My parents think I work in an environment that looks like the TV show ER.
I tell them it's not really like that, it's much quieter, there's a lot less drama-- but they don't really believe me.
So let me spell it out. We sit in a narrow little room with some phones and old computers, typing in orders and checking lab results. Every so often the phone rings, we pick it up, a nurse tells us the patient in room 816, his blood pressure is over 180. I get up, I go check on him, I tell the nurse to keep monitoring him. I go back to the little room and ask the resident what we should do, he says monitor him. We wait. I check my e-mail. I go to the bathroom. The phone rings, I pick it up, a nurse tells me another patient is having trouble breathing. I get up, I go check on her.
It's quiet, if that makes any sense. It's lazy, almost. Which sucks. Because it makes it feel really unimportant. Of course it's not unimportant for the patients, but in the scheme of things-- being a doctor is supposed to feel important, it's supposed to feel like it matters. And maybe it's a function of this particular service in this particular hospital, but, man, it doesn't feel important at all. It feels like medical babysitting. I don't get to know these patients, they're in and out. Our job is to get them out of the CCU -- whether that's by getting them moved to a regular floor, getting them discharged, or watching them die, our job is to keep as few bed filled as possible. So I meet someone, they stabilize, they leave. I'm not part of their care, I'm not really helping them get better, I'm not really a part of their team, they will never remember me. And I will never remember them. And there's no one here. You can hear a syringe drop.
This is the lack of sleep talking, but-- it's not fair. It's supposed to feel like it matters. If I didn't want a job that felt important, I would have skipped the past 4 years of school and become an accountant. Then I could work in a quiet office doing paperwork, ostensibly helping people but really not so much. That's what this feels like. I'm providing a service, sure. It's just not a very interesting one, and even the parts that are based on the knowledge I have aren't that interesting. We look things up in books. My lawyer friends do the same thing except at least the halls are busy, at least people yell at them. I wish I was on ER. Maybe it's the adrenaline rush that I want-- but I don't think that's quite it. Because I can imagine being happy in private practice-- or at least I thought I could-- where it might be a little slow but at least there's some personal connection, at least I know the people I'm working with and the patients I'm seeing, at least I feel useful. I don't feel useful here. I feel like a babysitter.
And I feel tired.
I'm sorry this blog is so depressing. I should have better stories. I should have more interesting patients and medical dilemmas and problems to solve. I should have more behind-the-scenes excitement I can share. Except there is no behind the scenes excitement, at least not this week. There's just a little, narrow office with a couple of computers, and me, waiting for a nurse to tell me someone's vomiting. At least I'm not a nurse. One of them pulled me aside yesterday, as if she was telling me a secret. "No clean-up staff here," she said, in broken English. "If patient make a doody, I clean up." Thanks. Seriously, thanks, because otherwise I'd be cleaning it up. But, gosh, being a nurse-- and being a doctor-- should be about more than patient doodies.
Friday, August 7, 2009
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somehow it is more than just about doodies and passing meds... when i first started nursing this last year i felt like it doesn't matter what i do.. anybody can follow orders and wipe someone's tail end... but in the moment that i'm doing that specific task - nobody else is. just me. and i'm doing something maybe that patient couldn't do for themselves. and beyond the factual and tangible image of what is happening there's really more going on than we think. especially when you really do care and you really do want to make a change for a patient...not just a patient, but an individual who's sick..sick enough to be in a hospital. who's probably going through a lot trying to sort out employment issues, family issues, monetary issues. and just think...when you're through all this medical tradition you'll be free to make a difference wherever and however you wish... i know it's several years off for you, but...it's something. in the meantime, thank you for caring for your patients and being thankful for your nurses :)
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