Would you say that focusing on acquiring something (like new skills) might make you blind to the baggage you’re already carrying? It may be the case that you don’t have any unproductive habits as a speaker. If so, go ahead and keep your eye exclusively on that prize of newly acquired skills. But just in case, peruse the list below of seven bad habits to avoid during conversation.
Highly confident people believe in their ability to achieve. If you don’t believe in yourself, why should anyone else put their faith in you? To walk with swagger and improve your self-confidence, watch out for these fifteen things highly confident people don’t do.
1. They don’t make excuses.
Highly confident people take ownership of their thoughts and actions. They don’t blame the traffic for being tardy at work; they were late. They don’t excuse their short-comings with excuses like “I don’t have the time” or “I’m just not good enough”; they make the time and they keep on improving until they are good enough.
2. They don’t avoid doing the scary thing.
Highly confident people don’t let fear dominate their lives. They know that the things they are afraid of doing are often the very same things that they need to do in order to evolve into the person they are meant to be.
3. They don’t live in a bubble of comfort.
Highly confident people avoid the comfort zone, because they know this is a place where dreams die. They actively pursue a feeling of discomfort, because they know stretching themselves is mandatory for their success.
4. They don’t put things off until next week.
Highly confident people know that a good plan executed today is better than a great plan executed someday. They don’t wait for the “right time” or the “right circumstances”, because they know these reactions are based on a fear of change. They take action here, now, today – because that’s where progress happens.
5. They don’t obsess over the opinions of others.
Highly confident people don’t get caught up in negative feedback. While they do care about the well-being of others and aim to make a positive impact in the world, they don’t get caught up in negative opinions that they can’t do anything about. They know that their true friends will accept them as they are, and they don’t concern themselves with the rest.
6. They don’t judge people.
Highly confident people have no tolerance for unnecessary, self-inflicted drama. They don’t feel the need to insult friends behind their backs, participate in gossip about fellow co-workers or lash out at folks with different opinions. They are so comfortable in who they are that they feel no need to look down on other people.
7. They don’t let lack of resources stop them.
Highly confident people can make use of whatever resources they have, no matter how big or small. They know that all things are possible with creativity and a refusal to quit. They don’t agonize over setbacks, but rather focus on finding a solution.
8. They don’t make comparisons.
Highly confident people know that they are not competing with any other person. They compete with no other individual except the person they were yesterday. They know that every person is living a story so unique that drawing comparisons would be an absurd and simplistic exercise in futility.
9. They don’t find joy in people-pleasing.
Highly confident people have no interest in pleasing every person they meet. They are aware that not all people get along, and that’s just how life works. They focus on the quality of their relationships, instead of the quantity of them.
10. They don’t need constant reassurance.
Highly confident people aren’t in need of hand-holding. They know that life isn’t fair and things won’t always go their way. While they can’t control every event in their life, they focus on their power to react in a positive way that moves them forward.
11. They don’t avoid life’s inconvenient truths.
Highly confident people confront life’s issues at the root before the disease can spread any farther. They know that problems left unaddressed have a way of multiplying as the days, weeks and months go by. They would rather have an uncomfortable conversation with their partner today than sweep an inconvenient truth under the rug, putting trust at risk.
12. They don’t quit because of minor set-backs.
Highly confident people get back up every time they fall down. They know that failure is an unavoidable part of the growth process. They are like a detective, searching for clues that reveal why this approach didn’t work. After modifying their plan, they try again (but better this time).
13. They don’t require anyone’s permission to act.
Highly confident people take action without hesitation. Every day, they remind themselves, “If not me, who?”
14. They don’t limit themselves to a small toolbox.
Highly confident people don’t limit themselves to Plan A. They make use of any and all weapons that are at their disposal, relentlessly testing the effectiveness of every approach, until they identify the strategies that offer the most results for the least cost in time and effort.
15. They don’t blindly accept what they read on the Internet as “truth” without thinking about it.
Highly confident people don’t accept articles on the Internet as truth just because some author “said so”. They look at every how-to article from the lens of their unique perspective. They maintain a healthy skepticism, making use of any material that is relevant to their lives, and forgetting about the rest. While articles like this are a fun and interesting thought-exercise, highly confident people know that they are the only person with the power to decide what “confidence” means.
The MELD score (Model for End Stage Liver Disease) uses a complex linear regression formula to transform a patient’s bilirubin (a measure of how well the liver is excreting bile), creatinine (a measure of kidney function), and INR (a measure of how thin the blood is) test values into a number between 6 (“normal”) and 40 (“you need a liver transplant”).? This score accurately predicts a patient’s chance of dying over time if no medical or surgical interventions are performed. This scoring system is used to determine where liver transplant candidates are on the waiting list: the sicker your liver, the higher your MELD score, and the higher you are on the list.
