So today I worked my first day as an attending.... all alone in the E.D. I kind of suspected it would be difficult. Mostly, I was just missing the camaraderie; working with the attendings and junior residents. Having someone to bounce ideas off of. Some to fall back on when I am uncertain about what to do next.
Primum non nocere - first, do no harm. That became my mantra today as I negotiated my way through what I felt was a sea of patients. Not many by some of my colleagues' standards, but it certainly seemed like a lot to me.
I had one sign-out from the prior ED Doc at the beginning of my shift that turned out to be a broken hand in a teenager who fell rollerskating. I splinted that one, and that's how my day began.
Some of my other patients:
- lost control of car while rubbing eye. Concussion and lots of bruising. My first trauma.
- fell and got a "blood blister" under fingernail. Subungal hematoma which I got to drain while burning a hole in the fingernail. Cool stuff
- abdominal wall abscess. Got to show my new nurses how we do VessiLoops in the E.D. Not to mention draining an abscess. Very satisfying as always
- wound check. Nothing exciting, just a follow-up but important nonetheless
- rubbed eye so hard they bruised their eyelid. Did a complete work-up to check for bleeding problems. Nada. Will have to try to figure that one out with their primary doc
- slipped on stairs and has a bruised coccyx. Yes, you can bruise it. Ouch.
- fell asleep at wheel and crashed car. Mild head bonk. Not a trauma.
- didn't take medications and now fluid overloaded. Take the fluid off and send to primary's office where they already had an appointment today
- fell on tree roots and cut head. Staples and a turban head wrap.
- ran over "tree part" that fell off logging truck and now having back spasms. A little muscle relaxer and some time off work should have you better in no time.
- I only stopped smoking because now I can't breath. Double pneumonia will do that to you. So stop smoking. And, here's your antibiotics.
Just a flavoring of the patients I saw today. Back to work tomorrow. At least I think I will feel somewhat more on top of things. Got to get my rhythm going and get with the "flow" of the department. It'll happen...