When I was an intern rotating in the ER, we got a patient who had recently been admited to the hospital. Unfortunately, we didn't have an EMR and there was no old chart available at that time.
The attending was Dr. Brown, not my favorite of the attendings. Dr. Brown suggested that I call the team that had admitted the patient and try to get information about her.
The team that had admitted the patient was post-call that day. And it was about 10PM. I did happen to have the phone number of the intern that had admitted the patient, but I really didn't want to bother him at 10PM on his post-call day. Finally, I told Dr. Brown that I'd be willing to page him, but being post-call, his pager was probably off.
That's when Dr. Brown started pressuring me to call the intern at home. He said, "If you were on a wards team and you had information about a patient, wouldn't you want to provide that information if you could to save the hospital trouble and save the taxpayers money, even if you were post-call? And if you wouldn't do that, maybe you need to be re-thinking why you're in medicine in the first place."
I was like, woah. I think I just stared at him. Finally he said, "I can see you're uncomfortable with doing this."
I handled the whole thing horribly. Mostly, I never should have admitted I knew that intern's phone number. I don't regret not calling him though. Calling someone on their post-call night is just mean.... especially when the next day you're short call and have to wake up very early... I would have felt awful if I woke up him or something.
I finally compromised by leaving a message on the intern's pager, which he never returned, of course.
I apologized to Dr. Brown. I think he felt just as weird about the whole thing as I did because he was trying to be really nice to me after that.
Attending was frustrated about lack of info on the patient, did not know what to do for the patient and panicked. And there is habitual disregard for resident's needs, so that is no wonder.ReplyDelete
We text each other regularly, with the understanding that if someone's asleep, they'll stay asleep, but they can return the text if they're awake. Although I've been woken up at 2:30 by texts and that's not really cool. So I leave my phone on vibrate now (the alarm still makes noise, but everything else just vibrates).ReplyDelete
Good idea, Dr. Brown, but here is a better one: Why don't YOU call the ATTENDING at home? Somewhere in the hierachy, there had to have been an attending overseeing the wards team. I am sure s/he would understand why you are calling them and would be more than happy to help. TCGReplyDelete
I didn't even think of that! You're right... total attending fail.Delete
Hmmm. when we had re-admits within the same month, they "bounced back" to the last team in the morning, so they'd have heard about it at 8AM. Also the attendings were never there with us at 10pm, for better or worse.ReplyDelete
But in your case, what about stabilize the patient, deal with urgent issues and again CALL THE TEAM IN THE MORNING. The poor half-asleep, angered intern may not have much useful to say from his bed at 10pm but may have tons of helpful notes/etc... at his desk the next morning.