This evening, I spent a couple hours doing evening rounds and writing "off service" notes for the intern coming on the team after me. These notes are essentially a summary of the patient's main (recent) issues and what we're doing for them. In other words, they're an expanded version of a daily progress note's assesment and plan.
It was kinda gratifying to see my patients one last time. On four separate occasions this evening, the patient or his family explicitly thanked me for my care! One of these patients is my pancreatitis patient from New Orleans who's been here nearly two months. His mother gave me a big hug when she heard I was going of service. Sadly, this patient and his wife have lost their home in the hurricane.
Ironically, one of my new patients today is also from New Orleans. He was evacuated from a hospital which had lost power there. My attending physician chose this patient as one to watch (and evaluate) me do a history and physical exam. I was a little self conscious doing so for at least a few reasons: 1. I was being evaluated. 2. Immediately before we walked in the room, my attending said, "Is that a little spinach caught in your teeth?" 3. The patient is a retired internist.
For another 83 year old patient and his daughter, I spent 15 minutes answering their questions about West Nile Virus. When I quickly realized that I hadn't read enough about this diagnosis we made today, I printed out a patient hand-out and spent some time going over it with them.
So the evening "tuck-in" rounds continued (see DoctorJ's medical slang glossary)... I love telling patients, "I'll be here all night. If anything comes up, please have the nurse give me a call." The beauty of it is that this is exactly what would happen anyway, yet it comes across as a very thoughtful and caring thing to say!
Here's a picture off the internet of a patient needing to be tucked in. Notice she's still sitting up. A milligram of Ativan will help with that. Also, her covers should be pulled up and her side rails raised. She must have some obstructive sleep apnea because I see some CPAP equipment in the background. And does she have IV access? I'd definitely get a line in before bedtime.
Well, it's 11:00, and the pager has been quiet for a while. Maybe I'll get some sleep before 7:00 AM!
1 comment:
Jonathan, I also noticed two visitors in the bed with that patient. I'm sure visiting hours were closed at that time, so those two definitely needed to go!
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