Sunday, August 12, 2007

The On-call-ogist

For all you non-medical folk who read this blog (most of you, I'm assuming) I thought I'd give you a small sample of what it's like when you are on call.

0500 - Alarm goes off. Hit snooze.
0508 - Goes off again. Feel bad for husband, who doesn't have to get up, so drag yourself out of bed. Shower, pack a bag, and try to ignore the pitiful look the dog is giving you since you don't have time to walk her today.

0613 - Arrive at hospital. Begin seeing patients, starting with a sweet 97 year old, who you get to pray with as she is very open in her love for Jesus. Get a little teary when she prays for you and tells you she loves you.

0645 - Work your way down each floor, stopping and writing notes on all of your patients. Realize that none of them are going home, and since you are on call today, your patient list is going to get huge.

0745 - Meet Jeff for breakfast. ( french toast - yum)

0800 - Start rounds with the attending and the other team.

1000 - Still rounding. As you finish, revisit each floor to write orders on your patients and discharge some patients from the other team.

1100 - Finish morning work, and sit down in the lounge for a few minutes. Foolishly think that maybe today won't be too busy.

1104 - Beeper sounds. Look at number to call and inwardly groan when you realize it's the ER. Write down the information about the admission, and slowly make your way down there.

1108 - Beeper sounds. Return call to nurse who is confused about your orders, since you forgot to write down a vital piece of information (ie- how often to give medicine, what strength.)

1113 - Beeper sounds. A patient has a headache and wants some medicine for the headache.

1118 - Start reading about new patient in ER. While using computer, another ER doc walks over with another admission. Now the race begins to catch up.

1218 - Finish first admission. Start second. When almost finished with second admission and you are beginning to think you might get to relax for a few minutes this afternoon, the ER doc returns with these words: "Hey - I've got another one for you."

1240 - Beeper sounds - Nurse "Doctor, patient such and such is doing this. What should we do?"
Doctor "Uhh....mmmmm.....??" Silence. Nurse "Why don't you give them this medicine?"
Doctor "Yes. Let's give them that medicine." Nurse "What dose?"
Doctor (scrambling to look up answer on PDA) "How about this much?"

1335 - While looking over admission paperwork with upper level resident, realize you made three somewhat silly mistakes and didn't request two very logical studies. Rush to the cafeteria and grab some quick lunch to eat down in the ER, since there is yet another admission.

1500 - Beeper. Nurse calls to tell you a patient has died (very expectedly) and you need to fill out paperwork and pronounce the patient officially dead.

1502 - ER doc gives you another admission.

1545 - Discharge another patient from the other team and return to ER. Stay in ER until 6pm when you finally finish and sneak out to eat dinner with Jeff.

1645 - Second page about patient who is dead. Want to go, but realize that the situation up there can't really go downhill, and there is so much work to be done in ER.

1730- Third page about patient who is dead.

1800 - Grab quick dinner and return two pages. Give prayer of thanks that the ladies of the verandah let you use the kitchen phone.

1810 - Fourth page about patient who is dead. Mention you had to get some quick dinner.

1812 - Fifth page from Nurse Manager about patient who is dead. Learn to never mention that you had eat.

1830 - Go to dead patient's room. When you get there, realize this is a 33 yo woman who has been in persistent vegitative state after a tragic and unexpected head bleed, and in some ways death is probably a mercy to her. Try not to look at her 5 and 8 year old daughters who watch you and you listen for a heart beat or breath. Awkwardly stumble through what to say. Pray with family and cry a few tears with them as they mourn. Try to collect yourself before returning to the 2 admissions you already have in the ER.

1900 - 0600 Stay in ER and try to work your way through the list of admissions that keep growing longer and longer by the minute. Tense up every time and ER doctor walks by as you fear they are coming to tell you there is another one you have to add to your list. Around 0230, begin to lose all capacity for coherent thought and run to the lounge for some caloric and caffein-ific reinforcements. Feel guilty about eating a delicious little debbie brownie.

0600 - Start writing notes on all the patients you already had before this call, PLUS the patients you just admitted. This will take a while since your brain is working at about 10% of its usual capacity.

0625 - Deal with difficult patient family. Pray for patience.

0900 - Start rounding with attending.

0945 - Still rounding. Begin to get emotional since no breakfast has been eaten. Subtly suggest some breakfast. Want to cry with joy when the attending agrees. Get breakfast and enjoy a few minutes of non-medical conversation.

1030 - Deal with same difficult patient family. Still pray for patience.

1100 - Still rounding. Wonder if you will ever leave, and realize you have to come back tomorrow and that you are on DAY CALL tomorrow, which only means more patients.

1145 - Still rounding, but you can see the light at the end of the tunnel. Visit with another precious 93 yo lady who makes you smile.

0100 - Finish rounding. Check out to oncoming resident who can't believe you are still here.

0130 - Rejoice as you walk outside to your car. Drive home slowly, hoping you don't wreck.

0138 - Arrive at home.

0142 - fall into bed. Hurray the day is done!

3 comments:

MamaBear of The Potter Place said...

This is truly frightening. I hope you're eating well and taking your vitamins.

Ken Shomo said...

I read through this once, then went through again to try to figure out where you grabbed some sleep. Not to mention write the blog!

Aubrey said...

Oh no....there was no sleep. Not until Sunday at 1:30 when I finally got home. I wrote the blog during the 2.5 hrs I was awake on Sunday afternoon (from 6:45pm - 9:00pm). Although I have gotten sleep on some call nights, I don't really expect it ever. (I yearn for it, always, but never expect it.)