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24 Hours On Call
MON 1:01PM At noon conference, Ryder
asks questions and listens to advice
offered by colleagues on how to handle
patients who show up late for appointments.
Today's noon conference is general
internal medicine's quarterly clinic
team meeting with the outpatient nurses
and secretaries, who give "tips on being
efficient in the outpatient workplace—that kind of stuff," Ryder says. Medical
topics—like "acute abdominal pain" or
"fluids and electrolytes"—are presented
other days. On Wednesdays, Ryder goes
to the Department of Medicine's weekly
morbidity and mortality conference.
MON 2:04PM Ryder reviews a patient's record with nurse
Beryl Samuels during "quiet hours" on the unit. From 2:00
to 4:00 p.m., "lights are dimmed and you're not supposed
to talk in loud voices, so patients can heal," says Ryder.
MON 2:08PM D'Souza, Ryder,
and Laquer are in the residents'
team room looking at a CT scan of
a patient's chest. Ryder is concerned
because the scan shows a lot of
fluid that isn't supposed to be
there. "Do you want to go to radiology
and have it read?" she asks
Laquer. While awaiting his return,
Ryder and D'Souza continue to write
up patient notes, examine test
results, and determine plans for
patients whom they saw earlier in
the day. At 2:20, Laquer returns
with the news that the scan shows
no clots, but that large bilateral
pleural effusions—significant
accumulation of fluid between the
rib cage and the lungs, on both
sides of the chest—are evident.
MON 2:14PM While waiting for Laquer
to come back with the radiology report,
Ryder munches on a piece of fruit as she
reviews medications lists with pharmacy
resident Brooks. The team room is designated
work space for residents and medical
students—a place where they can
hold meetings, make phone calls, discuss
patients, look up medical information on
the computer, type patient notes and
orders, and update electronic patient
records—as well as eat snacks and store
their belongings. Ryder's group shares
this particular room with the green
team, which works on the same unit.
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