Border Song

Just a little note to say that I've survived my ER rotation, maybe not unscathed, but I did make it. Also, I completed the remediation from my last clinical assessment, which went fine. I was still nervous, but things went much smoother. The official clinical assessment day this go-round went well this time too. I passed the computer exam as well as the practical exam with the standardized patient as well as the SOAP note write-up.

As a matter of fact, guess how many of us in my class passed the practical exam this time? Read Gary's lips:



As some of you may or not may know, I did my ER rotation on the border of Mexico. Shifts were usually 4 12-hour days or nights in a row. I was able to see & do a great deal. Here are some of the diagnoses or procedures I was able to perform:

• suturing a-plenty: eyes, cheeks, chins, lips, ears, knees, elbows, legs, arms, you name it, I stitched it
• full codes -- ranging from heart failure, aystole, diabetic keto-acidosis, stroke, etc
• various and sundry insect/animal bites/stings ranging from scorpions, rattlesnakes, spiders, ants, and dogs
• neuro procedures like lumbar punctures
  
• gastrointestinal disorders including pancreatitis, cholecystitis, cholelithiasis, vomiting, diarrhea, nausea, peptic ulcers, reflux, small/large bowel obstruction, diverticulitis, etc.
• fractures of all kinds, ranging from long bones, fingers, wrists, and even skulls resulting in intracerebral hemorrhages
• Psychiatric diagnoses including schizophrenia & bipolar disorder
• Helicopter transfers of serious cases
• Reducing a dislocated shoulder and dislocated jaw
• Removing a toenail
• pulmonary disorders like pneumonia, atelactasis, lung cancer
• HEENT disorders like peritonsillar abscess, otitis externa, corneal abrasions (with slit lamp exam), strep throat, herpes zoster (aka shingles)
• Plenty of interesting pediatric cases such as a young girl who superglued her eyelids shut and another one who stuck a necklace bead up her nose (removed via suction and alligator forceps)
• Cardiac cases like atrial fibrillation, malignant hypertension, pericarditis
• Renal/Urinary disorders such as UTI, pyelonephritis, nephrolithiasis, BPH
  

This is only a smattering of the cases -- most of the general areas fell in these parameters, but I know I'm leaving a few extraordinary cases out too. The 6 weeks went by in a blur, and before I knew it, I was driving back home.

Unfortunately, I did lose 2 patients during the rotation, which was not entirely unexpected but still tough to deal with. I have worked in nursing homes and hospitals in the past, so it wasn't the 1st time losing a patient, but it never gets easy. And perhaps the most difficult and gut-wrenching thing I had to do was inform a 40-something pregnant woman that her vaginal bleeding was a spontaneous abortion.

I got to work with a wide variety of doctors and learned quite a bit from the techs and nurses as well. To be honest, I was able to get everything I had wanted out of my Emergency Room rotation. I met lots of great people and while it was tough being away from home this summer, I am very thankful for the experience. To sum it up: