Clerkship Bloopers

I am going to come clean with my clerkship bloopers today. For all medical students out there, let's face it. Clerkship really is the time to make mistakes. I haven't met any clerk yet who hasn't done at least one blooper during her clerkship. For the past 1 month and 1 week, these are my own confessions...

1. Surgery rotation: Saw a px classified as Vehicular Accident victim. He came in, ambulatory, and said to have stumbled accidentally while driving a motorcycle. He had several abrasions, nothing too serious, didn't like to lie down on the stretcher and was even able to refuse me when I suggested for him to have an X-ray of his leg. I dressed his wounds with Betadyne and discharged him w/o referring him to our resident. He was a known hypertensive and his BP during the incident was 160/110. According to his wife, a doctor in their health center gave him a few Calcibloc pills which he should take during hypertensive episodes. I advised them to have the px take one and then, discharged the px without even referring him to our resident or to the IM department. A few minutes after, the px came in again, this time carried by his relatives and having a seizure tonic-clonic episode....

Jesus Christ! Why did I not refer the px to our resident nga uli? Arghhh!!! Our resident ordered an IV line for the px, infused him with Diazepam and in a few minutes, the man was okay again...
Shiyet... I couldn't face the px's relatives and tried to hide behind the surgery desk. My resident scolded me for not having the px brought to X-ray because it would have bought us some more time. If the px had the episode while he was already at home, he might not have been able to be managed right away. Thank God, he was okay or else, arggggghhhh! I don't even want to think about it.

2. Internal Medicine rotation: Saw a px complaining of inability to urinate. She has been unable to uriniate for a few hours. This was her first episode. There is no history of fever, chills, dysuria, flank pain, hypogastric pain. Upon examination, her bladder was distended. I called our PGI, who was at Ward 6 that time, to refer the px but he wasn't there. Based on my previous experience during Surgery wherein I encountered the same case except for the fact that the px before was male, when I referred the px to our Surgery PGI, she suggested catheterization. The Internal Medicine PGI was also there that time and she suggested catheterization as well. So, based on my previous experience, I cathetherized the current female px as well.

Big mistake... After having endorsed the px, Dr. Abubakar, the chief resident for IM, saw the px and asked who was responsible for cathetherizing the px. I'm sure if I was there that time, I would have been scolded so many many many times for the mistakes that I did.

Mistake #1: I did not refer the px to the PGI nor to Dr. Miranda, before cathetherizing the px.

Mistake #2: Females are prone to UTI and cathetherization will further promote UTI in the px. I forgot that.

Mistake #3: I did not refer the px to the PGI nor to Dr. Miranda.

According to Doc Abubakar, I should have applied warm compress on her hypogastrium instead, before even considering cathetherization. Warm compress? Eh, distended na nga yung bladder niya! Well, sige na lang. I am only a clerk. What do I know, ika nga?

In fairness, I did relieve the px of her ssx and she was thankful to me for it. Hehehe... Consolacion de bobo... Well, if she develops UTI, I only hope next year pa iyon and not while I am still rotating at Internal Medicine nor at any of my major departments. Hehehe...

Doc Abubakar hasn't talked to me nor to my partner about that case yet. I'm still waiting for the long lecture. Hope that ax never falls and he forgets about it... Ha! As if! I'm sure may demerit nang katapat yun. Wish me luck! =)