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- Publisher
- Wolters Kluwer Health
- Copyright
- Copyright © 2016 by the Association of American Medical Colleges
- Subject
- From the Editor
- ISSN
- 1040-2446
- eISSN
- 1938-808X
- DOI
- 10.1097/ACM.0000000000001103
- pmid
- 27023184
- Publisher site
- See Article on Publisher Site
Abstract
The triage nurse approached Jan, a rotating intern, with a request to order a head CT scan on a middle-aged woman who had a headache and was vomiting. (All identifying details have been changed.) This was Jan’s second week in the emergency department, and she wanted to be cooperative with the triage nurse and also to not miss any serious emergencies, like a stroke or bleeding in the brain, that could cause the patient’s headache. She knew that timely diagnosis could avert some of the complications of a stroke or brain hemorrhage. Jan saw no reason to disagree with the nurse’s suggestion and was putting the order into the computer when I happened to sit down next to her while working on another patient’s chart. She described the case to me, and I asked her to hold off on ordering the CT scan until we could speak with the patient and examine her together. A few minutes later we greeted the woman, who was in a dark room, crying and vomiting. Light hurt her eyes and made the headache worse. The woman was clearly in pain, and I could understand why the triage nurse was concerned. But as
Journal
Academic Medicine – Wolters Kluwer Health
Published: Apr 1, 2016