Wednesday, July 29, 2009

Night in the ED

The smell is still with me.


An 80 year old woman

brought in by her daughters.

She wanted to die in Mexico.

Her daughters wanted her here.

The daughters won.

Now I will share their nightmare.
Night in the EDSocialTwist Tell-a-Friend

Tuesday, July 28, 2009

When (not) to call the doctor

Knowing when to call the doctor is important inside the hospital as well as out.

One night as newly minted third year resident I received a call from one of the floor nurses at about three AM. The beauty of the third year was the fact that call meant you were expected to get some sleep. "Doctor!" the nurse exclaimed, "the patient in 722 is complaining of itching."

"Really? Well please tell me more about the patient in 722." I asked since I had no idea who the patient was.

"She is a 45 year old who had a vaginal hysterectomy yesterday." The nurse told me. "What are you going to prescribe for her itching," she demanded.

"What medications is she taking? Does she have any allergies?" I was still trying to figure this out.

"She is only taking tylenol for pain." The nurse stated.

As I tried to drag as much history out of the nurse as possible minutes ticked by. I felt that I might as well get up and go up stairs to see the patient. "Well, does she have a rash?" I finally ask.

"I don't know," replied the nurse.

"You don't Know?" I ask. "Why don't you know?"

"Well, you see the patient was so sleepy she ask me not to turn the light on. She was worried turning the light on would wake her up too much."

(No, I didn't say what you know I was thinking.)
When (not) to call the doctorSocialTwist Tell-a-Friend

Monday, July 27, 2009

More (writing) next month...I hope

It seems I need to hurry and get something on this page before the end of July. July 2009 will be a record month for me. I have seen more blood, sexually transmitted diseases, drug screens positive for cocaine, and dead babies this July than in any previous month of my career. I am hoping not to break more records anytime soon.

I remarked one day while rounding "If we could get some doxycycline (antibiotic to treat gonorrhea and chlamydia) in the water supply along with an oral contraceptive and do something about this cocaine, I could happily be without a job."

The residents are great, as is the nursing staff. They are up close and personal with all this stuff even more than I am. For instance, last Friday night while I was on the phone explaining to the operating room why I needed to do an emergency surgery on a lady with no blood pressure, the resident was in the room holding the patient's hand.

So, while this sounds like complaining, I am trying to make some observations. The final observation is: I am exhausted. This is truly only one month in. I have been trying to stay on a reasonable schedule. I am not sleeping in the day unless I can't help it. I want to be awake at home when I am there with my family. I am trying to exercise. I just can't on the days I am at the hospital for twenty-four hours. Tonight I had ice cream for dinner which wiped out the Lean Cuisine and fruit I had for lunch but I felt I needed it.

I have worked 184 hours this month. I have thirty-two hours to go.

And yes, I know I should not be counting.
More (writing) next month...I hopeSocialTwist Tell-a-Friend