The First Consult..

This week, Lan is rostered in the ICU/Emergency Clinic.

She is required to work two day shifts (6am-3pm) and one night shift (315pm-1215am).

It has been a.. an experience. It is remarkable to again see just how much clinics differ in their organisational systems and the varying protocols they adhere to.

On this rotation, Lan is required to hand in 2 assignments: a HEAP to be uploaded onto the computer database (patient History, Examination, Assessment and Plan) and a patient discharge form.

Ideally both of these should be from her own patients but given the lack of activity in that regard, it is slightly annoying that she might have to resort to theoretical cases.

However an opportunity arose one afternoon. One of the nurses asked if someone wanted to do a consult. Eager to get her first assignment over and done with, Lan volunteered herself.

What a silly thing to do. 

The nurse then thrusts the folder to Lan and tells her to run along. WTFISH? She doesn't even know where the consult room is let alone how to conduct a consult! Talk about being thrown into the deep end and told to swim.

Moreover, she had been under the impression that she was to have supervision during these consults.

Not the case!

Lan then put on her confidence mask and invited the client and patient into the consult room. She introduced herself and informed the client that this was her first consult and to please bear with anything noobular. This was not just a routine consult, it was in the EMERGENCY department.

What to do??

Patient was a victim of a dog attack and presented with obvious puncture wounds to the neck (and was also the subject to a tug of war contest).

Possible things to consider and examine for?
-Respiratory and/or cardiovascular compromise
-Internal bleeding
-Musculoskeletal damage

-Neurological deficits
-Whatever else a calm, cool and collected Lan would have considered

It was definitely an abrupt induction into the reality that will be her life in another 17 months.

Time to go to bed early and prepare for her 6am shift tomorrow.

DISCLAIMER none of the above content is to be taken as actual medical advice in any way.

They are merely the musings of a confused vet student.