* * Anonymous Doc

Wednesday, September 2, 2009

"The family wants to speak to the doctor."

I don't blame the family for not realizing this, but if you ask for a doctor at 8:30 at night, you're not going to get a doctor who knows all that much about what's going on. I have 75 patients when I'm working the night shift. I'm executing orders from the day team, I'm making sure nothing bad happens, I'm reading the chart-- but I don't feel terribly qualified to say anything to the family about the patient's condition without worrying I'm going to say something wrong or stupid. I'm only the babysitter, not the parent.

This is an unsolvable problem with hospital care. Because the patients are here 24 hours a day, 7 days a week, and the doctors aren't (or at least we shouldn't be), there are so many handoffs-- on the doctor side and on the nurse side-- and it's impossible to always be fully informed about everyone. Especially when you're on nights, or you're floating between hospitals filling in. You'll have one person during the day, another person at night, then the fill-in on the weekend, and another fill-in when the night person has his day off.

It's not a problem, it's just how it is. But it means that for the patient and the patient's family, there's not always going to be someone equipped to tell you everything you need to know. Which is frustrating for the family, I'm sure. Which is why I like to tell the families what time the attending does his or her rounds. Not that it helps.

"Be here at 8AM, and you'll get to talk to the whole team that's dealing with your mother's care."

"But I want to talk to someone now."

"I'm the only one here now, and all I know is what they've written in the chart. I met your mother an hour ago, and she was asleep. And she's still asleep. I understand you want to know what her prognosis is, but I'm not the one who's able to talk to you about that. I don't want to give you wrong information."

"This is a hospital. My mother should be getting medical care 24 hours a day, not just when her doctor feels like coming to visit."

"She is getting medical care. If she needs medical care, the nurses and the doctors are able to provide it, 24 hours a day. Right now, she's sleeping, she's stable, she's taking the right medications, we're giving her all the proper treatment. But if you want to talk to the resident in charge of her file, that can't happen until the morning."

"But I'm here now."

"I know."

"And I want to talk to someone now."

"If you'll tell me the questions you have, I can leave a note for the resident and he can either find you in the morning if you're here, or he can give you a call."

"I don't want to talk to the doctor on the phone, I want to talk to him now. What kind of doctor are you if you can't tell me how she's doing?"

"She's stable. Right now your mother is doing fine."

"But when is she going to get to go home?"

"I don't have the answer to that."

"Well, you should."

"I will have someone give you a call in the morning, if you'll leave your phone number."

"I don't want to give you my phone number."

"Then you can leave your phone number with the nurses when you leave, and they can relay the message."

"I want to speak to your supervisor."

"My supervisor is saving someone's life right now."

"Then I want to speak to his supervisor."

Surprisingly enough, the patient seems like a lovely woman.


  1. I can relate to this....relatives are much more demanding than most patients. (and so unrealistic!)

  2. 75 patients! Holy moly, I'm pretty sure I don't ever cover more than 40 max on overnight call. We don't have night float here though, we take admits on call nights.