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Okay, way about wake, about the importance of checking your sections and making sure they happened and how it's a really risky time. You just let me know that you see again, it's a really difficult time with patients and movie between clinical teams, varying degrees equality and eight with lots of different lots of different nurses a point when they're very unwell. So it's important that we check what we've done. One is, in fact, it has and that it's happened a little on documents. So, uh, can you hear me lately? Sentencing stunned. It is slightly faithfully. They said that momentarily. Yeah. Great. Okay, thanks. Um So what I did is I placed it to the later medical to people, and this is a response I got. So stay here. You are on how you can be contacted. So all of this information, your documents it. Like I said, we'll be reviewed multiple times throughout admission, But often you're seeing these will have questions about it. So putting this import bleed number is something that came up quite a lot and frustrated people when they couldn't get much with that with the clocking doctor, If you can't provide a history call someone who can often you've seen clocking, you know, things like patient, confused, unable to get history. But as we spoke about previously, there's a least four or five different sources where we can get some kind of history. You know, Ambulance notes CT Dr Clark in next skincare home so on and so forth really understands notes. If present this came up by about four different people were not just medical. I see you consultants, but prominence themselves, Edie, doctors and etcetera. And it provides such useful information, often concise but key information about when that patient, about what time you've seen the patient, might be 12 hours or even more for before you see them. So looking back is a really rich short of information that's often under utilized, and it will be uploaded University for patients that come in by the ambulance, uh, investigations and clinic collectors, which will frame presentation and reduce duplication. It's true, and I think we do duplicate a lot of investigations ever been already been done as an outpatient, so it could be useful to include that in your in your clocking a swell. So have a quick flick through and often only takes a few minutes, but it saves a lot of time down the line. So social history is not just independent of ADL. It's this in this one that might be another one. This came up loads, but particularly from your from our I see you know, and also I geriatricians. The independent of a Dios is just not enough. There's a huge depth of the information that we can get that it's going to influence the patient's treatment on often we won't get a full so through the streets in Occupational therapist of seeing the patient if they do several days later, if a patient becomes really, um well, for example, of the of the deciding for cessation admission toe I see you or even just was inpatient girls actually working where most of this information will be gathered on. There was a really good questions that came up, which I think you're on the next line, so I'll leave it to that about how you can get a good, uh, good feel of someone social history. If you don't ask those of information I don't know about trust our our pas lacking. So for ours rate, you'll be prompted to ask those questions anyway about what patient could do independently. Move supported. What package of care they already having, etcetera so really useful. And again, another thing that isn't immediately gratifying. The exit might not huge really implement what you do there. And then it's gonna have a huge impact on Patients Day. Uh, if you're unsure, make a difference. Have a stomach plan that came up a few times and we've spoken about that already on, I think, actually looking back on my take shifts and speaking to other people there. Some of the most rich learning experience is we get a junior doctors, because rarely away allowed that level of autonomy. Also get feedback from seniors pretty quick after, and also we have the opportunity to follow that picture journey Review. Lando's a Z. They progress free there inpatient admission, and we can really learn about about what we've done and whether it works and what changed after that. So, like, yeah, I'd strongly encouraged that's why we always have a good and obviously if you're unsure about what we're doing, is safe or indicated. Like I said, lots of people there to help you out. It's around seal questions you don't think we're still looking for was placed it anything. Don't just a current drug history document. Recent changes and the specific do not trust electronic records, and it course out by an old prescription. And this happens a lot. I don't know about other trust that we have access to our GP records, and frequently I collect the patients on the ward. They've been prescribed a drug that they have really taken. So two or three years just just was on the GP records. It's really important. Also, recent changes might precipitate admission. So very useful, uh, and often will be relied upon. It's in. Our pharmacist is a much message off in normal hours. S so here we are a social history is functional. Session ST really important that no one ever documents again after admission. But it's Kiefer. I see your views. Keep it simple. Come. They come in five stairs walking distance, etcetera. I really like this second one, which I've never asked that I'm 100% Steven this for all of my partners in the future, what's the most active thing you do during the normal week. Really good one for social history, and I don't actually get it right that the beta blocker and that easy and safe. If it's your plan senior of you should not be the whole plan. We see that this is really funny. One So so about three different people replied to me and said, Read everything you can before you see a patient rich amount of information And then I had another consultant say, Absolutely. Don't read anything before you see a patient because it's gonna It's gonna cause a degree of cognitive bias is we're gonna get diagnostic momentum. I think, probably as with most think, most things, that's probably some healthy middle ground and there. But I I certainly don't I don't know about other people. I don't look at the any crap from this surgery. Before I seen a patient because there's a really rest that we just get this diagnostic momentum and I see in patients, for example, be referred of abdominal pain that I have a skin nick limb and if we were to just look at the any cock it, we'll change on taking that on on face value that there's a real risk that will get agnostic moments of make issues. And ultimately, the Swiss cheese model only works if there's more than one layer of cheese, Know if we just like the first layer a bit thicker by duplicating someone else's decision making. It's personal about cheese. Think, please document days and frequency of drug use drugs on admission. It saves lots of time downstream that in TSP are talking about work again. A number one. I think people have a lot of bugbears about senior of you. So ultimately you are highly trained professional. I think we should have a girl investigating and acting upon upon the information we have gathered so far. Good one of my lifestyle. And then I think we can. We're getting close. The time that we can't are some questions, but I think I'd like to reiterate. This point is that even though what we spoke about a huge amount of information, available TV and lots of safety mechanisms, really, your patients are a risk. You basically for a patient, not because you're not constant, but like I said, because they are very unwell, probably so most of our patients, hopefully if we're doing our job making better. There are as well is that going to be for out there old mission They have swapped between two or three medical teams. They are seeing you, who is a relatively junior doctor. Sometimes you won't have all the information available to you. It will be on a very busy take shift in your multiple competing priorities and etcetera. Uh, so I think, you know, the assumptions are the mother of all efforts, so I think it's really important.