Wednesday, February 24, 2016

Foley

Somebody wrote in order to remove a Foley catheter on a patient, but subsequently the patient's husband told me the catheter should not be removed in no uncertain terms. For this reason, I wrote the below order to keep the catheter in:



I thought the order was very clear. But the next day, the Foley was removed. Can you guess why my order was ignored?

Sunday, February 21, 2016

Help

Does anyone here have any reasonable knowledge or experience with New York divorce law? It's not personal, but rather for something I'm writing.

If you can help me, email me or comment below.

Friday, February 19, 2016

Suffocation

Something my husband and I sometimes argue about is the way that I sleep.

At some point in the last few years, I started sleeping under the covers. And by that, I mean I am entirely under the covers. Including my head.

There are several reasons I like to sleep that way. First, it keeps the sun out in the morning. Second, it's nice and warm under the covers (my face gets cold). Third, it makes me less likely to be disturbed by my husband coming to bed a couple of hours after I do.  (it used to keep me from getting blown on by his CPAP machine, but he doesn't use that anymore.)

Anyway, my husband doesn't want me to sleep under the covers because:

1) he's worried that it might be bad for my health

2) it makes me look like I'm dead

I figure since I'm the one actually sleeping, it should be up to me whether I'm under the covers or not. But I thought I would post it to the readers to ask whether my husband has a point or not.

Wednesday, February 17, 2016

Med student do's and don't's

Examples of bafflingly awful/annoying med student behaviors I observed in residency:

1) When I'm writing a note on the computer, leaning over my shoulder to watch me write the note.

2) Showing up late every single day. In the case of our last med student, showing up an hour and a half late every single day. And we don't start that early.

3) Interrupting me mid-sentence to ask the patient a question about a slogan on their T-shirt.

4) After observing me take a history and do a physical on a patient, attempting to take the chart away from me to present the patient to the attending herself.

5) After being told to look up a topic at about 10AM in the morning, leaving clinic and spending the entire day looking up articles on that topic (instead of seeing patients). When an attending says to look up a topic, that means look it up on your own time, at home.

6) Not showing up to one lecture in a month rotation.

7) Going in to examine a new patient without asking permission.

8) Staring at me while I dictate.

9) Asking too many personal, inappropriate questions of the residents.

10) Making an excuse to leave early every single day.

Wednesday, February 10, 2016

VA work ethic

A while back, I used to do outpatient clinic at the VA and our clinic receptionist was possibly the worst receptionist I’ve ever seen ever.

I've done a lot of clinics in the last few years and dealt with a lot of nurses and receptionists... and for the most part, they have been pretty good. I mean, some have been great, some have been okay, and some have been not so great. But this woman, let's call her Hilda, was amazingly bad.

I don't know what her job entailed exactly because every time anyone asked her to do something, she replied, “That’s not my job.” Basically, every time I came to her desk, she was either chatting with patients or more likely chatting with a friend on the phone. When a patient arrived, we (the doctors) would call the patient out of the waiting room ourselves and bring them to the examining room. I guess she scheduled patients for regular visits, but she wasn't even allowed to schedule any of the EMGs, Botox, epidural steroid injections, or anything else because she was constantly accidentally overbooking patients. So we (the residents) had to do much of the scheduling.

She definitely didn't clean the examining rooms. When I walked into the examining rooms in the morning, they looked like a hurricane hit. There were dirty gowns strewn around the room, dirty tissue paper on the tables, dirty pillows on the examining tables. When I was 40 weeks pregnant, I had to change dirty pillow cases and put new sheets on the examining table for every patient I saw, because Hilda said “that wasn’t [her] job.” One of the rooms ran out of tissue paper to put on the examining tables and I asked her if she knew where more was, and she didn't. She'd been working there for YEARS and she didn't even know where the paper was for the tables?? I had to ask my attending to change the paper on the table.

Another resident told me a story about Hilda: he was doing consults in another part of the hospital, so he asked Hilda to page him if one of the clinic patients showed up. (We had a high no-show rate.) A patient showed up and Hilda just let the patient sit there for over an hour and didn't bother to page the resident or any doctor to let anyone know the patient was there. She said she “forgot.”

I remember there was one week when Hilda called in sick to clinic, and me and the other resident did the receptionist work. We basically just put a sign-in sheet near her desk and grabbed the charts ourselves. It wasn't any extra work whatsoever.

I have honestly never been in any other situation where the residents had to schedule their own patients, room their own patients, and clean their own rooms after every patient. But I guess it’s the culture of the VA that useless, lazy, or incompetent people can’t get fired. An attending at the VA once said to me that the only way to get fired from a VA job is that you’d have to make babies with a dead patient three times. The first two times you made babies with the dead patient, you’d just get a warning.

Saturday, February 6, 2016

Lesser evil

I haven't written anything political on here in a long time, but I have to say, with the primaries officially underway, I spend a good amount of time with my husband (who I usually agree with politically) arguing over our choice of candidates.

He thinks that Trump becoming president is the worst thing that could happen to this country.

I think that Ted Cruz becoming president is worst thing that could happen to this country.

In reality, the idea of Trump becoming president is incredibly frightening. But on the other hand, Cruz is vocally against all the issues that are personally really important to me: Gay marriage, Planned Parenthood/abortion/birth control, global warming, gun control, Obamacare.  Don't get me wrong, Trump is on the wrong side of all of these issues, but not quite as vehemently.

On the daily show, they compared it to a blood clot versus cancer. I can't remember who was who.  

Thursday, February 4, 2016

Mystery email

This was an email that my mother sent me yesterday:

"Got two leg wrenches. What about the elves?"

It took me a long time and deciphering one typo before I figured out what she was talking about. Any guesses?

Wednesday, February 3, 2016

Med school living

I lived in college dorms for four years but I've never experienced such shitty living conditions as in my med school dorms. I give you an example of messages they have left me on my answering machine:

"Sorry to inform you that your water will be shut off for the entire weekend, from Friday night through Sunday at midnight."

"We will be replacing your carpet tomorrow. Please remove all items from the floor of your room."

"You have failed inspection due to boxes in your kitchen. You will be charged a penalty."

"Workers will be entering your individual rooms every morning this week."

"An exterminator will be coming this week. Please remove all food and other items from the kitchen."

"Due to unforeseen circumstances your water will be shut off until 6 PM today, starting in ten minutes."