Sie sind auf Seite 1von 3

7/22/19 8:00 PM-6:00 AM, 10 hours; 7/23/19 8:00 PM-6:00 AM, 10 hours; 7/26/19 8:00

PM-6:00 AM, 10 hours; 7/27/19 8:00 PM-6:00 AM, 10 hours


Hours worked this week – 40
Total hours – 448/456

I wanted to work on my project. Unfortunately, it was crazy busy in the ER

tonight. Even with my limited exposure, I could realize that the theme was repeat

customers. I recognized many of the patients from my early rotations – many coming

back for the same issues. Exacerbations of heart failure, hypertension, and diabetes in

conjunction with noncompliance with medications, and dietary indiscretions (one patient

with severe shortness of breath due to heart failure tried to tell us that hot dogs do not

have that much salt in them, only the condiments do!) caused a long backlog in the ER

waiting for admission. This caused the fast track people to have longer than normal wait

times, which in turn made them mad and rowdy. I can see that waiting a few hours to

have a UTI assessed or a child’s cough would be aggravating. The cynical answer is that

the UTI or cough did not start at 2 AM, nor is either a true emergency. Both patients

waited hoping that the waiting time would be lower, and neither one could miss work the

following day. Neither had insurance or a PCP, but both had symptoms for at least 3 days

and hoped they would resolve. The UTI needed an antibiotic prescription and the cough

was a cold that was improving already. Each case took under 10 minutes for discharge.

What a waste.

Summer brings out the emotional in people and enhances their need for

polysubstance abuses. There are between 4 to 6 people in the ER waiting for in patient

placement into psych centers voluntarily and 4 people that are involuntary or 1013. They

have been in the ER 2-5 days waiting. Although they are obviously being medicated and

cared for by the nursing staff, they are not receiving the full treatment that they need.
They act up in frustration and due to exacerbated baseline psych issues. There is a lack of

beds available state wide, per the intake coordinator. According to her, psych admissions

are not easily reimbursable or socially acceptable on this level (no fancy hotels – just a

step up from jail) so financial aid needs to be carefully vetted. Interesting, repeat patients

are not usually re – admitted to the inpatient programs unless they are a documented

harm to themselves or others, not for substance withdrawal. Alcohol and narcotic

withdrawal are admitted to the hospital for medical management.

Trying to fine tune my presentation. I am going to present my project and

pamphlet to small huddles of the healthcare team. Tonight, I want to present it informally

to the medics to hear their assessment and critique, thus allowing me to readdress any

issues they have problems with. I am surprised with how nervous I am when I know my

audience and material very well! They all had positive feedback, endorsed that there were

no changes to be made, and that I taught them something about public health services

available. What a relief. I hope all the presentations go this well.

I sought to inform and educate small groups of healthcare providers at a time

regarding the pamphlet I produced that would provide easily accessible information on

the services available to those Henry County citizens in need. They were impressed that:

1. I listened to the issues they presented,

2. Realized that the issues had a common theme,

3. Sought to find a possible answer to the issues,

4. Came back to them to present the data,

5. Wanted to educate them in a way that was the least disruptive to patient care.
In hindsight, I wished I had gotten to see the available resources first hand and spoken to

the people who work there as to the issues they see and what their perception was that

limits accessibility, if there were any prejudices, or factors that prevent people from

seeking them out. I can imagine that this aspect of public health is both rewarding and

frustrating at the same time.

Overall, the people were wonderful – my preceptor Dr. Susan Dupree, the medics,

nurses, physicians, housekeepers, radiology staff and the associated patients that passed

thru the automatic doors for the 448 hours I have works thus far, soon to be 478 after next

week. It was definitely an experience.

Das könnte Ihnen auch gefallen