Standard Operating Procedure Overhaul

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Standard Operating Procedure Overhaul

Postby Aces » Wed Jan 27, 2016 11:01 pm

https://wiki.vore-station.net/Standard_ ... _Procedure

Help me rewrite this for each department.

Security is one I'm handling. Help me write the others.
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Re: Standard Operating Procedure Overhaul

Postby Wickedtemp » Thu Jan 28, 2016 2:39 pm

The only department that I've really worked in is Medical. Sadly, there isn't much to re-write unless we're adding things in.

We can remove the bit about viral outbreaks, I believe they've been taken out of the code because I've never seen one here. That would leave "cloning a suicide/voluntary death".

Now, being VORE, voluntary deaths happen frequently. So I think that it should be changed to reflect that. "Given the nature of the station and crew, voluntary deaths are a common occurrence. Once assured that there isn't a DNR on medical records, cloning should be done UNLESS there's substantial doubt that the death was a suicide." Also while I know that the Captain has final say in most things, but I think that cloning suicides should be a "Forbidden by CentComm. Bring the body to Central, they will investigate and decide whether or not to clone." kind of thing. First off, the Captain isn't a medical professional, it wouldn't make too much sense to give them the final say here. Then, I'm wondering about the "genetic scan is automatically considered to be a 'clone upon death' request"... A lot can happen in a 6 hour shift. They could've gotten a scan at first, then maybe something real shitty happens. Suicide would be acceptable in that circumstance, they do it, but because they had a scan they're now being cloned. So I think it should be made more clear that "Absolutely a suicide" =DNC regardless of a previous scan.

Honestly, suiciding characters don't normally contribute anything but negative drama, the rule on suicides should be much more strict to prevent that. Out of three or four times I've seen a character commit suicide, twice I was told that it was fine. One time was when a character had a LOT leading up to it, so I can agree. But the other time was just someone killing themselves because they lost their job, as far as I can tell. Anyways... Back to SOP.

There should be a "What to do when a patient refuses care." here. And it'd likely go like this.

If the injury is life threatening, provide painkillers and talk with the patient. If they die as a result it can be treated as either a suicide or a voluntary death, depending on what investigations reveal. The CMO can give the order to forcefully sedate the patient for treatment. If it's a lesser injury, ensure it won't get infected or worsen, then let them be. Any fractures are to be splinted at the absolute least, if not treated.

If the patient refuses anesthesia before a surgical operation, use a painkiller. If they refuse the painkiller, use it anyways or inform them that you can't cut open someone without them being numbed beforehand. This is for a number of reasons: 1) It's just plain wrong. 2) Pain = Involuntary muscle movement = bad when in surgery. 3) It'd probably pain-crit the patient, which is bad. 4) Seriously, no good doctor would do this. 5) It'd likely also be illegal under Neglect of Duty/Malpractice.

And a further OOC note: I understand that some people dislike the black screen that anesthesia gives you. But for christs sake, don't pull the "IM STRONK! NO FEEL PAIN!" card. You're a living, sapient creature with a working nervous system. You feel pain. Getting cut open while not under any painkiller is dangerous and IRL would probably actually kill you via cardiac arrest or something. So if you don't like being put under, request a painkiller instead. Don't do the "THERES NO TIME JUST DO IT!!!" shit unless there's something or someone breaking into Medical to kill you both. Yes, there IS time. It's actually rather difficult to die in medbay since Medical can heal everything except for fractures with Chemistry. Even internal bleeding can be slowed (possibly stopped) with a Bicaridine overdose. Organ damage can easily be treated with Peri, too. So there's no reason other than "imminent threat to the lives of everyone here" and "medical negligence" that would prevent a doctor from giving you 5-10 units of Tramadol real quick... Seriously, again, if you don't want anesthesia, just ask for a "local anesthetic". I've never had a surgery other than having my wisdom teeth removed, and I had the choice between being put under or just have a painkiller. But I'm 100% sure that if I refused both, they'd send me on my way.

Then there's...lets see... Aside from doing real micro-managey stuff like "SoP dictates that bicardine and shit should be on-hand, use your medical belts" which is something I would NOT want to see, I'm not sure if there's anything left to add...

Maybe something about following the Hippocratic oath or something similar, maybe? I think I've already touched on the things that I normally run into here that would require a bit of a manual. So! Thoughts? Comments? Concerns?
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Re: Standard Operating Procedure Overhaul

Postby Aces » Thu Jan 28, 2016 7:18 pm

Wickedtemp wrote:The only department that I've really worked in is Medical. Sadly, there isn't much to re-write unless we're adding things in.

