Beer rating for today:
Every Wednesday we have several morning meetings. First, we all meet in our individual classes (interns, second year residents, and third year residents) and discuss selected chapters in our Emergency Medicine textbook for an hour. It helps to correlate the science aspect with the clinic aspects of our jobs. Then we have Grand Rounds for about 3 hours. Grand Rounds consists of several lectures, usually themed together, with occasional guest speakers. We then might discuss a clinical case as presented by one of our colleagues (my presentation will be in May '08) or discuss some clinical scenarios.
Our shifts on Wednesdays then don't start until 1400 (2 p.m.). We work until 2100 (9 p.m.). The night shift then comes in and works 2100 - 0700. So, instead of a 12 hour shift, we work shorter shifts on Wednesdays which makes it nice because things just seem to go by a little faster.
My patients this afternoon:
- 80 something with diarrhea for a week = get admitted for dehydration and weakness
- 70 something with abdominal pain = get admitted for pain control of your underlying colon and pancreatic cancer (and, I might just add, cancer patients in my book get all the drugs they want)
- 20 something with chest pain = get admitted for observation in chest pain center
- 50 something passing out after a fall = still getting worked up when I left, but I worry when I read that the patient can't be placed in a normal shelter because he's listed as a "sexual predator" which makes living in most locations difficult
- 70 something with swollen hands = still being evaluated to make sure he's not going into heart failure, he just wanted to eat the same things he ate in the hospital so that his hands won't be swollen
- screaming 50 year old who I was asked to see because she only understood Spanish = would not listen to me when I tried to explain that I don't arrange for housing, I can only take care of her medical needs. From my conversation with the social worker, she's been thrown out of every local shelter around for being annoying and demanding.
Finally, we were signing out patients at shift change (where the on-coming residents take over our patients that are still being evaluated) when one of our own, a resident, was brought in by EMS. I think he was more embarrassed at having to be brought in than by what actually happened to him, but then he's got nothing to fear... we take good care of our own.
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2 comments:
Okay, three questions and an excuse:
1) What, praytell, did your resident do that got him into his own place for care? You're not naming names, and really, you can't drop a teaser like that and not expect quesitons. :-P
2) Isn't sedation a nice prescrption against 50-year-olds with a prolonged history of annoying the shit out of everyone in their sphere of whining?
3) When are you going to give up Molson and take up real beer?
e) On a big push to get my marketing program going before I go broke and have to sack out in the local ER. Said program consists of mailers, website, and touching, heartfelt letters to my intended clients. Will retuirn your call regarding your upcoming <secret, happy, life-changing event> this weekend, you romantic DocMontey you.
a - spouse of recent EM grad goes to park car in slanted driveway and doesn't place car in "Park," car begins to roll down driveway and out onto the street where it T-bones EM resident on his way to work, where?, to the E.D. where he ended up on a stretcher instead of on his own two feet
b- if we sedate them, we'd have to keep them and the whole point is to get them out of the ED
c - It's Canadian made Molson and I preferred it to the local Labatt's Blue everyone here drinks... still haven't made it to any of the local breweries to sample the fares and "upgrade" to something more palatable
re: excuses - "the Lord helps those who help themselves" these I do not mind
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