Dr. E pulled her chart out, handed it to me. "Go take a look, see what you think." I came back and reported on reflexes and strength, and he quirked a brow. Said it didn't make sense. He went along, did the Rhomberg test on her and a few other things, and then handed me the chart. "She's all yours. We'll move her MRI up and when it's scheduled, call her neurologist and see what she wants us to do." And there I am with a chart. Write me an order, please, says D on the desk. It dawns on me that I don't know what we're MRI'ing. So I grabbed the PA on duty, asked him. Just the head? Sure, sounds right. So I wrote MRI head in the blank and put it in the queue.
Told the girl on the desk I needed Dr. S on the line. She got her for me, a couple hours later. "I'm Nykki, a third-year medical student on rotation here in the ER, and I've got a patient of yours here, P. We're going to move her MRI up and wondered what else you wanted done." Well, let's do the standard bloodwork...and then she went through it, just in case, I think. So I marked up the order again and handed it over. And I stuck my head in to give her the reports and let her know what was going on, and after Dr. E saw her briefly, I was the only person to talk to her. Went over her chart with the docs and was given the go-ahead.
Finally discharged her with a completely normal workup ten minutes before I left. Go follow up with your family doctor. Was just...very empowering.
Mitigated by failing to diagnose ringworm + impetigo on a wrestler and not realising that a little kid with an elevated alk-phos is normal. Can't win them all. I did get pyloric stenosis in my differential of the kid who had it.
Paediatric surgeon came in and needed stitching up. He'd dropped a rock on his finger working on his rock garden. "I've got surgery at 6, can we expedite X-rays?"
Two drunks today, one with a BAC of 0.359 at first measurement, the other refusing all treatment. And a diabetic who got happy with the insulin or something, blood sugar of 28. It was a bit of a looney bin today.
Met Dr. U, who's neatospiff, and followed Dr. B around. I'm beginning to get a feel for things, although forgetting my stethoscope is a Bad Thing. I had a suck-ass loaner.
Saw J today, the EMT who took me on my ridealong. He's still working the same shift, we chatted a bit, he said I should come back again. He was fun.
Feeling much better than I was this morning. Thinking I should go to bed relatively early, as I'm due back into the ED at 8 AM.