We can remove the bit about viral outbreaks, I believe they've been taken out of the code because I've never seen one here. That would leave "cloning a suicide/voluntary death".

Now, being VORE, voluntary deaths happen frequently. So I think that it should be changed to reflect that. "Given the nature of the station and crew, voluntary deaths are a common occurrence. Once assured that there isn't a DNR on medical records, cloning should be done UNLESS there's substantial doubt that the death was a suicide." Also while I know that the Captain has final say in most things, but I think that cloning suicides should be a "Forbidden by CentComm. Bring the body to Central, they will investigate and decide whether or not to clone." kind of thing. First off, the Captain isn't a medical professional, it wouldn't make too much sense to give them the final say here. Then, I'm wondering about the "genetic scan is automatically considered to be a 'clone upon death' request"... A lot can happen in a 6 hour shift. They could've gotten a scan at first, then maybe something real shitty happens. Suicide would be acceptable in that circumstance, they do it, but because they had a scan they're now being cloned. So I think it should be made more clear that "Absolutely a suicide" =DNC regardless of a previous scan.

Honestly, suiciding characters don't normally contribute anything but negative drama, the rule on suicides should be much more strict to prevent that. Out of three or four times I've seen a character commit suicide, twice I was told that it was fine. One time was when a character had a LOT leading up to it, so I can agree. But the other time was just someone killing themselves because they lost their job, as far as I can tell. Anyways... Back to SOP.


We did have a discussion over that, and the consensus with admins was it should be "Automatically clone unless you have blatant evidence that the person committed suicide. Someone has to witness the act, find a suicide letter, etc. Just because someone beat themselves to death with a crowbar according to autopsy doesn't mean they did it on purpose. (Might just be some dolt not knowing the game mechanics. You should probably Admin PM.)"

There should absolutely be a part of SOP regarding suicides.

There should be a "What to do when a patient refuses care." here. And it'd likely go like this.

If the injury is life threatening, provide painkillers and talk with the patient. If they die as a result it can be treated as either a suicide or a voluntary death, depending on what investigations reveal. The CMO can give the order to forcefully sedate the patient for treatment. If it's a lesser injury, ensure it won't get infected or worsen, then let them be. Any fractures are to be splinted at the absolute least, if not treated.

If the patient refuses anesthesia before a surgical operation, use a painkiller. If they refuse the painkiller, use it anyways or inform them that you can't cut open someone without them being numbed beforehand. This is for a number of reasons: 1) It's just plain wrong. 2) Pain = Involuntary muscle movement = bad when in surgery. 3) It'd probably pain-crit the patient, which is bad. 4) Seriously, no good doctor would do this. 5) It'd likely also be illegal under Neglect of Duty/Malpractice.


I have mixed feelings of this. If they refused to be sedated, you can just inform them that you cannot perform the treatment safely and not do surgery at all. But I prefer there still being an option. If someone wants to die of their own stupidity that's their prerogative.

And a further OOC note: I understand that some people dislike the black screen that anesthesia gives you. But for christs sake, don't pull the "IM STRONK! NO FEEL PAIN!" card.


Well that's just straight up powergaming AdminPM if that happens.

But I'm 100% sure that if I refused both, they'd send me on my way.


Actually they wouldn't lol. They'd just try to intimidate you. "You sure?" *whirrs up drill*

My father has refused painkillers but he actually is someone who can say "IM STRONK! NO FEEL PAIN!" and fucking get away with it and not cry like a bitch. He's startled doctors on more than one occasion. It's possible. It's just stupidly rare.

Of course I'm pretty sure even he's had his mouth numbed for teeth-related things. Then again he's also busted his hand (more than once), had blood oxygen levels so low that he should have been dead much less conscious and fully aware and functioning and able to drive himself to the hospital, among other things. And don't get me started on my grandfather. I lost count of how many heart attacks it took to kill him.

Then there's...lets see... Aside from doing real micro-managey stuff like "SoP dictates that bicardine and shit should be on-hand, use your medical belts" which is something I would NOT want to see, I'm not sure if there's anything left to add...


It's probably worth adding some basics. "Emergency Medical Technicians should be equipped with X, Y, Z." That's about it. Normal doctors have everything they need in the medbay. Maybe also talk about what to do in certain emergencies like a phoron spill. I wrote up a whole guide for that.