Every doctor, advanced practice nurse, or medical assistant has his or her own approach to listening to the chest. Achieving patient comfort and obtaining a thorough examination are more of an art than a skill. The room certainly must be quiet and the patient at ease to truly appreciate some speciﬁcs of heart murmurs. The murmur must accurately be described in terms of its loudness, site of maximal intensity and timing. Murmurs are graded from 1 to 6
Practically speaking, murmurs are considered either loud or soft because despite the accurate gradation of murmurs there is still controversy. The site of maximal intensity at ﬁrst listen could be misjudged, but with careful reevaluation can be accurately described to help decipher innocent versus pathologic murmurs. Most murmurs are heard along the sternal border. Upper sternal borders can be on the right side or on the left. Lower sternal borders are typically on the left side with variable gradation. Systematic auscultation of all areas of the chest and reassessment are imperative to ﬁnding the maximal intensity of murmurs. The timing of a murmur is also important. All diastolic murmurs are pathologic. However, most murmurs are systolic and can accompany a short period of systole or an entire period of systole. Continuous murmurs despite their name are not heard throughout the entire cardiac cycle. Continuous murmurs start in systole and continue without a pause into diastole.
In addition to the loudness, site of maximal intensity and timing, multiple adjectives can be used to describe some of the classic tones and qualities of heart murmurs. A twangy, musical vibratory murmur that is soft and at the left lower sternal border can almost universally be diagnosed as an innocent Still’s murmur. A harsh machinery continuous murmur at the high left sternal border, subclavicular area is not innocent and consistent with a PDA (patent ductus arteriosus). Most harsh holosystolic murmurs at the lower left sternal border are VSDs (ventricular septal defect). Pediatricians should not be afraid to use multiple adjectives to describe murmurs, as these can be useful for follow-up referrals and cross coverage.
How bad a patient’s liver disease is can be reasonably estimated by various scoring systems that are based on laboratory values and findings on physical exam. The two most useful are the Child-Turcotte-Pugh scale and the MELD score. The former (often referred to simply as the Child’s scale) takes into account the degree of encephalopathy and ascites, as well as blood test results to gauge how well the liver is functioning (bilirubin excretion, albumin synthesis, and blood clotting factor production) to form three classes: Child’s A, B, and C. Child’s A cirrhotics have well compensated liver disease and don’t have significant problems with confusion, spontaneous bleeding, or abdominal fluid accumulation. Child’s C cirrhotics, on the other hand, are quite symptomatic, sick, and tenuous.
Don't let small minds convince you that your dreams are too big.
You Are Never Too Young To Dream BIG.
The GOLD staging system classifies people with COPD based on their degree of airflow limitation (obstruction). The airflow limitation is measured during pulmonary function tests (PFTs).
Vent. rate 64 bpm
PR interval 122ms
QSR duration 120ms
What do you think this is?
1: left bundle branch block
2: right bundle branch block
3: true posterior wall MI
4: some other interpretation
Do you think this ECG is helpful in explaining the probable cause of this patient's symptoms?
We all want to succeed. One path to success is identifying the habits that can help us on our journey.
One way to start the path is reading Stephen Covey’s best-selling book, The 7 Habits of Highly Effective People.
But how do we find time to read all 432 pages?
Most of us don't. The book becomes another item on that backlog of to-dos we never seem to go to. That's why i tried to summarized the entire book for you.
habit 1 - be proactive
This is the ability to control one's environment, rather than have it control you, as is so often the case. Self determination, choice, and the power to decide response to stimulus, conditions and circumstances
habit 2 - begin with the end in mind
Covey calls this the habit of personal leadership - leading oneself that is, towards what you consider your aims. By developing the habit of concentrating on relevant activities you will build a platform to avoid distractions and become more productive and successful.
habit 3 - put first things first
Covey calls this the habit of personal management. This is about organising and implementing activities in line with the aims established in habit 2. Covey says that habit 2 is the first, or mental creation; habit 3 is the second, or physical creation. (See the section on time management.)
habit 4 - think win-win
Covey calls this the habit of interpersonal leadership, necessary because achievements are largely dependent on co-operative efforts with others. He says that win-win is based on the assumption that there is plenty for everyone, and that success follows a co-operative approach more naturally than the confrontation of win-or-lose.
habit 5 - seek first to understand and then to be understood
One of the great maxims of the modern age. This is Covey's habit of communication, and it's extremely powerful. Covey helps to explain this in his simple analogy 'diagnose before you prescribe'. Simple and effective, and essential for developing and maintaining positive relationships in all aspects of life. (See the associated sections onEmpathy, Transactional Analysis, and the Johari Window.)
habit 6 - synergize
Covey says this is the habit of creative co-operation - the principle that the whole is greater than the sum of its parts, which implicitly lays down the challenge to see the good and potential in the other person's contribution.
habit 7 - sharpen the saw
This is the habit of self renewal, says Covey, and it necessarily surrounds all the other habits, enabling and encouraging them to happen and grow. Covey interprets the self into four parts: the spiritual, mental, physical and the social/emotional, which all need feeding and developing.
Get More Stuff Like This In Your Inbox