I followed my normal morning routine so there's nothing to write about there. In the afternoon I did 3-4 cases with my sister and then 8-9 cases back to back in the evening with my girlfriend. I was inconsistent in asking about the job, stds, drugs. At times I would ask at other times I would be so caught up in the case that I would forget. Also, I need to work on my DM and HTN follow up visits, and to work on being more observant of the patient, what they are doing and their environment. I might have missed things because I was exhausted but exhaustion is can not and will not be used as an excuse. I have to be on point always. Will review what i missed tomorrow morning in addition to the usual.
Today my best time for completing the patient section was 16 minutes.
modifications:
1)for chronic cases always screen for depresion
2)for each new complaint get a description ( if in ros there is pain somewhere else rewrite SIQORAAA, if there is another complaint rewrite DOCPAAA, and if there is vomitus get descriptions and ask if blood or mucous and ask to descrip.
3)for social history use pneumonic to remember alcohol use and drug use work etc.
4)for sexual history use pneumonic to remember std, protection, types of partners, counsel
5)counsel as you go along
6)focus focus focus and pay attention to details around you.
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