I remember it like it was yesterday. 70-something yr female with a chief complaint of not feeling well and cough x 2 days, insists something just isn't right. 3 prior admissions in last 2 months for dyspnea with a neg. CTPE, 2-D echo, and stress test . Vital signs completely normal. Physical exam shows obvious URI symptoms. Cardiac work-up and CXR completely normal. Discussed with patient that we aren't finding the big bad things that would need hospital admission. Pt accepted that explanation, thanked me for taking care of her, and while I'm delivering my spiel regarding outpatient f/u she mentioned that she has an appointment with both her PCP and cardiologist tomorrow. Shortly after that, the hospitalist who normally takes forever to call back and acts like you're trying to sodomize his dog every time you admit a patient called back 10 minutes after being paged. He accepted the ESRD patient with chest pain during dialysis without a peep. Then I had a 78 yo lady from the nursing home with changed mental status and the nurse saw the order for the UA and realized that the patient wore a diaper and so straight cath'd the patient right after drawing blood. And after dispo'ing her I was able to finish up my t-sheets, leave on time, and make it home to tuck the kids into bed.
DISCLAIMER: Due to HIPAA, some identifying information has been changed. Additionally, some of these patients and situations are composites. The above is not a typical day and your results may vary.
