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Dr. Grant

Member Since 21 Aug 2017
Offline Last Active Apr 24 2019 04:05 AM
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Posts I've Made

In Topic: Dr. Braun's Office

22 April 2019 - 04:29 AM

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Dr. Braun, Dr. Abboud, and myself have just finished a lengthy QA/QI review of runs from the last month. With our work essentially complete we make small talk and get onto the subject of the nice weather recently. 

 

'Yeah. I just got a new smoker and I can't wait to break it in. With the weather being so darn nice I'm hoping to do so this weekend. Only problem is I end up making a feast out of it.' I say with a smile on my face.

 

A thought comes to mind.

 

'You both should come down and help me break it in....make an afternoon out of it.' I offer. I haven't cleared this with the wife yet, but I know she's never one to turn down a gathering.

 

'I'd have to clear it with the wife first, but I don't see her objecting. You're more than welcome to bring your spouses, kids, Gardners, whoever...'


In Topic: Cafeteria

22 April 2019 - 04:18 AM

'Well, that's good, I'm glad she's showing improvement....anyway, thank you for sharing that with me. I don't often get to find out what happens to patients once they leave the department, so I appreciate you sharing that with me.' I say with gratitude.

 

'Make sure you take care of yourself, too.' I say, knowing just how stressful it can be when someone you love is sick.

 

'Anyway, thanks again and enjoy the weather. It's beautiful out today.'

 

*I proceed back inside and back to the ER.*

 

I've been MIA long enough for someone to have noticed by now.


In Topic: Cafeteria

19 April 2019 - 04:14 AM

I grow tired of my water bottle, so with the ER being slo....uneventful...I sneak away to the cafeteria for something a little bit more exciting to drink.

 

As I walk in, I notice that it's pretty empty, but that's no surprise, it's between meal periods. I walk over to the drink display, bypassing all of the snacks and prepackaged foods. I grab a bottle of Sprite Zero and proceed to the check out.

 

The cashier scans the soda, $1.50 pops up on the register display. I hand my ID badge over to the cashier. She swipes it and presses a few buttons on the touch screen register.

 

'You're all set.' she says. I pick up my drink and proceed out. 

 

One of the many perks physicians have at this hospital...we get a limited food credit in the cafeteria.

 

As I'm exiting, I decide to take a quick little detour outside to get a few seconds of fresh air. As I exit to the outdoor seating area I notice Dunne sitting at the table just outside the door.

 

God, I know i've seen him before...but where?

 

I think hard, trying to recall where I recognize him from. Then it comes to me.

 

That's right. I treated his sister for a UTI yesterday. I wonder how she's doing. Dare I ask? Once she's left the ER, I can't really access her records since I'm no longer involved with her care, so there's no way for me to find out otherwise.

 

I fight with myself for a second and finally give in to my own sense of curiosity.

 

*I walk up to the table and politely try to introduce myself again*

 

'Excuse me? Hi there...sorry to bother you...I treated your...*I think for a second* sister? ... yesterday in the ER.'  I say as politely and non-intrusively as possible.

 

'May I ask how she's doing?' 


In Topic: Emergency Department

26 March 2019 - 05:00 AM

After exiting the room I proceed to the nurse's station and hop onto the computer and start typing up my note.

 

*I look at the clerk*

 

'I need a burn consult for room 41, would you mind paging them for me, please?' I ask as I continue typing my note.

 

She gives me a little bit of a look and then picks up the phone.

 

I continue about my work. I finish my note on the last patient and start looking at my others. I go and examine another patient and return about 8 minutes later. As I'm writing up my note for that patient my hospital-issued VOIP phone rings.

 

*I pull it out of my coat pocket and answer it*

 

'ER, Dr. Grant' I say.

 

A sweet, young female voice replies on the other side.

 

'Hey Dr. Grant, this is Dr. Romano, I heard you have a patient that needs a burn consult?' she replies.

 

She sounds....cheery....not like your typical surgeon. Usually when I ask for a consult I get attitude and passive-aggressive undertones. Ok...maybe not all the time...but it seems to happen all the time. Everyone hates the ER doctor...all he does is give everyone else more work.

 

'Hey Dr. Romano, yes, I have a 21 year old male firefighter who was burned on the job. He's got a localized, well circumscribed, thermal burn about 6cm in diameter on the lateral aspect of the right upper extremity. It looks to be mostly partial thickness but it has a central area of full thickness burn about 2cm wide....' I continue and give her the run down on the patient.

 

'[Sigh], okay...I've got a couple consults ahead of him, it seems like everyone decided today was a good day to play with chemicals and hot things. We're swamped up here. I'll be down as soon as I can, but I have to warn you, it might be a while.', she continues, 'How's his pain level?' she asks.

 

'He's a trooper, I'll give him that. Not a single drop of analgesics since he's been here. He seems to be handling it well.' I reply.

 

'Okay, well....I'll be down to see him as soon as I can.' She says.

 

'Thanks for your time.' I reply. We say our goodbyes and I hang up.

 

*I continue my work.*


In Topic: Emergency Department

25 March 2019 - 11:42 PM

*I smile at some of his answers, but try and keep things moving*

 

*I ask about his past medical history, allergies, and ask about any prior hospitalizations or surgeries.*

 

Nothing, except for a history of sinusitis.

 

*With my physical exam complete, I begin explaining my findings*

 

'Alright, so the burn on your arm does indeed have a central part that is full thickness, or third degree, but the majority of it..'

 

*I start to gesture around the burn*

 

'...is all partial and superficially burnt, meaning they will heal just fine on their own. This full thickness part, unfortunately, will not heal on its own unless a skin graft is performed...otherwise it just scars over.

 

Unfortunately your particular burn is too large for me to make the call as to whether we just let it scar over or if a skin graft is warranted. So what I want to do is call one of our burn specialist surgeons down to take a look, and he or she can give you a definitive answer as to what the best course of action is going to be in your particular case. I will say that from my personal experience with similar cases, the surgeon will probably recommend a skin graft, especially given it's location.'

 

*I pause for a moment before continuing*

 

'As far as everything else is concerned, you're in good shape. It's pretty localized and your strength and sensations are all good, but I do want to give you a tetanus booster. It's pretty much standard practice that every burn patient gets a tetanus booster, unless they've had one within the last year....Have you?'

 

After I get my response I continue on my long winded rant:

 

'Okay. Before I go, I just want to take a second to kind of give you the low down on what's probably going to happen. As you probably have noticed, we're a bit busy in here tonight, so. I honestly don't know how long it's going to take for the surgeon to come and see you. If they're not busy they can be here pretty quick, but my guess is that's not likely. So instead of having you stew in here just wondering without a clue as to what's going to happen...I'd like to offer you what I think will probably happen based on similar cases I've seen.'

 

'As I said before, they're going to probably recommend the skin grafting or some similar procedure. However, the good thing is I can almost guarantee you'll be going home today. The surgeon will clean the burn, get rid of all the dead skin and debris, and bandage it up with antibiotic dressings. They'll let you go home and follow up again in the clinic with them within the next 2 to 3 days to talk specifics if a procedure is warranted.' I say.

 

*I pause, and get up from the stool*

 

'Can I offer you some medication to take the edge off of any pain you have? Or are you doin' alright?' I ask. 

 

He seems to be doing okay, at least based on his demeanor. If he refuses, I hope the surgeon can at least convince him to accept a short-acting pain killer before they debride the wound, because that is a very painful process.