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24 Hours On Call

MON 5:40PM Ryder (seated) and emergency department nurse Mary Trono examine one of the patients who is being admitted to the hospital this evening through the ED. "I'll be your doctor tonight," Ryder tells the patient. As part of the admissions process, Ryder will ask the patient about her medical history and current condition and do a physical exam.

MON 5:46PM As Ryder examines the patient, she checks for lymphadenopathy—swollen lymph nodes, which are often associated with inflammation or infection. While she's conducting the physical exam, Ryder asks the patient a number of questions—such as "Does it hurt when you lie flat?" and "Have you been short of breath?" and "Does it hurt when you pee?"—to help her assess the patient's medical condition and come to a tentative diagnosis regarding her problem.

MON 6:09PM By now several new patients have been admitted to Ryder's unit, and she's at a computer in the ED writing their admission notes. In addition to the medical history and physical exam results, she includes the reasons the patients came to the hospital, their medications and drug allergies, and an assessment of their problems.

MON 7:36PM The red team got to the DHMC cafeteria for dinner just before it closed at 7:30 p.m. Laquer is now enjoying his meal while Ryder answers yet another page. "I've gotten called about a few patients that we need to admit," she says. She does manage to eat between pages; despite the hectic pace of the day, she knows how important it is to find time to eat. She makes sure the people on her team stay well nourished, too.

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