Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood.
Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine)
Round on your patients and repeat your initial scripting.
- “It’s Zack the medical student again”
- “Anything I can do to make you more comfortable?”
- “Do you have any questions?”
- “I’m doing my best to keep things moving fast for you, here’s an update”
Perform one of the 4 most important reexamination protocols.
- The ambulation trial
- Best for patients with low oxygen on arrival or geriatric patients with weakness/dizziness/etc
- The repeat physical exam
- Best for patients with abdominal pain or respiratory complaints
- The repeat vital signs
- Best for patients with multiple abnormal vitals documented in triage, hypertension, fever, etc
- The PO Challenge
- Best for patients with nausea and vomiting or pediatric patients
Update your attending the MOMENT everything is back (and choose one of 3 dispositions)
- Admit them
- Best when you have confirmed a specific, bad diagnosis
- Discharge them
- If everything is normal, including your reexamination
- Recommend follow up in 1-2 days
- Observe them
- Best for patients with concerning symptoms, risk factors, or red flags but reassuring testing or no clear diagnosis