At Work

At work this week, a couple of noteworthy patients.

The first was a woman who brought in her year old baby because the baby had a purple spot on her tongue and about a dozen red spots on her body, just isolated 1mm red dots. The baby’s tongue looked just like this:

This is called purpura, and the ones on the skin are called petechiae. It can be genetic, or can be triggered by a virus that causes the immune system to misbehave and attack the patient’s blood. So I went to go tell the doctor, who ordered a blood test. Sure enough, the baby’s platelet count was 3,000. It should be between 150,000 to 450,000.

The disease is called thrombocytopenia. It can be caused by a number of different things, this will require more testing. No matter what, it isn’t going to be good news. We transferred the baby to a children’s hospital.

The second one was a fine example of how people abuse the system. A woman came in telling me that she had called in sick to work so her and her boyfriend could spend the day smoking weed. She had no medical complaints, but wanted a doctor’s note for work so she wouldn’t get fired for calling in again.

We ( the nurses and doctors) were offended, but the doctor wrote her note. Why? Because payment rates for the hospital for all patients are set by satisfaction scores, according to Obamacare.

On the business front, we began showing the rental finally. There have been two people by to look at it, but no one has put in an application yet.