Friday, July 27, 2012

Day 15 ER: Last Day

So here it is, my last 12 hour shift in the ER. This month, I officially spent over 180 hours in this place.

It was kind of a bittersweet feeling. At first I thought this place would drive me crazy with how unorganized everything is. But this rotation granted me a lot of freedom to practice a ton of patient care. I got to pretty much do everything for a patient, from the initial exam, to ordering diagnostic tests, getting medications, and performing procedures. And from what I've heard from other students, you don't get this kind of freedom in other rotations. One student told me that in surgery you are lucky if the attending lets you hold a retractor, let alone suture the patient.
Anyway, today was pretty much your standard day in the ER. Lots of super ghetto people who were raised to believe that the ER is the place to go when your joints hurt (even though there is a FREE clinic for that stuff literally next door), then complain and become verbally abusive when we don't see them for hours because we have patients with acute issues.

There were nursing home vegetables sent in because their mental status has changed.... usually meaning that they could respond to verbal commands before, but now just lay there. So we did a basic physical, ran a bunch of labs, then told ICU/Internal Medicine it was their problem. Usually a good kind of patient to practice listening to heart sounds on, because they usually have some kind of cardiac issue, and they don't care if you take forever to listen to their chest.
Towards the end of the day another med student, who's last day it was today as well, pulled me aside and said in a whisper: "I've secured a laceration case in the Fast Track area, its all ours, lets quietly go over before another student/resident sees and takes it"

So like ninjas we exit the ER and go down to the fast track area. She had already grabbed everything we would need and laid it out on a bedside table. For our last case in the ER, she had found: a nursing home patient who had a laceration on his scrotum.
What.

How does that even happen.
He had a deep, Y shaped cut along the whole front surface of his ballsack.

The patient couldn't or wouldn't tell us, and the nurse we called at the nursing home wasn't forthcoming either.

Anyways we got to work. The patient kept saying "Get off my balls!!!". At one point he grabbed my elbow and tried to bring it to his face.

 "Don't bite me sir!!" I said

"Don't have real teeth anyways" he grumbled as he let go.

One of the nurses came over to see what was causing the big commotion. He said, while laughing, "honestly I'm taking his side, I'd try to bite you too!".

Anyway, it was a memorable last case for the ER rotation. Suturing some old guys scrotum.

See y'all in September for Family Practice, probably won't have anything exciting to say there :(




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