Alright, friends. I'm keeping this one short and sweet because my brain is sore and my dog is annoying.
This week, I have learned....
1. There should be a time limit hospitals should have to fix a problem. If things aren't better after, say, 15 days, let someone else try.
2. I'm in the mid Atlantic of the US with spring travel plans to Florida, and I'm actually feeling nervous about Zika. I had a guillian barre syndrome patient in nursing school. On his way driving home from work, his chest felt off, so he course corrected to the ED. When he pulled up and walked to the doors, he struggled with leg weakness. After he was done in triage, he couldn't stand. He was intubated, and completely paralyzed, before he left the ED for ICU.
3. A patient on neuroleptics will still have detectable epileptiform patterns on an EEG.
4. A good neurologist knows no matter how crazy the patient sounds describing symptoms, what they say is legit and will stay the course for diagnosis.
5. My favorite doctors to work with are the ones who will sit and talk patho with a nurse and enjoy that the nurse legitimately loves to learn.
6. Sliding scale coverage alone for inpatient management is not currently supported by research.
7. If working day shift doesn't eventually make me check into a psych ward, nothing will.
8. The GI doc who left me scrambling to save a guy's life (what felt like) single-handedly by doing no intervention before he got dumped on us (actively bleeding out 2 points of hemoglobin over 8 hours and maintaining a BP that won't leave 70s-80s) has suddenly become cautious enough to send a perfectly stable (hemodynamically, symptomatically, and on CBC) rectal bleed to ICU before meeting or scoping her after I've literally done all the work needed on her for the shift. And of course, I was rewarded with an end of the shift admission.
9. The Florida Man Collective has evolved to include its latest - Wrinkles the Clown. He is a scary-looking clown who is for hire to scare anyone you want, for any reason.
10. The more you annoy the doctor about the same thing, over and over and over, the more likely it is they will listen and maybe put in an order.
I have nothing else right now. My broken brain is feeble!
