Everyone’s tucked in


This call night hasn’t been so bad, except for the 10 pages I received in the span of 3 hours, most of which demanded I either see the patient or at least drop a quick note. A sampling of a few of them:

  • The cross-cover patient with a hemoglobin of 4 who got a transfusion reaction when we tried to transfuse her. (I made a call to the attending hematologist on that one!)
  • Irate family
  • A demented patient who wanted a sip of water, wanted to hold my hand, didn’t want me to leave!
  • The cross-cover patient who should have been discharged since his stress test was negative, but fell through the cracks for several hours!

But lastly, there was the cross cover patient with a short run of a nonsustained ventricular tachycardia. We usually see this rhythm in patients with sick hearts (notably after a heart attack or with severe congestive heart failure), or with electrolyte abnormalities. I ordered a chemistry panel on this elderly gentleman who, though clear and lucid, was quite content to lie on his bed totally naked from the waist down. I think it weirded out the nurses.

Anyway, I wanted to make sure that he was asymptomatic during his arrhythmia. He was, but he was concerned about the Congestive Heart Failure Information Packet left at his bedside. “Do I really have CHF?” he asked. “Why didn’t someone tell me, instead of just leaving this packet?”

I went out to the hall and checked his chart. An echocardiogram had been done that afternoon which showed he had severe congestive heart failure. I went back in, and apologized, telling him usually a doctor would have sat down with him to discuss the diagnosis. I didn’t know why the primary team hadn’t better communicated with him.

Later, as I was talking to the nurse, I found out that everyone on that telemetry floor receives a CHF Info Packet, whether or not they have CHF! This patient was handed one indiscriminately, but it was reading material he needed in the end!

I think all loose ends are tied up for the night, all the cross cover patients are taken care of, and it’s time for me to get a little sleep before the next admit or code!

n.b.: The picture above is a representative patient who is surprised to hear that she too has CHF.

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3 Comments

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3 responses to “Everyone’s tucked in

  1. Anonymous

    “What, me–CHF? Doc, this won’t interfere with my upcoming triathlon, will it?”

    DH

  2. Anonymous

    And she’s about to grab your notepad!
    gfh

  3. Melissa

    I think she’s really saying “Excuse me are you old enough to be a doctor…I want to talk to a real doctor”

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