Liar!

Patients lie. We all know that sometimes it's more obvious than others, but for one reason or another patients will lie to us about history, drug use, etc. I understand and accept that to a certain degree. What I don't understand is why lie about getting imaging done? You won't get your procedure or prescription any faster. You WILL waste an hour of my time while I try to track down your doctor or the hospital or facility where you supposedly had it done only to find they have no record of it. And you get to sit in our cold exam room for another hour instead of simply getting the order for your MRI and getting to leave.

Life on Pain (not in pain)

I'm currently on pain management and while a lot is what I expected, there are a lot of surprises.

Most people know that we use the pain scale from 1-10 to assess severity.
I learned this week that there is also a scale for the amount of pain medication a patient is taking.
This scale ranges between a "scosh" and a "shitload".

For example:
Mrs. Stenosis is doing much better after her surgery but she could use just a scosh as needed when the pain flares up.

Mr. Suboxone has a long history of opioid use and is still NPO after his emergency laparotomy, so he is getting a shitload of IV Dilaudid.

While learning about the use of the medications and procedures is great, by far the most useful part of this rotation is in how to deal with pain patients. They are a notoriously difficult population to work with because you cannot just treat the pain, you also have to address the physical and psychological toll that pain takes. I think coming out of this rotation, I will feel a lot more comfortable dealing with pain and pain patients. How you approach the patient and his or her pain can make the biggest difference in how your interaction goes.