How to Crush Your SLOE (Tips 26-30)

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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