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Discussion in 'Emergency Medicine' started by realruby2000, May 4, 2007.
do any of you guys pick up patients the final hour of your shift?
Yes. I pick them up within the last 10-15 minutes or so. We do it to keep the flow moving and to at least get some work ups started. I hate leaving a rack full of charts for the on coming guy and I hate to come on shift with a bunch of charts in the rack. Our volume is such that it is relatively easy to keep the rack clean.
I usually try to get an H&P done and documented with an initial set of orders put in for patients up until about 20 minutes before the end of my shift. I don't expect to wait for labs to come back, etc before I leave; I'll just be sure to give a really good signout with the explicit instruction that this patient was "started" by me and whoever inherits them really needs to spend a lot more time with them than the average pass off that already has a dispo.
It depends on the patient and time left. If they are truly sick, I"ll see them. BullSheet chest pain, I'll usually see. Vag bleed 1 st trimester, I"ll see. Other things like abd pain, ha, etc, I usually leave in the rack.
I definately won't pick up a patient within 10-15 minutes, though. Our signouts are kind of long where I'm at and its a bit of contention lately. 1 hour to go, though, I"ll see most any patient. Because if I see a patient 40-60 minutes before, I can get maybe a basic lab or two, and see if there is any response to treatment so far, which can help guide disposition.
A lot depends on where you work and if there is sign out of patients at the end of shift. At most academic centers pending workups and dispositions can be checked out to the next shift. At some private EMs, you are responsible for dispo'ing all patients you see and so you may end up staying for hours later if you've picked up a belly pain with 10min left in your shift.