Patient is an obese female who came in with a fractured ankle. It was deformed tremendously. I was having a hard time with the patient because the pain medications were taking a really long time to take effect. Out of no-where a nurse shows up to test the patient sugar level with a…..FINGERSTICK…..which of course has the patient screaming and the patient instantly becomes less drowsy….ugh!!!!
An hour later I have to review a patient who came in with a headache…..I have to review the patient’s chest x-ray and abdominal x-ray…..WHAT???? I guess someone was on who was even more tired than I was.
A bit of a frustrating day.
Ever so often I encounter stressful days. They creep up on me when I least expect it and I SHUT down!!!
I had been working for five nights straight then, on the last night, with only 3 hours of sleep I had to wakeup and attend an early am meeting. Of course my brain is fried. However the head Doctor who is leading the meeting looks like he has slept for hours!!!!
Then I had to receive a messy shift handover. I mean come on guys, are you kidding. I know everyone is exhausted, but don’t write a barely visible scribble and then quickly rush off……
Way to go team….UGH!!!!!
Elderly female in no apparent distress from whom I am taking a simple history.
‘Ma’am have you had any surgeries recently?’
Patient: ‘Well doc since my husband and I stopped having sex that weird pain has gone away’
The sex doc, the sex……????
Patient comes in panicking and telling me that she overdosed herself today by taking one extra pill of her blood pressure meds.
I asked her to give me the name of her tablet………which she did not know…????
All vitals signs were stable, it was 2 am, she took the pill ‘sometime in the evening’ and forgot to come in earlier on………
I sent her home thinking next time take a ‘chill the hell out pill’ instead………
One thing that is true in the medical community is that we work hard. Now, with that being said another important factor is knowing which doctor among your colleagues you can trust and who you can’t trust.
I don’t ever discriminate…….I don’t trust ANYONE!!!
Let me give you an example.
I primarily work in the ER of a level 1 trauma hospital. I know all of my colleagues well, and, I know who to listen to and who, while they are talking, I am making up my grocery list in my head. The latter are the kind of doctors I REALLY don’t trust. I won’t leave my worse marble with them.
They are lazy, take a half-assed history. Barely do a physical, and may/will miss an important diagnosis.
One such colleague handed over a patient to me today.
Sleepy doc: ‘So tell me about this patient’
Slick: ‘Well she is a 20 something female with shortness of breath, dry cough and decreased breath sounds on the on side of her chest.’
Sleepy doc: ‘Ok, well you can go on your break now’
Slick: ‘Ummmm….. You heard me tell you about the decreased breath sounds???? Oh and she has asthma.’
Sleepy doc: ‘Yeah, go ahead on your break.’
Note: Slick disappears for the next two hours and noone can find her.
I immediately REASSESS the patient. Who is a young asthmatic, breath sounds equal in BOTH lungs. O2 saturation is 100%. I treat the mild asthmatic attack (which by the way I think was an aniexty attack due to personal problems with her boyfriend’, check the chest Xray and she is out and home within 3 hours.
Later on I ask Slick if she had done a physical on the patient. ‘No, I was just telling you what the EMS worker told me……..’
Always reassess a patient that has been handed over to you, or, you could end up in trouble.
Consider the fact that I have been working for the past 8hrs non-stop with one or two bathroom breaks in between. Sleep was definitely not optional this time around.
Also I forgot to bring a ‘healthy’ snack…..no not carrot sticks, more like chocolate kit kat bar.
I am tired and irritated and my colleague who is supposed to relieve me is 45mins late AGAIN!!!!
Everyone has a life, please be considerate. Ugh!!!!