ER

Thursday was my day to go to the ER for an "off unit experience". It was pretty cool. It always helps when the nurse I'm assigned to actually welcomes my presence. She was very good at her job, and I had a good experience. Our initial patient of the day--right at shift change--had had tonsil surgery the day before as an outpatient procedure. They had bled from their tonsils and throat all night before reporting to the ER (at a completely different hospital from the one where they had the surgery no less.) Patient was in obvious respiratory distress and had sats in the low 60s. O2 through a nasal cannula brought that up to the 70s, but it took a venti mask to make it into the 90s. ER doc couldn't find an ENT doc willing to come behind another surgeon so the patient got transferred back to the original hospital--with much gnashing of teeth.

After that patient, the nurse just handed me the clipboard and sent me in to assess the patients that came in. After I did my interview and assessment I'd report back and she'd help me see what things I did well, and what additional things I might have done.

I saw a wide variety of patients. I saw an 18 y/o drug overdose/wrist slashing suicide attempt. I saw a 9 y/o with an asthma flare-up. I saw a patient with a bowling ball size abdominal tumor--CT showed mets in the liver too. I saw (and helped suture) a full skin/subcutaneous thickness and partial muscle thickness circular saw lac to the forearm. So, no major gunshot traumas or MVC's, and thankfully no chest pain patients, but I think that was probably a good thing. I got to actually participate much more because patients weren't terribly acute. ER might be a fun PRN job on the side at some point.