Friday, January 9, 2009

ER 3pm to 2am

I spent this past week on ER from the 3pm to 2am shift, which is my favorite, Typically the ER is busiest from 5-10, so you see the most, and then things usually slow down so you can finish your paperwork and leave by 2am....not so this week. I had a great time and did really well, but I am exhausted. Thank goodness it was only a 4 day week. Several of my classmates were on their core rotation at the same time, and they all pissed me off since most of them avoided taking cases and left them for me since all of their shifts ended earlier then mine. And to top it off the clinicians loved working with me so they kept signing me up for their cases while I still had other cases going on, so it was a little overwhelming but flattering. The earliest I got out was 3am. So Monday I was there until 3:45am, Tuesday until 3am, Wednesday until 3am, and yesterday, Thursday, until 3:30am. For some reason every night was slow until 10pm, and then every owner brought in their emergencies between 10-1am. ughh..

Again, the best news was despite it being an elective week I was showered with compliments by the doctors. When I started the week Russell was so excited I was back on since he had so much fun working with me before. I worked with a new doctor, Kristen, whom I absolutely LOVED. She was a great teacher, every night she told me great job and thanks for your help, and last night she was so upset my week was over and she told me that "I was one of the best students she had ever worked with, that I had a very wide knowledge base, that I wrote the best discharges and transfers she had ever seen, and that she couldn't wait for me to come back to the ER for more elective in March."

The cases I saw? Let's see if I can remember them. These are the ones that stick in my head as being neat and complicated and rewarding:
1. 5 month old kitten with a pyothorax
2. 10 year old rotti with a brain tumor that came in in status epilepticus (seizing non-stop)
3. 3 month old duck that prolapsed his phallus- this was the most rewarding. No one in the ER knew anything about birds, and I ran the entire case. Russell kept joking with the other doctors how great it was working with me cause he could just sit back and let me be the doctor and I made him look good. The next morning exotics got the case, and the exotics doctor came to see me to tell me how I had done a superb job and it was one of the best transfers she had ever gotten from the ER. Russell came to find me yesterday to tell me that exotics had come to him to compliment him on a great job treating the case for the night, but he told them to find me since I was the brains behind the operation.
4. 12 year old shih tsu with a slipped disk and an anal gland abscess
5. 12 year old wheaton attacked by a coyote with about 7-8 lacerations that I got to clean and stitch up
6. 4 year old black lab in liver failure, probably from cancer
7. 8 year old cat with a perforated cornea
8. 2 rat terriers also attacked by a wild animal, one needed a laceration stitched, one with a scratch to her cornea
9. 1 year old cat squished by a bed when it broke from under its owners
10. 12 year old sheltie with an anal mass and uncontrolled heart failure
11. 4 month old boston terrier with cerebellar dysfunction, most likely from meningitis
12. 3 year old persian cat with 1 day history of vomiting
13. 5 year old poodle with 1 day history of vomiting, uriinary incontinence, and pain
14. 10 year old bichon with severe back pain and right leg pain
15. 2 month old shih tsu with an esophageal foreign body that was compressing his trachea
16. 2 year old terrier mix with bloody firm stool that was badly constipated
17. 3 year old shiba inu with ibuprofen toxicity
18. 6 year ols cat with an arterial thromboembolism at the level of the renal arteries
19. blocked cat that presented dead (CPR performed)
20. HBC boxer that had a neck and skull fracture and was bleeding out in to both her abdomen and her chest

In 4 days I think those are most of the cases I saw, not sure. Could be more I am forgetting. But not bad considering I was working with 5 other students, and on average we would see 10 cases a day during my shift only. So out of about 40 cases, I saw 20, even though there were 6 students total working. Nice and productive. Now I can catch up on sleep since driving and getting home at 4am, followed by being woken up at 8:30am by the noise from your roommate and his dogs, is not the most fun.

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