How to Crush Your SLOE (Tips 26-30)

Tip #26 Update your attending when the nurse is having difficulty with your patient’s IV or drawing blood. Tip #27 Get the urine sample from your patient (there is no greater delay in patient flow than waiting on urine) Tip #28 Round on your patients and repeat your initial scripting. * “It’s Zack the medical student again”* “Anything I can do to make you more comfortable?”* “Do you have any questions?”* “I’m doing my best to keep things moving fast for you, here’s an update” Tip #29 Perform one of the 4 most important reexamination protocols. * The ambulation trial* Best for patients with low oxygen on arrival or geriatric patients with weakness/dizziness/etc* The repeat physical exam* Best for patients with abdominal pain or respiratory complaints* The repeat vital signs* Best for patients with multiple abnormal vitals documented in triage, hypertension, fever, etc* The PO Challenge* Best for patients with nausea and vomiting or pediatric patients Tip #30 Update your attending the MOMENT everything is back (and choose one of 3 dispositions) * Admit them* Best when you have confirmed a specific, bad diagnosis* Discharge them * If everything is normal, including your reexamination* Recommend follow up in 1-2 days* Observe them* Best for patients with concerning symptoms, risk factors, or red flags but reassuring testing or no clear diagnosis