ER: Second Day

Today I was scheduled to work the 5:30 pm shift with Dr. McC, who showed us around the ER at orientation, because he said if we needed suture practice he'd be happy to show us early in the rotation. Because I just came back from 3 days in Philadelphia for interviews, I had yet to complete the online courses required to get an Epic password, so I needed the (lone) scribe to log me into computers to document my HPIs, ROS, and physical exams. For the most part it was fine. One notable case was an 85-year-old woman with "poop coming out of her vagina." There was a lot of fecal matter in her diaper and we had to make sure that there really was a rectovaginal fistula so this poor woman got a pelvic exam. And when Dr. McC removed the speculum, the head was entirely covered with fecal matter. So yeah...looked like there was a fistula except it wasn't visible on CT, so surgery had to be consulted. For the most part it was a fairly busy night, but Dr. McC never fell behind. I had to learn some terminology/Dr. McC-isms like IGYWUs (I got your work ups, pronounced "Iggy-woos"), IGY-Qus (I got your quickies), Triple Whammy (Vicodin, Motrin, and Robaxin) and BAH (big-ass heart).

There were other ER docs working around us, most notable was Dr. "Trot," who was getting a lot of attention b/c he recently appeared on a TV commercial. He and Dr. McC discussed colleges for their kids at one point, so I offered some input about UT. Then towards the end of the evening, Dr. Trot came by and asked if I'd done any LPs before. I said no (which wasn't entirely true; Dr. F let me attempt one on my last shift but I'd failed), so he sent me to another room to do an LP on a young guy with a fever. Fortunately with Dr. Trot's guidance (he let me set up, which I did correctly except for marking the spot where the needle was to go in), I was able to get CSF on the second try, and I talked to the patient to keep his mind off the procedure (we knew we were in the spinal canal when he said, "OW!") CSF looked clear, which was good. Fortunately we all finished by midnight (by which time Dr. McC was ready and eager to go home so we didn't go over sutures), so I spent the next 30 minutes taking all my courses so that I could activate my Epic password. I'll be working with Dr. Trot tomorrow, and I do not want to appear like I don't know anything in front of him.