Maybe something about following the Hippocratic oath or something similar, maybe? I think I've already touched on the things that I normally run into here that would require a bit of a manual. So! Thoughts? Comments? Concerns?


Yes.
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Re: Standard Operating Procedure Overhaul

Postby Wickedtemp » Fri Jan 29, 2016 1:00 pm

Aces wrote:
We did have a discussion over that, and the consensus with admins was it should be "Automatically clone unless you have blatant evidence that the person committed suicide. Someone has to witness the act, find a suicide letter, etc. Just because someone beat themselves to death with a crowbar according to autopsy doesn't mean they did it on purpose. (Might just be some dolt not knowing the game mechanics. You should probably Admin PM.)"

There should absolutely be a part of SOP regarding suicides.

-----

I have mixed feelings of this. If they refused to be sedated, you can just inform them that you cannot perform the treatment safely and not do surgery at all. But I prefer there still being an option. If someone wants to die of their own stupidity that's their prerogative.

-----

It's probably worth adding some basics. "Emergency Medical Technicians should be equipped with X, Y, Z." That's about it. Normal doctors have everything they need in the medbay. Maybe also talk about what to do in certain emergencies like a phoron spill. I wrote up a whole guide for that.



Yes. [In response to the bit about adding a bit of the Hippocratic oath into SOP]


Okay! So we've got a "Definitely." on the bit regarding how to handle suicides, which is already in there but I think it should be polished a bit to better fit this server. Or at the least, it needs to be well-known, because I've seen more than one case of Security: Clone them. Medical: I can't, it was a suicide. Security: Clone them or I arrest you.

As for treating patients without painkillers... I'd personally have it like this. Broken hand or foot? Sure, I could see someone doing a surgery on an awake, un-numbed patient. Fractured ribs? That'd call for moving around their internal bits, at the very least a painkiller would be needed. Brain surgery? I don't think anyone would want to be awake for that. Strongly, strongly advise full-blown anesthesia. And I'd agree, giving the CMO the authority to over-ride the patient's decision would be stretching it, it's likely just a slight bit of bias on my end, because I've seen many people in SS13 walk out of Medbay with a ruptured lung because stupid reason. Takes literally like 30 seconds to fix via peridaxon, no reason to NOT have it fixed, y'know?

For adding basic instructions for workers, I've actually already written up a lil' guide that I give to people who are new to Medical. It goes over the damage types, what to use for each damage type, explains why KeloDerm > Dermaline, tells you how to fix organ damage and all that, lots of handy stuff. I even put in a step-by-step Chemistry guide that, instead of saying "1 part dylovene 1 part inaprovaline" it lists each step. I've found it's easier to follow that way. It ALSO includes what I, personally, see as the optimal medical load-out for Bay-code servers... I think it's a bit 'advanced' for EMT's and Nurse's maybe, but it'd likely be helpful for MD's. It'd allow them to treat pretty much everything except for fractures and internal bleeding right there, on-site. The drawback is, it relies HEAVILY on Chemistry. You HAVE to have a good Chemist for the good chems, which is why I added the guide, and I've also spent quite a bit of time teaching people Chemistry in-game. So many people underestimate how OP Chemistry is, and it doesn't take twenty minutes to get a kickass load-out in the chem vendor.... Anyways, I can send it to you in a PM if you want to give it a look-over, pick and choose what you want included I guess.

And lastly, for the Hippocratic Oath... Even Chakat Tempest doesn't follow it COMPLETELY, mostly due in part by the fact that shi'd administer euthanasia in some circumstances, to end suffering. And of course, we couldn't have the strict "Don't kill at all, ever." bit in there because... well, vore/digestion is a thing. But we CAN have the concept of "Don't refuse to heal anyone, even criminals." We MAY have to cherry-pick a bit (as much as I hate it) so it better fits the server.

Also, I just want to put this out there... When you see me saying "I like to use ____ personally, so that's what I'm advising YOU use as well.", that isn't me saying "Be like me, assimilate! ASSIMILATE!". It's just that I've found that this particular idea or way of doing things works excellently for me. Emphasis on this when it comes to medical load-outs. So don't worry, I'm not trying to force everyone through the same cookie-cutter here, I'm just showing you the cookie-cutters that make my favorite cookies, use them if you want, ignore it if you don't.
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Re: Standard Operating Procedure Overhaul

Postby Aces » Fri Jan 29, 2016 5:10 pm

Well SOP is just ideally how things should go in a normal day. It's not the law, and it's not the server rules.

