Sunday, May 27, 2007

why the f#$@ do you have that cap in your throat?

Survived the first round of nights, I was pretty lucky no one died on my watch. You must be humble as the reason no one dies is rarely related to you. A really busy night last night. There were three "Rapid Responses", the emergency level right below a "medical code" (what you see on television). Regardless with only four doctors managing the hospital you must run for these as well. The first was a "GI bleeder" she was bleeding from her mouth and rectum. She looked like death but medically speaking she was boring, not much to do since she is DNR (do not resuscitate ) and is not a surgical candidate so I called the daughter and told her her mom may die tonight.

The next two rapid responses were for an alcoholic recently arrived from the ICU (my co-interns patient) who was having difficulty breathing. I actually didn't hear the overhead the first time it was called as the overhead system isn't very good and I was either in the ED or elsewhere. They gave him nebulizers hoping he gets better. The next overhead for the same guy I came running. This guy looked like he was having a tough time I reckoned. We check the vitals Blood pressure OK but for some reason he kept getting worse so we prepared the patient for "bagging" and imminent intubation( putting a tube in his throat and hooking him up on a ventilator). As this was going on his oxygen start dropping precipitously, we are about to start bagging (helping him breath by blowing air in with a large balloon) him when the respiratory therapist goes, "first take out that thing in his mouth" ..........what did she say ?......Thing in his mouth ? Holy Shit I quickly yell to the nurses to get a spoon as my friend and co-intern turns him on his side and starts wacking him on his back. Fortunately the nurses bring me instead of a spoon a pair of tweezers. Not having done any practice in surgery or stitching in some time I was a little concerned with my hand-eye coordination, one wrong push and this is down his throat and he is dead. My first try was unsuccessful but on the next try I succeeded. The pt may now be brain dead but alive.

One other quote from a guy with a skin infection last night . "When was the last time you used drugs"?
"A few days ago I put cocaine on the infection to kill the pain, pretty dumb huh"? I told him "Well I don't know I have not heard of that before ". In theory though maybe it does work, not so dumb after all.

Tuesday, May 22, 2007

Beer goggles

Now that I am on night shift and can't really go out much I have noticed some nurses (I strss some see other post ) are getting more attractive, is it the late nights in the hospital or lack of any other choices all week long or maybe they are actually attractive. I really need to know before I make any choices I regret.

Saturday, May 19, 2007

Nurses, are they brain dead?

My only free night here as I am now on nights, which really means the night and half the next day. All I can say is WOW! Working my ass off running around covering 8 lists following up labs and admitting 5 new patients. So I get pretty frustrated about incessant dumb pages from nursing, Examples from last night 1:00 AM "Doctor, the patient is coughing can I give him cough medicine?" I say, "sure do you need an order for it?", "No I just wanted to know".

Fine, stupid is one thing. I then get 5-10 pages between 1 and 3 am about a patient (who is a drug seeker) who wants more medication but who is under strict parameters because of his drug seeking behaviour by the day team. "No, tell him he can't get, he is over his alloted amount", click, 10 minutes later again I get paged same thing. Each time I run to answer it because it can be an emergency requiring my immediate response. The nurse tells me "but he is standing on top of me what should I do?" Call security I tell her after the 6th time what the fuck ( i didn't actually curse to her) am I supposed to do? She wants me to get the patient off her back so she can go back to her relaxation. As I go running around like a chicken without a head all I see on every floor are the nurses sitting on their chairs some sleeping, some yucking it up some talking about their next break, but one thing is clear....none of them are working. Not until 4 AM that is...

Nursing has alot of work after 4 am (meds, bp, and other real stuff) so obviously I get paged again...alot. 6 AM is my first "real" page of the night, this time 2 in a row and an overhead page within 5 minutes (I was in middle of a procedure so it took 5 minutes to return the page), it was regarding a patient who was real sick. I quickly run upstairs and start assessing the situation, I ask the nurse for an ECG as this patient was in bad shape. The response I get is, "Does that need to be done stat?" I already know where he is going, (officially nurses don't perform stat procedures). YES it needs to be done stat (you fuck) the patient is very sick, "Oh, we don't do stat procedures" I was gonna kill this guy, here I am alone trying to save this patients life and all this fuck cares about is to finish giving out his medications so he can leave on time. Where are his priorities, why is he nurse then? I myself left 2 1/2 hrs late. .....The patient died.

PS just to qualify the above, I do not feel all nurses are like this, just the ones at my hospital that share night shift with me.

Just how busy is the rest of the world?

Just to get this off my chest.

Was just cancelled on by my semi-blind date. You see this is my only free night for the entire week, not because I am going to the beauty parlor, but because I must work 15 hours a night, overnight, for the entire week. So I am a bit confused when I call this girl for a second date and tell her I can meet anytime arond the 24 hour window that I am not working and told that she is so busy she only has one hour available. Regardless I say fine and arrange my schedule and rush so I can meet at the specific hour that is conveniant for her. She then cancels at the last minute but would like me to call because she would "love" to go out again.....I don't think so

Friday, May 4, 2007

The Dilemma Part 2

Here I am, on vacation. The first few days were spent catching up on much needed sleep. But here comes the question, Do I just chill out for another week with the likelihood of being bored part of the time or do I push myself to go away just for the sake of getting away and come back to work (night shift no less) exhausted? As I ponder my question in bed the answer is coming to me by default.

The Dilemma

My apologies to any of the recent comments, I haven't been on this blog in a while to comment or publish, your thoughts are appreciated though. Two issues I have been troubled with recently. The first I will discuss here. If as the expression goes, "don't s--t where you eat" applies in the hospital setting and I have witnessed many poor results (though I must admit it is always from the girl end) then who are you supposed to be physically intimate /date? Our exposure to the outside world is severly limited by the hours and schedule we put in.

I myself am lucky enough to have social networks outside but even with that I spend sooo much more time with my co-workers. In addition to working together we also all live in the same building, so if you are tired and bored you call a co-worker and not someone living 35 blocks away to hang out. So I guess I am answering my own question and you must only hope to not catch any fecal oral diseases.

The second issue will be in my next post