AMA

Done with another call day! I can't believe I have only one more call left. We had a packed night yesterday. 4 admissions total, which is a lot for our service, which is capped at 13. My co-subI and I each admitted 2 patients each.

My first admission turned out be very straightforward - small bowel obstruction and aspiration pneumonia. The second, however, was craaazy! Our patient tried to leave AMA (against medical advice) on us. Perhaps "tried" is an understatement. The nurse literally put her foot in the elevator door as the patient was storming downstairs to take out her IV, which the patient threatened to self-remove. Our sweet attending, who is the most even, soft-spoken, kind person I have ever met, remained so collected throughout the episode (and it was quite an episode, involving multiple nurses and security guards). Our patient apparently went out for a smoke and wanted to return to the emergency room to get admitted to another floor. Apparently, once the patient got to the emergency room and realized how insane it, the patient returned to the ward within 30 minutes. Yikes. Goes to show how you've just got to be prepared for any kind of patient behavior. At least it wasn't physically violent. I'm leaving out much of the backstory, but I think our patient was just at the end of his/her rope and completely frustrated with system. Our attending, bless her heart, made a teaching point out of it and actually debriefed during our hectic night.