I'd say staffing is about 75% travelers at Travel Hospital #2, so it's understandable that we're viewed with caution at best and pure dislike at worst. It's tough trusting the care of most of the department to people you've only worked with a couple of times. I'm hoping my stock has risen slightly though, after I took care of a patient and made some solid decisions for her.
I had a lady who came in for typical vertigo - she'd had a few similar episodes years back which resolved quickly with po meclizine and a work note. When she came in this time though she was vomiting, pale as shit, and had that vertigo lean-to-the-side-like-you're-drunk hold on the bedrail. I hit her with meclizine, valium, zofran, and a liter of fluid which seemed to help her quite a bit. Her head CT was also negative. I came back in later and she was starting to feel really terrible again. I went to her doc, who also happens to be the ED director, and got some orders for another dose of meds. Again she felt better for about 20 minutes. The doc had gone in to reeval at that time, so seeing that she felt better he wrote her up for DC. When I got her up to see how she did, the vertigo came back full force and she couldn't even make it the ten feet to the bathroom without hugging the wall. I got her back in bed, and went back to the doc. He was actually really nice about everything, and agreed to call the hospitalist to admit for obs. The lady's ride home was kind of peeved that she had driven to the hospital to pick up the patient only to find out she wasn't needed anymore, but overall was fairly pleasant about it.
A couple of days later the doc came up to me and was like, "hey, remember that vertigo lady you couldn't discharge? She had an MRI in the morning, and guess what? Cerebellar infarct. Thanks for not making her go home."
He was already pretty nice to me, but I'm hoping he realizes I'm not totally incompetent and spreads the word among the docs so some of the others will quit being dicks.
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On a side note, I really wanted to work the phrase "Ya done messed up" into this post, but I couldn't make it fit well. So I'll just show you the video it came from, and that should suffice.
Makes me laugh every time.
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3 comments:
NIce save. Also, LOVE those guys! My husband and I will casually throw in lines from that video throughout the day. My favorite is, "you wanna go to war, Blake?".
So question-is vertigo that common that a head CT isn't necessary on a routine ER visit?
Wow. That shit is scary. Nice catch. And I LOVE that sketch. A have a friend named Aaron who I now will only refer to as A-A-ron because of this.
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