After 2 weeks on the job, I can gladly report that all is well.
Last Monday presented me with a unique challenge - I had my first afternoon as the provider assigned to minor care. Minor care is, essentially, a mini-emergency room. Most ERs now actually have attached minor care departments - a walk in clinic for everything from lacerations, to acute infections, to traumatic injuries sustained while playing sports (generally stuff that is acute but non-life threatening). Ours is no different from the ones attached to an ER except that we are a stand-alone facility. We are at least 20 minutes from the closest ER, thus in our minor care we often have patients walk in with worse problems than your average family practice clinic minor care. Crushing substernal chest pain (we're worried about heart attack here), inability to breath because of a COPD exacerbation or acute asthma attacks - these are but a few of the potentially life threatening problems we handle at our facility. We get fractured bones of all types, and there is a rumor that we once had a patient who had sustained a gunshot wound. We, of course, contact the local ER and stabilize these patient while paramedics are called to transport them to definitive care. But the process of getting a patient with acute ST segment changes stabilized and ready for transport can be... intense. I didn't have anyone complaining of chest pain, but my day was still jam packed with patients complaining of acute problems. The patients came every fifteen minutes, some complex, some simple. It was a busy day, the adrenaline flowed freely, and in the end everything went as smoothly as my first day in minor care could go.
The following day was also quite challenging - I had 12 patients on my schedule. Most were people I'd never seen before, so this requires an added level of attention to detail. I need to essentially do a complete H&P and complete their chart notes in 30 minutes plus I have to address their chief complaint with a plan and directions for follow-up. Generally this is a minimum 45 minute process (at least, for me it is). So I was stacked to the rafters again. Add to that an hour long surgical procedure in the middle of the day and by the end I was done. I can't remember the last time I was that tired. But it felt good to have accomplished so much.
By Wednesday I was only 6 notes behind in my charts. I had another relatively intense day (for a new provider) in that I had to man the minor care again to see the pediatric patients coming through our doors. Thankfully it was all straightforward and everyone, to my knowledge, was fixed up appropriately. I have only had a few of the 75+ patients I've seen so far come back in for care sooner than the scheduled 2-3 weeks - so hopefully this means I'm doing something right. Thursday came my reprieve.
I was scheduled for minor care again, but since Thursday is day #4 of minor care, there are generally only a few people who seek treatment. It was nice, slow, and nothing complex came through so I was actually done with work almost on time.
Friday was a sweet gift straight from God (all days are, but this one was particularly sweet). I saw just an average number of patients and all went smoothly. I had the opportunity to leave by 3:15 (very early, which is almost unheard of). I picked up two minor care patients - both with complaints in an area that I am very comfortable with - and was done precisely at my scheduled 5:00 leave time. A marvelous day!
I ended the week completely caught up. Tomorrow the cycle begins again. I find myself not exactly looking forward to it, and hoping that it goes better than last Monday. That said, I am not dreading the proposition and I think that this week will be a good one. As always, time will tell.
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