Last days at work always polarize me. It was the best, it was the worst.
This was my last day as a chief resident. This was my last day as a resident. This was my last day.
In the final meeting of the peer review committee on which I sit, we looked over one of my cases. A gentleman was divericulosis we admitted, tanked up and sent home. We made an error. We assumed that he would tolerate his home dose of a certain medication. This was the wrong decision. He represented the next day with dizziness and low blood pressure. It was multifactorial as he was bleeding again, however, his medication misadventure could have and should have been prevented.
Time for some Critical Self Reflection:
What did I do well?
- The diagnosis and treatment of his primary problem was appropriate.
What did I learn?
- Hospitalized folks, often are not taking or will not tolerate their home doses of medications.
What will i do differently?
- Run the medication list with the patient before discharge and if there are medications that can cause side effects related tot he primary diagnosis, consider just starting at half dose or holding until the PCP visit.
tough year, tough day. Mistakes are great teachers and are opportunities, not the result of personal failures.
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