job satisfaction
like i said before, I don't enjoy ED because I don't know what happens to most of the patients i see. I can find out if patients I discharged home returned the next day because they didn't get better, but I wouldn't know if they went to another ED because they didn't want the awkwardness of seeing me again. I don't know what happens to the patients I admit. Did I admit them with the right provisional diagnosis? Were my initial management appropriate?But just the other day at work, I saw a patient I discharged a few days ago. I was pretty confident when I approached to ask how she was (although I couldn't at first recall what she came in with that time) as she wasn't in a patients gown and looked like she came in with a friend who was sick. She was all smiles when she saw me and told me excitedly how she'd taken my advice about quitting smoking and is on Nicabate tablets to help her quit. Then it all came back to me. She came with left-sided chest pain which after a rather vigorous work-up I put down to musculoskeletal/chestwall pain. But on X-ray of her chest, there was evidence of chronic lung disease secondary to her long-term smoking. She was diagnosed with asthma 3 yrs ago but didn't know she's irreversible damaged from her smoking. And from her history she wasn't getting enough symptoms relief on her Ventolin puffer alone. So after discussion with my senior, we put her on Seretide to prevent her from getting SOB and needing her puffer repeatedly for symptoms relief when she gets an attack. When i saw her this time, she was extremely happy with the Seretide. She uses it once in the morning, and for the rest of the day, she gets much less frequent attacks of SOB and hardly needs to use her Ventolin puffer!
so, wow. i actually did something good! medications do work! and the medical system's actually working!
posted by zhinger @ 12:36 pm
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