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Tip #26
Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood.
Tip #27
Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine)
Tip #28
Round on your patients and repeat your initial scripting.
- “It’s Zack the medical student again”
- “Anything I can do to make you more comfortable?”
- “Do you have any questions?”
- “I’m doing my best to keep things moving fast for you, here’s an update”
Tip #29
Perform one of the 4 most important reexamination protocols.
- The ambulation trial
- Best for patients with low oxygen on arrival or geriatric patients with weakness/dizziness/etc
- The repeat physical exam
- Best for patients with abdominal pain or respiratory complaints
- The repeat vital signs
- Best for patients with multiple abnormal vitals documented in triage, hypertension, fever, etc
- The PO Challenge
- Best for patients with nausea and vomiting or pediatric patients
Tip #30
Update your attending the MOMENT everything is back (and choose one of 3 dispositions)
- Admit them
- Best when you have confirmed a specific, bad diagnosis
- Discharge them
- If everything is normal, including your reexamination
- Recommend follow up in 1-2 days
- Observe them
- Best for patients with concerning symptoms, risk factors, or red flags but reassuring testing or no clear diagnosis