* * Anonymous Doc

Tuesday, September 8, 2009

Why does everyone die at 5AM?

Oh, maybe it's because that's when the nurses do their morning rounds to check if everyone's still alive... and some of them aren't.

I wish I could say I was off for Labor Day, but I wasn't, and instead, for the fourth night in a row, I did chest compressions at 5AM on someone who'd probably been dead for hours, and they're still dead. Not that any of these people weren't going to die in the middle of the night, but it's sort of pointless to have night nurses if they're only checking on the patients every 4 hours. The big secret no one gets about hospitals is that, by and large, we're not doing a whole lot more for you than you could have done at home.

Unless we're performing surgery, or you're getting IV drugs or fluids, what are we really doing except giving you a bed, making you (terrible) food, and giving you brief daily access to a doctor who may or may not know all that much about your file, and might tweak your medications, mostly a stab in the dark to see if maybe you aren't actually as close to death as it seems.

For most people, probably better off at home.

Plus, it's filthy here. I did get to lay down for two hours on Sunday night, because no one was paging me and the dead patients had yet to be discovered by the nurses. We have cots here. Dirty, stained cots. And then today my head started itching. And itching. And finally I had my co-intern check if there was anything going on-- and I had lice.

The hospital gave me lice. Maybe that's why I'm especially angry today, or especially fed up, or, I don't know, especially negative about this whole enterprise. The cot for the interns to sleep on gave me lice. You're not supposed to get lice in the hospital. (I would add, "especially if you're a doctor," but, hey, we're exposed to the same stuff the patients are.) Now, maybe you could argue it's not the hospital's fault-- if another intern had lice, and slept in that cot, what are they supposed to do?

Well, how about CLEANING the bed? How about making it a policy to sterilize the places anyone-- patient or doctor-- might be sleeping, since, hey, it's a hospital, there's illness floating around. If a patient has lice, and then leaves the hospital, I would hope the next patient wouldn't be exposed. I would hope they'd be cleaning things thoroughly enough that whatever you have doesn't pass to the next person who's in your bed. That hope would be false hope.

We have patients every night threatening to leave AMA (against medical advice). We're supposed to convince them not to-- and a few of them probably shouldn't, because they'll just end up back here in 24 hours, or dead. But a lot of them, hey, they should probably just go. Not just so they'll stop being terrible patients and taking our attention away from the people who actually want our help, but also because they'll probably do better outside of here, where they can eat real food and spend time with their families and not be tortured and prodded and poked all day.

And they probably won't get lice.

And we don't even have any lice shampoo here-- it's over the counter, I have to go to the drug store on the way home and get it myself. This is a HOSPITAL. A dirty hospital where every night patients are dying and no one's noticing for hours.

This is my job. This is the life I've signed up for. 33 more months.

Tomorrow I start days again. I have two hours in between tonight's night shift and tomorrow's day shift. I don't know where sleep falls into that schedule. But I wouldn't really want to be my patient tomorrow afternoon, when I've been awake for more than 24 hours and am running on fumes. And I have lice.


  1. Don't know what to say, other than--Hang in there...Hopefully things will get better soon.

  2. Hey now, don't blame the night shift nurses! We're busy too, and I for one check on my patients very frequently. Perhaps you're in a hospital where there isn't a very good nurse to patient ratio, which is unfortunate. Nice to have insight as to what some doctors really think of us though...

    I am sorry you got lice. I actually happened across your blog because I took care of a patient last night who had lice - gave him a bath and everything - and I'm paranoid that I'm going to get it. Hospitals are very dirty, I agree!