5/19(金)
●本日の新患(担当患者: 9→7人)
●本日の診断・救急
・失見当識 → 頭頂葉出血性梗塞 …MRAは重要だ…
・自損事故、怪我無し、手のみ指示通りに動く → 痙攣発作
・洞房のWenckebach
・ステロイドによる骨粗鬆症
・Fe欠乏性貧血
●本日行ったこと・みたもの
6:10 出勤
6:15 採血準備
6:25 採血開始
7:15 救急へ
8:00 朝食
8:40 回診
9:30 カルテ記載、オーダー
11:15 今朝のまとめ
11:30 再度オーダー
12:00 EVL見学
12:30 オーダー
12:50 食事
13:15 カンファに向けて準備
途中、健康診断 7人
オーダー書きつつサマリーかく
16:00 内科カンファ6人発表
17:00 オーダー続き
17:30 救急検討会出席
19:00 オーダー続き
19:15 夕食
20:00 帰宅
●今日うまくいかなかったこと・失敗
・朝の採血でスピッツ間違える…
→ 寝不足は、だめだ。5時間を下回ると疲労感が、4時間を下回るとミスが目立つ。
6時間は、睡眠時間を確保!
→ 予定していた順番が、患者さんがトイレいっていたりでくるうと、取り違えおこりやすい
さて、忙しい朝、どうしよう…。
・EVLのときは、GFはラスト…
・退院時、次回外来予約をコンピューターにいれて安心していたら、指示書にも書かなきゃいけなかった…。
・直腸診、まちがえた
・ぎりぎりで印刷しようとしたら、印刷がおそい…
・サマリー、間に合わず…。入院の晩に、必ずまとめるしか、手はない…
…なんで今週はできなかったのかな?おかしいなぁ。
●今日気づいたこと
・カルテ、ひととおり回診してから書く、はだめだ…。忘れる…。一区画ごとにかくべぇ。
・オーダーは16時までに、と前言われたのだけれど、どうも、採血オーダーだけみたい…。もうちょっと気をほぐしてオーダーしていこう。…とおもったら、夕方までに用意されている点滴もやっぱだめだった…。抗生物質がめんどいなぁ
・時間つけてみるとやっぱり、だが、オーダーがばらけすぎ。一日2回くらいにまとめて仕事したいな
●今の気持ち・今後学びたいこと
・AV Blockの中年女性!!
・とにかく、今日はやばいくらい体がぼろぼろだ…
●明日の予定
・放射線科の先生へ依頼書
・ざっと回診
・食止めから復帰のひとの食事
・退院する人の準備
・サマリーの仕上げ、できるかぎり…
とくに、退院しちゃったひと…
たまっている宿題…
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