Note: Due to limited wireless Internet access, this blog will be updated semi-frequently. Stay tuned for my subsequent "post boluses..." :-)

Sunday, April 11, 2010

Day Three: Revisiting Low Acuity

One of the challenges of being a lone med student is that you don’t have a resident or attending who can supervise you to work with patients. Knowing this, I had feared that the only clinical exposure I would get would be through chart reviews and official attending rounds. Luckily I had nothing to fear. The residents, upon finding out that my language skills were adequate, were all too eager to put me to work. So right from my first day, I was sent to check in and write progress notes on the patients in the Low Acuity Unit (LAU).

To be a patient in the LAU means one of two things. Either you really don’t have any pressing medical issues, or you got moved there because there weren’t enough beds in the Inpatient Unit. Upon reviewing the patient roster, I couldn’t help but be surprised by just how sick some of these “low acuity” patients were. There was, for example, one patient who was still having 19 bloody bowel movements a day from dysentery. There were also several patients recovering from bacterial meningitis, and one patient with a high fever from an unknown source who seemed to be on every antibiotic known to man.

For the past two mornings, I would take my time reviewing the charts in the LAU and then proceed to examining each patient and writing notes. At first, I’m certain the patients and the families were quite taken aback by my presence and my horribly broken Khmer (the Cambodian language). But already, I think they are getting used to me.

What is really striking to me in the LAU is that some patients have been there for such a long time. The kids in bed 1, 5, and 7 are being kept there to finish off their IV antibiotic regimen. And in bed 4, there is a baby who is in for malnutrition and is simply being observed for adequate weight gain. Back in the U.S., keeping patients like that in for such periods of time is absolutely unheard of. So having gotten used to seeing kids sent home with PICC lines after a 2-day hospital stay, it is really refreshing to have the chance to keep observing them until they fully recover.

As for other news, the good thing is that I did not have the same near-fainting episode as I did yesterday during rounds. Unfortunately however, I didn’t have the chance to apologize to the attending I was with before. Oh well…at least I managed not to actively offend anyone today!

Tonight, some of the residents have invited me out to a “traditional” Khmer restaurant. I’ll be sure to post later on what promises to be an interesting experience.

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