Sunday, November 28, 2010

learn from mistakes

#1 miss A: she came to ER 5 minutes before my shift ended. she complained of abdominal discomfort, she felt nauseous and kept vomiting even though she's already had treatment the day before. since i wanted to go home soon, i checked her real quick and suggested that she should be admitted. since she showed no specific signs of any specific conditions, i admitted her as dyspepsia case and being treated by an internist. the internist came in the afternoon and examined her, also found nothing specific and ordered USG for the next day. turned out she had perforated appendicitis! gosh... and then, the problem didn't stop there. after she's being discharged, she came back again because there's pus from her operation site. and her case became worse. she needed the second surgery and stuff... hufff... really... pretty complicated from an unspecific case.

#2 mr.S: he also came at injury time. i already exhausted. and the moment he came to ER, i already knew that this won't be easy. multiple trauma case. and i needed to act quick. so i consulted to a neurosurgeon that still in the hospital at that moment. unfortunately, since he needed a lot of examination, and he got multiple lacerations plus he's delirious, it was hard to stitch him up. it took me more than an hour to stitch him up. and then, i couldn't pass him to the morning shift because she had another trauma case also. pretty hectic morning. so, in my exhausting state, i consulted him to various doctors. and then, as we evaluated again what has been done and what hasn't been, it turned out that we haven't done the USG. the nurse told me that they could do the USG in the ICU, so after stitched him up, the nurse took him straight to ICU as he still had to wait the radiologist to get the ultrasound. again...turned out he had hepatic rupture... :( and he had to stay lonnggggg in the ICU until the family decided to take him to another hospital which was cheaper.

#3 mr.A :this is probably the worst case so far. he came to ER for getting x-rays after falling down a day before. since there were problems with his company insurance, and he couldn't afford to pay it first, so he decided to go home and won't back to hospital even though i had called him to get back to the hospital because he probably needed more examinations and probably an abnormal results and he needed to be admitted. he refused. and i don't know till today if his result really came back abnormal. so...this is a slap in my face to be more careful. and listen to my gut.

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