A Day in the Life of Clinic
Posted by Dr. Cason on Thursday, October 2nd, 2008
Here’s a glimpse of today- as best as I can remember.
9:30- Patients trickling in but still being triaged. I’m finishing notes from yesterday. 19 charts to go. An extra 11 charts sit next to me to review. So is a coffee cup with- no not coffee- water. Hmmm…Keeping the stories straight can be challenging. Ooops- off to room 3.
9:50 Still with patient number one. Need to talk with another doc one to one. Never mind they can see her tomorrow. Thank Goodness. Off to patient number two.
10:15 Twin physicals down. Now I’m even more behind.
10:00 I give up and stop charting as I go. I’m later than late and it’s important to keep the clinic flowing. I make sure to write down what’s abnormal on exam and their diagnosis and the plan. I’ll have to go back later to fill it in.
10: 35 Patient #7 walks in with respiratory distress. Solu, albuterol and we wait. Then patient Number #11 walks in with same exam. It’s bronchiolitis season.
12:15 Cleared out those charts sitting next to me. Two are still waiting there. I need to do some research on current therapy.
12:40 Done with morning clinic- 2 patients are still getting nebs. Pt number 7 is hanging out. Will be repeating nebs and exams and trying to keep her from being admitted. Patient number 11 seems to be worse too. Time for some rocephin and another treatment. I now have 20 minutes to finish my charting from this am and yesterday and then afternoon clinic starts.
12:43- I eat lunch and power through only 9 charts. Ugh.
12:50- My one o’clock two week old comes in. After he’s triaged I spend some extra time him. Sibling died at 6 months of age. Now I’m really behind and the afternoon just started.
2:00-Another bronchiolitic comes in for follow up. I consult ENT for the stuffy nose and then send the parents out to get: Afrin, Nasal saline and Dexamethasone Ophthalmic Solution. I await their return and give albuterol nebs to see if it helps. It doesn’t really.
3:06- Number 7 and number 11 are finally discharged. Strict instructions to follow up the next day.
3:20- Another little boy in a long list of little boys comes cruising in. The mom looks so delightfully rested and beautifully attired that it makes me want to go take a shower. Or at least brush my teeth.
3:35- My staff is standing around waiting for me to clear a room so they can do something. I’m the rate limiting step. They tell me- In case I don’t know- that I have a full waiting room. I nod my head in acknowledgment and keep on moving.
4:00- My staff asks me if I need help. I say no. They ask me if room three is done. I tell then I can’t remember who is in room three. I have to peek my head in and see. Ahhh yes I remember. They can go.
4:40- I can hear the door ringing every time it’s opened. I don’t know if they are coming or going. All I know is my exam rooms are full and it’s still standing room only in the waiting room.
5:00- I wonder if my husband is home and preparing dinner for our three kids.I decide to admit little stuffy nose to the hospital. Despite the ENT concoction she still tugging hard.
7:30-The last patient walks out the door. We all breathe a sigh of relief. I wonder how many I have seen but I’m too tired to count. No charting has been completed. None. Zip.
Highlights of the Day
A lollipop red tongue that then sings me, “Tweeeenkle Tweeeeenkle little Star”
Dodging a perfectly arc’d urine stream in a follow up circ.
Twirling a pigtail into one long spirally curl. The grandmother and I launch into a discussion about how you just can’t get good Shirley Temple movies anymore.
And for the umpteenth time I have the following discussion:
“So you’re not going to give her antibiotics.”
“No.”
“Why?”
“Because as far as I can tell she has a virus. If she’s still febrile in 2 days please bring her back.
“So I have to come back?”
“Yes.”
“You’re not going to give her anything”?
“No.” ( I say this as nicely as possible- just in case you were thinking that I was being mean)
8:15- I’m home. I tiptoe in and kiss my sleeping children goodnight. My husband and I discuss the kids. Did Miss blue Eyes get her homework done? Did Smiling boy get his iron? And his antibiotics? Did they eat ok? Go down okay?
9:55- I finish my blog post and crawl into bed. Tomorrow I’ll go in early to chart.
Filed in Everything Medicine,My Life | 5 responses so far
tiffon 02 Oct 2008 at 10:19 pm 1Sounds like a very very busy day.
Nikkion 03 Oct 2008 at 12:58 am 2Wow, I now have even more respect for my MD. No wonder they try not to sneak extra patients in.
Nikkis last blog post..leech
Kylaon 03 Oct 2008 at 1:39 am 3What a day! The end is just like mine. While I’m in school, Josh is on dinner/bath/med/bed duty.
KayTar sings Twinkle, Twinkle for all her docs, I think. The girl likes a captive audience.
Kylas last blog post..Little baby seal
Kathleenon 03 Oct 2008 at 9:17 am 4Oh Sheila, how many times have I seen our nurse practitioners and doctors go through this same pace – too many times. I can feel for you. Sometimes they are so busy I know they will not ever eat. That is when I announce I will order pizza, Jason’s deli, Chinese or burgers in for everyone – just give me your order and your money when I come by the clinic. I keep menus scanned on my computer I can ship to everyone by e-mail FAST.
It is such a crazy pace I know. All the time wanting to give the patients the best of care, and having to worry about proper charting, etc. for the HIPAA and JCAHO guidelines – needless to say the protocol requirements.
You all are angels. I do not know how you do it. I really do not.
Kathleens last blog post..Nascar Racing and Riding Cowboy
Amy Wrighton 03 Oct 2008 at 10:42 am 5And that is why I appreciate you reading my blog and emailing me yesterday. Thank you for taking the time. We meet with an ENT tomorrow and I am going to trust my pediatrician.
Was your husband ever based in Jacksonville, FL, by any chance?