2 more days

My time at Methodist is almost over. Only 2 more days of work in the peds ED and and exam left, where has the time gone?? I was going to blog about my Tuesday morning shift last night, but I was so exhausted that I fell asleep around 6pm :) So, it was not surprising to wake up at 5am today :) I have to go in at 8am, so I have some time to write now. Lets start with sunday's shift, then I'll fill you in on Tuesday's.

Sunday, I was in the peds ED with Micah another 4th year student. And unfortunately, it was very slow. The shift was 4pm-12am (I missed the final episode of True Blood, although Chelsea and Matt were kind enough to let me make it up Monday night :). I have come to the realization that I just don't like peds ED. As you all know, I am not much of a "kid" person, but its more than that. I get so annoyed when parents know nothing about their kids illness: when it started....how high the temperature was (most don't even own a thermometer or know how to use it)...how to dose medication properly...or the worst, waiting until the child looks like death before coming in to see someone and then getting mad at us because their child needs to be admitted and that would cut into their precious time. Seriously??

So, I have a 13 year old girl on Sunday who is having knee pain and swelling. Very bright and intelligent girl, answered all of my questions with complete sentences, not just "I don't know" unlike Mom who seemed to be bothered by the whole experience of being away from home and the television. Anyway, I find out that this young girl was run over by her cousin on a bicycle one week ago. Over the last 7 days she has been limping and the pain and swelling have increased. So, what does her mother do....she brings her into the Emergency Department at 9:30pm on a Sunday. We send the girl for x-rays....the mother complains about everything (putting the gown on (her daughter, not herself), going across the hall, waiting for the radiologist to read the films). We tell the mother there is no sign of fracture....the mother complains (what a waste of time, this ED is horrible and I'm not coming back, how much longer do I have to sit here). We ace wrap the knee and give the girl some crutches to use for the next week AND the mother complains (how is she supposed to go to school with crutches (I seriously almost laughed in the mom's face for this statement). My daughter needs a note to stay home from school, what?? you aren't giving one, fine then one for gym for the next month. What do you mean for only 2 days until I follow up with ortho I am not taking her to no ortho doctor. How am i supposed to get her to the bus stop, I want a voucher for a taxi company for the next month....etc, etc, etc. This went on for almost 20 minutes, until finally the doctor gave the mom all of the paperwork and told her to leave. Interestingly enough, the daughter was fine with the directions and fully understood everything we were saying. I almost felt bad for the girl having to put up with a mom like that.

So, my final adult ED shift was Tuesday morning 12am-8am. I was hoping it was going to be busy and was it ever, the time flew by and I was so happy, although the night had its moments, specifically with the nursing staff. We were so slammed that patients were waiting 6 hours to be seen by a doctor. I was working with a 2nd year resident who did a great job for having so many high acuity patients at one time. Unfortunately, the nurses were not doing a great job at all. I had to do most of the IVs and blood draws on our patients, and was asked by one nurse to do her job because "I am too busy right now" and then she proceeded to sit down and talk to another nurse for 15 minutes. Then, at one point our patient needed pain meds so the resident asked me to go to the nurse and inform her the order was just placed and to give the medication. As I am telling the nurse this, she says "I am going on break, it will have to wait" and she walks away. I was floored. I understand you haven't received a break yet, but neither have I...or my resident....or the attendings for that matter because its so froggin busy. Luckily I found a nurse willing to give the meds for our patient.

The one thing about Emergency Medicine that I love is the team atmosphere. It really takes effort from everyone in that department for a successful night. The clerks...the nurses....the transport team....the xray techs...the residents....the doctors....and even med students. What sucks about Emergency are those nights when this system falls apart.

So, today I have a peds ED shift 8-4pm. Tomorrow is my written final and oral presentation. And my final shift is Sunday from 8-4pm. Soon, it will be Monday and I will be back at Coney Island, my first home, doing medical ICU :)