By the end of some of my ER shifts, I feel exhausted. Triaging patients, collecting pertinent medical histories from owners, examining patients, coming up with a list of differential diagnoses, and presenting treatment options takes a toll by the end of the day. Throughout the process of seeing numerous patients walk through the door (or be carried by someone), I am constantly on my feet, save for the times when I attempt to input information into the electronic medical record, which is a stressful process in and of itself. The emergency and critical care team of interns and residents are very important in keeping us students in line by teaching us what to do and perhaps even more importantly, what NOT to do. I have made myriad mistakes but thankfully none of them have been too costly for the patients.
Sometimes in taking a history from an owner, I may take too long a time in the exam room. In the first week of the rotation, I think that I went too quickly because I just wanted to get down to the brass tacks related to the patient’s presenting complaint. When I presented the history to the supervising clinician, I often was lacking information that they asked me, because I did not deem it important to ask the owner(s). In recent days, I have been erring on the side of asking too many questions lest I not be able to provide enough information to the vets in the ER. But I have learned that there is a narrow window within which I have to work. Taking too long in an exam room is perhaps more detrimental, as all hands on deck are needed in the ER. As time progresses, I hope to get a better handle on taking a history.