As for things like chemistry, that should really be under the Chemist page for tips and tricks on how to be a good chemist or wherever it fits in the article. SOP is more about things that CentCom already expects you to do, such as dispose of dangerous chemicals in a safe manner and not chuck them down fucking disposals.
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Re: Standard Operating Procedure Overhaul

Postby Scree » Fri Jan 29, 2016 7:49 pm

Oddly enough, a friend of mine went in for surgery on his hand after he sliced it with a knife and nicked a nerve, and the surgeon had to completely put him under as he couldn't risk even the slightest movement.

Whereas brain surgery - the brain itself doesn't feel pain to they'll often keep the patient awake and talking and holding conversation and answering questions and so on just to make sure they've not sliced anything important.

Regarding suicide, the reason we have the "if there's a scan, clone them" thing is so we don't end up with some dickhead CMO declaring that a willing vore scene was suicide and refusing to clone them.
Bear in mind that suicide is actually a thing we'll slap people for OOCly, so it's easier to just clone them and ahelp it if they offed themselves purely for the sake of cheap drama.
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Re: Standard Operating Procedure Overhaul

Postby Wickedtemp » Fri Jan 29, 2016 9:02 pm

Scree wrote:Oddly enough, a friend of mine went in for surgery on his hand after he sliced it with a knife and nicked a nerve, and the surgeon had to completely put him under as he couldn't risk even the slightest movement.

Whereas brain surgery - the brain itself doesn't feel pain to they'll often keep the patient awake and talking and holding conversation and answering questions and so on just to make sure they've not sliced anything important.

Regarding suicide, the reason we have the "if there's a scan, clone them" thing is so we don't end up with some dickhead CMO declaring that a willing vore scene was suicide and refusing to clone them.
Bear in mind that suicide is actually a thing we'll slap people for OOCly, so it's easier to just clone them and ahelp it if they offed themselves purely for the sake of cheap drama.



I don't think I'd want to be awake for brain surgery, mainly because of the whole "Gotta crack the skull to get to the brain." part. Even if I didn't feel pain, I think I might still feel SOMETHING and just know "Yep. That's my skull." which would likely be followed by a pathetic whimpering noise and tears, because that would terrify me to such an extent that I would die inside.

But uh... Yeah, for me, bottom line, if patients aren't numbed at least with Tramadol during an operation, I'd be tempted to slap them with "medical negligence", otherwise you'd have a screaming patient. And it'd be implied that involuntary muscle movements would result from pain, causing more problems. I'm not sure if there's even a drawback to just throwing the patient down and cutting em open, but RP-wise, there's plenty of reasons.
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Re: Standard Operating Procedure Overhaul

Postby Aces » Sat Jan 30, 2016 12:06 am

Wickedtemp wrote:
Scree wrote:Oddly enough, a friend of mine went in for surgery on his hand after he sliced it with a knife and nicked a nerve, and the surgeon had to completely put him under as he couldn't risk even the slightest movement.

Whereas brain surgery - the brain itself doesn't feel pain to they'll often keep the patient awake and talking and holding conversation and answering questions and so on just to make sure they've not sliced anything important.

Regarding suicide, the reason we have the "if there's a scan, clone them" thing is so we don't end up with some dickhead CMO declaring that a willing vore scene was suicide and refusing to clone them.
Bear in mind that suicide is actually a thing we'll slap people for OOCly, so it's easier to just clone them and ahelp it if they offed themselves purely for the sake of cheap drama.



I don't think I'd want to be awake for brain surgery, mainly because of the whole "Gotta crack the skull to get to the brain." part. Even if I didn't feel pain, I think I might still feel SOMETHING and just know "Yep. That's my skull." which would likely be followed by a pathetic whimpering noise and tears, because that would terrify me to such an extent that I would die inside.

But uh... Yeah, for me, bottom line, if patients aren't numbed at least with Tramadol during an operation, I'd be tempted to slap them with "medical negligence", otherwise you'd have a screaming patient. And it'd be implied that involuntary muscle movements would result from pain, causing more problems. I'm not sure if there's even a drawback to just throwing the patient down and cutting em open, but RP-wise, there's plenty of reasons.


Hence why the SOP says a doctor can go, "Well okay, I'm not obligated to treat you because I'll make it worse if you refuse pain meds."

Also the CMO can only override to do a cloning; not to reject it. Perhaps I can make it more clear.
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