When I was an intern, there was a third year resident in my program named Anna. I never liked her that much in the past because she always seemed really tired and irritable. She had a reputation for being a super ICU blocker. This means that when she was the resident in the ICU, she'd block patients that she knew were ICU level and make the residents on the wards manage them so she didn't have to deal with them. (Even though she knew they'd just come to the ICU the next day, after she was done admitting.) Conversely, when she was on the wards, she'd call the ICU and tell them she "doesn't feel comfortable" managing a sick patient on the ward and insist they go to the ICU. It's the sort of behavior that doesn't get other residents to love you.
But one month I started talking to her a little bit, and even though she was sort of tired and irritable, I kind of liked her style.
I collapsed into a chair in the admitting unit around 9PM and said, "This is the first second I've had to sit down all night." (And that included my "dinner", where I got paged no less than ten times and had a nurse demanding that I talk to a family NOW.)
Anna: "Yeah, night float is an awful rotation. It's really miserable."
Me: "It really is."
Anna: "But it's still better than wards."
Me: "....Yeah.... you're right, it is."
My revelation: Oh my god, you hate it here as much as I do!
I sent a patient down to ICU last night (well, around 7am, but it still felt like "last night" at that point). I'm coming off a week of night float, which mercifully was mostly light floor call, but paired with some not-so-light cardiology call. I think, last night, I was just so mentally exhausted that I really didn't want to have to deal with, say, patients with frank blood per rectum or others with persistent hypotension due to massive belly hematomas. Though I was probably just spoiled by my earlier evening activities of watching Netflix and eating lots of snacks.
ReplyDeleteWRT to nurses insisting that you do X NOW, a trick that I learned as staff that I wish I knew as a resident is; when a nurse asks to do something right away that you know is by no means urgent, you just tell her that you'll be there right away, and then just go about your business eating dinner or finishing up your consult or whatever, and get to whatever it was when you get to it. If the nurse asks what took you so long, just say something came up and you got held up. Just don't get into a discussion about how you're gonna finish dinner/finish your consult/etc when she calls because it'll become a drawn-out pointless discussion. If she keeps calling you for the same non-urgent issue, then you may have no choice but to tear into her just a little… because, seriously, enough!
ReplyDeleteThanks man.
DeletePerhaps the nurses should print out this reply and show it to their patients when they repeatedly ask "what took the doctor so long to " and then reply with, "Oh I'm so sorry, Mr. Patient, your doctor was finishing dinner and didn't want to get into a drawn-out pointless discussion or else he/she would have had to tear into me just a little."
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