Started ER yesterday and it's an experience quite removed from psych as anyone can tell you. I also keep introducing myself that way as "this is my first MEDICAL rotation" lest anyone thinks that 6 weeks of dealing with schizophrenia entitles me to put in an IV.
There are two sides to this particular ER: Acute and Urgent. Acute is for people that have complicated diseases, may require being admitted, and may be in danger of dying if not treated fairly immediately. Urgent care is your broken bones, lacerations, stomach pains, throat aches, and that sort of thing. I spent yesterday in Acute care being terrified and trying to elicit a history from a 105 year old without full uhh... mental acuity. I also got seriously pimped for my first time ("This may be your first medical rotation, but I assume you know BASIC physiology?") and learned how to do and somewhat read EKGs.
Today I was on urgent care; saw viral pharyngitis and a corneal abrasion, the latter of which I got to not only examine but say "Uhhh yeah, there's something in his eye" because I could *see* it. They saw it and confirmed with dye and a Wood's lamp, but I suppose I'm not as useless at eye exams as I thought. Either that, or it was a really big piece of something. Then I screwed up by taking the patient's charts up to ophthalmology but not the patient, because I didn't know I was supposed to, so he was like "you forgot me", and it's like "no! I'm just an idiot!"
Then bounced to acute care for a while and had a patient that was kind of a mess, with ulcers, a serious UTI causing sepsis, and a whole host of other problems, so I hung out there for a while, helped the nurse and CPA clean up the mess (don't ask; let's just say, I'm still washing my hands) and in return, got to see a Foley cath and a wound cleaning, which was cool. Came back to urgent care and got to do a tetanus shot (woot!) before interviewing an ob/gyn patient and getting a crash course on pelvic exams (I get to do the next one) and starting IVs (I get to do the next one).
So it was an interesting day. I feel like I know absolutely nothing and somehow manage to forget to ask the most basic questions that the residents then immediately ask about like "does the pain radiate to her back?" "Uhhh... no? Okay, I didn't ask. Even though I know to ask."
Oh, now that I'm back at Brooklyn instead of MPC, I get to use meal vouchers, so that should shave a significant portion off my costs. Unfortunately today, I was spectating through lunch and by the time I got to the cafe for my free meal, they were closed. So sad!
Jul 7, 2009
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