of compartmentalize everything. First I have a table for all the research subjects. For each subject there are 10 or so different observations or types of treatments so I've made tables for all of those. What I've ended up with is a relationship diagram (in Access) that looks like a pinwheel. The field that ties all the tables together is the subject ID. It's present in every table except the ones I use for lookup lists. So, I have lots of one to many links from the subjects table to all my other tables.

Is this the best way to organize this type of log or journal type information? I thought I pretty well understood the concept of normalization and relationships--primary keys, etc.--after going through it again recently, but when I try to apply that to this database it seem that maybe I don't understand it as well as I thought. One problem I'm having trouble with is that there's very little unique in any of the tables' records except the research subject table. I set up artificial primary keys for the tables since for most of them I'd have to use all or most of the fields to identify a record as unique.

I'm thinking there must be a better way to organize the data. Unfortunately I haven't found a discussion anywhere of this kind of database. Or, else I haven't been able to see the many video store and shipping company examples as the same as what I need.

How can an older student without a psychology background get into a psychology PhD program?

sobriquet — Sat, 27 Sep 2008 08:38:47 -0800

As a (somewhat) older student, how can I best prepare to get into a clinical psychology PhD program? Say I want to be a therapist. Say I've had several good therapists in the past, one of whom I worked with closely for a couple of years. Say I have a pretty decent idea of what being a therapist is all about, and that I want to take my previous therapists as professional role models.

These therapists I've liked have all had PhDs, and I want to get a PhD, too, and eventually go into private practice.

I'm nearing 30, and though I have a great academic record, it's not in psychology. I have good grades from good schools, a master's degree in English from a top university, teaching experience, and some work experience that involves people-management (and helped convince me I could be a good therapist), but is of course not psychology per se.

Can I apply to doctoral programs as I am? I hear they're crazy-competitive. Do I need to take a bunch of undergraduate science and psychology courses, and/or do a master's in psychology first?

Assume my GRE general test scores are good. Will I definitely need to take the psychology subject test as well?

I am not 100% against getting an MSW instead, as I understand that it can also qualify one to be a talk therapist, but I'm leaning towards a doctorate because (1) I want the added prestige and earning power of this degree; (2) I want to write about psychology and I imagine a PhD would give me extra authority; (3) it seems to me that social work school attracts people who are more interested in working with seriously structurally downtrodden populations, which I think is super noble, but not exactly where I want to go; (4) I am not sure, but I might like to be able to teach it someday.

I also thought about PsyD's, but heard that they continue to be less well-regarded than PhDs, and also that you have to pay your own way completely.

LCSW or Ph. D in Psychology?

bydar — Tue, 30 Oct 2007 13:33:29 -0800

I'm currently completing a B.A. in Psychology with the intentions of becoming a practicing therapist (mental heath, family, individual, children). Here's my question: the path to practice as a therapist diverges. I can get a Masters of Social Work in two years following my undergrad, but in order to be able to practice, I would need to get my license, which would require typically another 2 years of supervision. I could work, by at a low salary. The other path would be to following up the Undergraduate degree with a Masters in Psy and then a Ph.D. Any thoughts?

Types of part time jobs for a psychology student before applying to grad school

bydar — Sun, 30 Sep 2007 14:47:45 -0800

I'm presently completing a B.A. on Psychology (via distance learning) with the intentions of continuing towards a Masters in Clinical Social Work. I have a couple of questions: 1) I'm 42 years old and have done back to school as a career changer. I have a wife and daughter and need to work part time while I'm a full time student. Does anyone have any suggestions for work which might help with graduate schools looking at both my academic and work background? All of my previous work experience involves working with people, but not much similar to work a therapist would be engaged in (worked for last 8 years as a talent agent) 2) Does anyone know which cities offer the greatest potential for work as a clinical social worker as I hope to eventually open a private practice, but will work in hospital or mental health facility while gaining experience?

Does the word "paranoid" have an antonym?

mgtrott — Tue, 16 Dec 2003 16:11:19 -0800

Does the word "paranoid" have an antonym? In other words, can there be a one-word opposite of paranoid? My guess is no since it's a defined clinical state; however since it's used casually, has an antonym evolved?