Stuff Learned at PMH – #1
So, I came up with the idea of trying to post entries every hospital day when I get home. Here’s an incomplete list of the stuff I’ve learned thus far at PMH.
1) If I don’t eat all day long, and then see a large amount of blood, I almost hit the floor. (Actually, I already knew this, but rediscovered it….longer post about this to come.)
2) Many patients at PMH can’t pay for many of the diagnostic procedures, hence they rarely get them done.
3) If and when they can get the procedures done, it’s usually too late to help.
4) When performing a lumbar puncture, patient positioning is super important, otherwise you might not be able to get any CSF.
5) IV diazepam works very well for grand mal seizures.
6) Mixing some lidocaine with the lubrication when putting in a urinary catheter is a really nice way to make the procedure less painful for the patient.
7) I feel like an idiot when a family member calls me “doctor” and asks me to help their relative, because I am not a doctor, and I probably don’t know/can’t help their relative. All I can do is get the real doctor.
8 ) It’s important to get on the ward early and go over all the patients’ charts before the attending comes in. That way, you won’t go “umm….I’m not sure” when he/she starts drilling you on the patient’s details.
9) Electronic PDAs are awesome ways to store medical information, and are good for impressing your attending.
10) Don’t be afraid to ask any question (e.g. “Why is that patient on propanolol? Isn’t that contraindicated for patients with COPD?). You might be surprised by the things you notice that your higher-ups have missed. It’s better to risk saying something stupid, and help a patient, than to remain quiet and potentially do harm.
My name is Kendra and I am a newly minted doctor about to begin my residency in Psychiatry at 
wow
that is so good
good luck sweet heart
Interesting list.
Do keep on posting the things you learn. After sometime you’ll end up having an awsom collection.
GL …
The asking questions bit is awesome and so important.
A resident once took Peyton off of Valtrex because he was also on Ganciclovir which are both used for treating Herpes. The problem was that for whatever reason, Ganciclovir was no longer an effective prophylactic against herpes outbreaks for Peyton. He was on it because it was apparently effective in preventing CMV retinitis. Consequently Peyton endured an unnecessary and extremely painful herpes lesion.
When I noticed the formation of the lesion, I went balistic on the resident. All he had to do was ask Peyton’s physician (or even me) who one would assume had prescribed both drugs simultaneously for some reason.
Diazepam is a primary anti-seizure medication. It’s so important that every paremedic is taught that it is effective when given IV, IM, rectally, or through the ET tube. Good stuff!