ER Day 2- Poop

Yesterday was my first full 12 hour shift, and it got much better. Instead of having all the new residents and medical students there at once, it was just me and a 4th year student, and one of the new residents with 2 attendings. The 4th year student was so nice to me. She let me follow her around all day while she showed me the ropes. She made me do and assist her with some procedures, and gave me some basic tips for surviving rotations.

That said, as the title of the post suggests, the theme of the shift seemed to be poop. I dont think I could ever be squemish with any kind of bodily function after yesterday. The first patient I saw, the 4th year made me do a rectal exam and get a quiac sample (basically smear poop on a card). That same patient for the next few hours had me look at her poops because she kept thinking she saw blood.

Another thing that I had to adjust to yesterday was the fact that everyone refers to the med students as doctors. I'm really not used to being called that, and I really don't feel like I've earned it yet. The patients call us doctor out of ignorance (white coat seems to = doctor), the nurses call us doctor with a humourous/aww look at them try tone, and some of the residents refered to me and the other 4th year as "baby doctors".

I did get the hang of what is expected of medical students and how ER shifts generally work. Basically we keep an eye on the computer's grid of patients as they get admitted. If we see a patient on there that has yet to be seen by a doc, we go up to an attending and ask if we can go see the patient. If they say yes, you go and get a basic history of why they are in the ER and do a physical exam on them. Go back to the attending and give them a brief report on what you found. The attending asks you for what you think the diagnosis is and what labs/tests you want to order to confirm. They either agree with your plan or go tell you to learn more cuz you are an idiot and come back when you know what to do. When they like your plan, you order the relevant tests (ER we get PA privliges so basically we can order stuff and meds, just need an attending to cosign). You wait for the labs to come back, interpret the results and again present to the attending. Then they ask you for a treatment plan. If they like your plan, you place an order for the meds and you are basically done. You go back and can check on the patient later but thats as much as they really expect the students to take care of.

                         (pretty sure thats what some of my patients thought yesterday haha)

Also I'm learning slowly how to survive the shifts. You really are on your feet for most of the shift, so I caved today and bought these super expensive but medical grade orthotics that I saw all the residents wearing:

We really also don't get much of a chance to eat. I packed myself a lunch but I didnt really get to eat it all because we only are allowed one 30 min break for the whole 12 hour shift. I think I'm gonna go to trader joes later and buy a shit ton of granola bars to hide in my white coat.

There's more to report but this post is long enough as it is. I'm off to enjoy the rest of my day off, because tomorrow is..... MY FIRST OVERNIGHT SHIFT. omgbbqwtf.

Things I saw today:
-Gastroenteritis
-Lots of dehydrated little old ladies
-A hypotensive chronic renal failure patient who became unresponsive during dialysis
-Lots of alcohol overdoses covered in sand from beach parties (one enterprising 14 year old, poured out her urine sample and replaced it with water... like we wouldn't notice.....)
-Many many psych patients (the ER gives psych admits quick exams to make sure there is nothing medically wrong with them)

Procedures learned to do today:
-Rectal Exam
-Replacement of a suprapubic catheter