So glad I don't have to page at 0400. ER = stick your head out of the curtain and say "hey! I gave atropine on this patient, hope you're okay with it...if not I'll grab another doc."
I hate paging docs to begin with*, so I can't imagine doing it at 0200 for something ridiculous. I figure I'm more likely to get what I want when I'm talking to a "well-rested" doc anyway.
Ahahah. Love it. You need to do a follow up of "ER Middle of the Night Pages" - the FTC page, the "oh shit my shift is over, better pass this off to someone else", etc....
Hahaha, I'm a night nurse on med-surg, we keep going back and forth between "y'all are calling too much during the night, cut it out" to "there haven't been enough calls!" (last one was heartburn medication - physician complained that they were not called for this)
Personally I have a sort of mental flowchart of if not emergent, is it something that is going to change because I called? (Okay technically constipation MAYBE but in the long term does it matter if it is six more hours? really unlikely) Is there some obligation to call (written parameters, policy dictate, etc.)? Is it something I as a generally rational person would call someone about at 2am ("I woke up at 2am with some pain but fell back asleep for four hours" - No).
The froot loops one reminded me of something I'd probably argue with my psych patients about, "No, really, froot loops are not a critical thing, go back to bed, no I am not calling your physician to get an order to give you froot loops." I remember picking up one patient with a "During the night patient may utilize the tub baths and have a bowl of oatmeal" order... never did find out the story behind that one.
HavenNyx: That froot loops page actually happened and I will NEVER forget it.
Tenya: I wish more nurses were like you. I remember after a busy night (where I was on home call so I had to work the whole next day), I finally got to sleep, only to be woken up when a nurse paged me at 5AM to ask if she could put ice on a patient's knee. Even though I didn't complain, the charge nurse actually apologized to me for that later and said, "I can't believe she woke you up for that."
I read things like this, think about the people I am graduating with who will become RN's at the end of this year, and I become extremely worried about my mental health, every doctor's mental health and patient safety.
I try to see the nurse's point of view when paged so I actually find most of the pages to be appropriate (we do have great nurses at my hospital, tho' the traveling nurses sometimes tell another story), but I get annoyed when nurses page with no info:
Nurse: Mr. Jones is in A-fib w/heart rate up to 150s. Me: What is his blood pressure? Nurse: Ummm, I'm not sure...
OR
Nurse: BP is 115/80 Me: I see in the system that was 3 hours ago when he was in sinus rhythm. What is his BP now? Nurse: (lightbulb moment) Do you want me to go check?
My sister got paged once at 2 a.m. with a request to move a patient from one room to another because the patient wanted a better view the next day when the sun came up.
When burdened with calls in the middle of the night during my hospitalist days, I tried to remember that the nurses had probably done everything within their powers before calling me. I never had the "unprepared" calls. That would, indeed, be annoying!
Sarah: I almost had to drive an hour round trip to the hospital in the middle of the night because some patient wanted to switch rooms and that couldn't be done without the resident signing some paperwork.
I remember the RN's during internship saying "Doctor, patient in room 3501a has a blood pressure of 160/90." I'd ask what the heart rate was and if they had a history of HTN and 9/10 times (at night) I'd get "I don't know" as the reply.
::laughs:: The f-ing Froot Loops page!
ReplyDeleteThis may be your most accurate cartoon yet.
ReplyDeleteSo glad I don't have to page at 0400. ER = stick your head out of the curtain and say "hey! I gave atropine on this patient, hope you're okay with it...if not I'll grab another doc."
ReplyDeleteI hate paging docs to begin with*, so I can't imagine doing it at 0200 for something ridiculous. I figure I'm more likely to get what I want when I'm talking to a "well-rested" doc anyway.
ReplyDelete*Y'know, unless the patient is in peril.
Ahahah. Love it. You need to do a follow up of "ER Middle of the Night Pages" - the FTC page, the "oh shit my shift is over, better pass this off to someone else", etc....
ReplyDeleteHahaha, I'm a night nurse on med-surg, we keep going back and forth between "y'all are calling too much during the night, cut it out" to "there haven't been enough calls!" (last one was heartburn medication - physician complained that they were not called for this)
ReplyDeletePersonally I have a sort of mental flowchart of if not emergent, is it something that is going to change because I called? (Okay technically constipation MAYBE but in the long term does it matter if it is six more hours? really unlikely) Is there some obligation to call (written parameters, policy dictate, etc.)? Is it something I as a generally rational person would call someone about at 2am ("I woke up at 2am with some pain but fell back asleep for four hours" - No).
The froot loops one reminded me of something I'd probably argue with my psych patients about, "No, really, froot loops are not a critical thing, go back to bed, no I am not calling your physician to get an order to give you froot loops." I remember picking up one patient with a "During the night patient may utilize the tub baths and have a bowl of oatmeal" order... never did find out the story behind that one.
HavenNyx: That froot loops page actually happened and I will NEVER forget it.
ReplyDeleteTenya: I wish more nurses were like you. I remember after a busy night (where I was on home call so I had to work the whole next day), I finally got to sleep, only to be woken up when a nurse paged me at 5AM to ask if she could put ice on a patient's knee. Even though I didn't complain, the charge nurse actually apologized to me for that later and said, "I can't believe she woke you up for that."
I read things like this, think about the people I am graduating with who will become RN's at the end of this year, and I become extremely worried about my mental health, every doctor's mental health and patient safety.
ReplyDeleteThe ridiculous 2am page I'll never forget...
ReplyDelete"I think your patient may be depressed."
I try to see the nurse's point of view when paged so I actually find most of the pages to be appropriate (we do have great nurses at my hospital, tho' the traveling nurses sometimes tell another story), but I get annoyed when nurses page with no info:
ReplyDeleteNurse: Mr. Jones is in A-fib w/heart rate up to 150s.
Me: What is his blood pressure?
Nurse: Ummm, I'm not sure...
OR
Nurse: BP is 115/80
Me: I see in the system that was 3 hours ago when he was in sinus rhythm. What is his BP now?
Nurse: (lightbulb moment) Do you want me to go check?
My sister got paged once at 2 a.m. with a request to move a patient from one room to another because the patient wanted a better view the next day when the sun came up.
ReplyDeleteWhen burdened with calls in the middle of the night during my hospitalist days, I tried to remember that the nurses had probably done everything within their powers before calling me. I never had the "unprepared" calls. That would, indeed, be annoying!
Sarah: I almost had to drive an hour round trip to the hospital in the middle of the night because some patient wanted to switch rooms and that couldn't be done without the resident signing some paperwork.
ReplyDeleteI remember the RN's during internship saying "Doctor, patient in room 3501a has a blood pressure of 160/90." I'd ask what the heart rate was and if they had a history of HTN and 9/10 times (at night) I'd get "I don't know" as the reply.
ReplyDelete