Walked in and it was swamped. Dr. K sent me to see a few patients, but I came in at 2 and he was off at 3:30, and Dr. S came on.
I take back all the bad things I was thinking about him not letting me do anything. He made a point of explaining: When the ER is full and rushed, he lets his dictations back up; he can't handle keeping track of my patients and dictating on them too. I can accept that. Especially when he sent me in at 21:15 to stitch up a laceration, took time out to show me radiographs and explain the findings, and let me know exactly what orders to write when I asked what he meant by "Give him five of morphine". And he sent me in to see patients as soon as he was caught up, and asked for my differentials, and listened to my suggestions for treatment.
Dr. W. made me go listen to a woman in a-fib with a murmur today, discussed the difference between her murmur and the crescendo-decrescendo I heard the other day.
Saw a guy - I love this story - who'd backhanded someone for touching 'my ol' lady' two weeks ago, damaging his hand. Then he got bit by his cat. So he got antibiotics. Presents today with a swollen, immovable finger, a lot of pain, a 2-mm foreign body on X-ray, and red streaks up past his elbow. Oh, and tender lymph nodes in his armpit. Guess who's staying for IV antibiotics and having his finger cut open by the orthopods?
Nothing else too interesting today. Bruises and lacerations, pelvic pain and a little boy who was throwing up. The usual. Tomorrow is my pap smear, then back in for evening shift. Working morning on Wednesday, and finally got in touch with the IAFP people, and I am going to the conference, and they're paying for my room and lunches and fees and all. So I'm staying at the French Lick Resort Thursday through Sunday, so keep lakos amused for me, in case I can't swing online access.
Notes from Saturday:
Saw a little girl, two years old, who'd put a rock in her nose. Whoops. Fortunately, it came out with little effort. It was a purple aquarium rock, and when it came out, she squealed "I so HAPPY!" and hurled herself at her mother. The next ten minutes were a montage of "I so happy" and "You proud of me", in the cutest voice I've ever heard. Chii!
Saw a 19-year-old who'd taken his bike up for a wheelie on the motocross track and gone off the back, six feet in the air. V. cute little brother, about 8 or 10, reenacted the whole accident for me, with hand gestures. Verdict: Beautifully broken collarbone, no more biking until it heals. There goes his season.
Saw a 14-year-old girl who'd gone up for a kick in her Taekwando tournament and lost her footing. Bounced her headgeared-head off of the floor and came back up dizzy, so the paramedics backboarded her and shipped her over. Extraverted, alert, perfectly fine. She was really cute about it, thrilled to be out of the ER in time to eat with her team.
C. comes in complaining of agonizing pain around her right kidney, nausea and vomiting. For two weeks. She's now running a 101.4º fever, has foul-smelling urine, and boy, big surprise has a rampaging kidney infection (pyelo, ishotkenney, they always freakin' call it pyelo). Plus, her vaginal wet prep comes back with a whole bacterial party of PID. Dr. W, to me: Maybe I should swab her throat, see if she's got something growing there too...
Those are the ones that stick in my mind.
Everyone wish ishotkenney well, she's starting her third-year orientation and will begin with paediatrics.
Chili from the crockpot was marvellous, I had a whole yummy bowl. And now I'm going to go sleep tonight, yay for sleeping.