Is this my life? Where?
I just slept for fourteen hours straight. It's official now. I used to eat and sleep and work (not in that order) and now it's down to just sleeping and working. (Well, I did do my one minute number on a Clif bar during rounds yesterday morning, and then inhaled yogurt on my drive home--more to keep me awake than anything else). I'll ask it again, who lives like this?!?
My schedule this month is ridiculous. On call nights I am up most if not all of the night, so that's 30 plus hours without sleep. This last call I got the 2 am admission and could barely remember what questions to ask. Fortunately she was stable and we could sort her out in the morning (a little more anyway, she's actually really complicated and interesting: 14 year old girl with acute onset vertigo and hearing loss after a whistle was blown right next to her ear while playing soccer).
What really slowed me down this last call was having three med students working on most of my patients. It's nice when you have med students to write progress notes and it's actually great to be able to teach them a lot, but they are not as fast as I would be by myself (understandably) so it takes longer to get everything done. Which is okay.
Got to do the lumbar puncture this call again, too. Went much better than last time. We got in with only two tries. That little baby is interesting, too. She's only 15 days old and has this huge hard lump behind her right jaw. She has persist ant fevers and on CT the following day it looked like an abscess, so we're pretty sure that's what it is. But the real questions is why does this 15 day old have an abscess there at all? ENT was going to see if they could drain it either today or yesterday. The mom lives way far away and has no money or phone. The last time she called in she was at the bus station about three hours away, hopefully she'll be there when I get in this morning.
That's the other thing that cuts into my lifetime: on non-call days, we have to go in at 6 am and stay until 6 pm...everyday! In medical school once we were done with our patients for the day, we checked on to the on-call team and left, but not here. That is really a hard part. I really am the the hospital all the time. And up for admissions all the time. If I were in charge of the world, I'd change things around at the hospital schedule and systems level.
One of my other parents would agree with me, she's frustrated because her son can't get anything down on Sunday and she isn't included in rounds. I know that is hard. Plus he's pretty sick with HUS and just past the peak of his acute renal failure. He's miserable and, as a parent, she hates it and feels powerless. And, frankly, the way the system is at the hospital, we don't do much to help. In Cincinnati, we did "family centered" rounding, with the attending and the whole team AND, imagine this, the family present, so everything could be discussed at once and there wasn't a bunch of running around and having to check with this person or that person. It was all right there. The families loved it.
I could go on, but guess what? I have to get to work. I'm rounding on twice as many patients this morning because the other intern on the team has a day off. That's sixteen patients to see (when I don't know half of them very well) in one hour and fifteen minutes. It's impossible; I've already accepted that. I'll just do my best.
My schedule this month is ridiculous. On call nights I am up most if not all of the night, so that's 30 plus hours without sleep. This last call I got the 2 am admission and could barely remember what questions to ask. Fortunately she was stable and we could sort her out in the morning (a little more anyway, she's actually really complicated and interesting: 14 year old girl with acute onset vertigo and hearing loss after a whistle was blown right next to her ear while playing soccer).
What really slowed me down this last call was having three med students working on most of my patients. It's nice when you have med students to write progress notes and it's actually great to be able to teach them a lot, but they are not as fast as I would be by myself (understandably) so it takes longer to get everything done. Which is okay.
Got to do the lumbar puncture this call again, too. Went much better than last time. We got in with only two tries. That little baby is interesting, too. She's only 15 days old and has this huge hard lump behind her right jaw. She has persist ant fevers and on CT the following day it looked like an abscess, so we're pretty sure that's what it is. But the real questions is why does this 15 day old have an abscess there at all? ENT was going to see if they could drain it either today or yesterday. The mom lives way far away and has no money or phone. The last time she called in she was at the bus station about three hours away, hopefully she'll be there when I get in this morning.
That's the other thing that cuts into my lifetime: on non-call days, we have to go in at 6 am and stay until 6 pm...everyday! In medical school once we were done with our patients for the day, we checked on to the on-call team and left, but not here. That is really a hard part. I really am the the hospital all the time. And up for admissions all the time. If I were in charge of the world, I'd change things around at the hospital schedule and systems level.
One of my other parents would agree with me, she's frustrated because her son can't get anything down on Sunday and she isn't included in rounds. I know that is hard. Plus he's pretty sick with HUS and just past the peak of his acute renal failure. He's miserable and, as a parent, she hates it and feels powerless. And, frankly, the way the system is at the hospital, we don't do much to help. In Cincinnati, we did "family centered" rounding, with the attending and the whole team AND, imagine this, the family present, so everything could be discussed at once and there wasn't a bunch of running around and having to check with this person or that person. It was all right there. The families loved it.
I could go on, but guess what? I have to get to work. I'm rounding on twice as many patients this morning because the other intern on the team has a day off. That's sixteen patients to see (when I don't know half of them very well) in one hour and fifteen minutes. It's impossible; I've already accepted that. I'll just do my best.
posted by S. at 5:08 AM
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