In case you missed it in previous posts, $hospital depends on residents to fill the early morning shifts. Specifically, there is one ER physician and one resident on every morning from midnight to 7 AM. Our Level II trauma center ER gets 52,000+ patient visits a year. That's an average of 6 patients an hour, if you lay it out evenly across the day. Fortunately, we don't. From midnight to 7 am is a little bit of a low shift, although the bars close at 2. Normally, we see about 35 folks instead of the expected 42 - I see 12 or so, and the ER docs see a whole bunch. For this service, they cover my malpractice and pay me $75-$85 an hour, which amounts to a decent takehome to cover some of the med school debt with. Some shifts are absolute murder, when the trauma call folks are in and I'm running the rest of the ER alone. Tonight, my attending had a gunshot wound to airlift to $tertiary_center and an ectopic pregnancy to send to surgery, so I handled the rest for a while. It had the potential to be quite bad.

Instead, in no particular order: A six-year old with an overanxious mother and an asthma exacerbation (99% on room air: one duoneb, steroid burst, discharge home). A colicky month-old baby (complete physical exam demonstrates farting and improvement of colic: reassurance, discharge home). A teenager with a urinary tract infection (antibiotics, discharge home). A year-old with croup (vaponefrine, observe, discharge home). A teenager who picked up the wrong cat (betadine scrub, discussion regarding the last rabid cat in Indiana in 1984 and the much higher risk of Pasturella joint infection, Augmentin, discharge home, followup tomorrow). An elderly woman sent from the nursing home with diarrhea to rule out dehydration and with an elevated INR (can't work out what's wrong with her, argue with the hospitalist, call her primary care doctor and oncologist and admit). A very nice lady who woke up in the middle of the night with pancreatitis (argue with attending that she has GI problems and not cardiac disease, admit).

Seven patients. And it's holiday dinner morning, so at 3 AM I got chicken cordon bleu, green beans almondine, and cheesecake. Not bad money, tonight. Not bad at all. I think it's time for a nap before Dermatology.

Current Location: $ER
now feeling:: content