I'm getting sick. Which sucks for me, and sucks for my patients, since I'm not sick enough that anyone's going to actually want me to stay home, but I'm totally sick enough that I feel like I'm sleepwalking through the day. I don't think it's anything real-- right now I'm just a little sniffly and there's a little scratchiness in my throat-- but it's still hard to be "on" for 12 hours in a row when all I want to do is lie down and take a nap.
Today was my first day of the new rotation, which is a relief because if I had to spend one more day where I was, I think I was going to jump out the window. On Friday I was at the hospital until midnight, and it wasn't much better on Saturday. We had one patient who came out of surgery and started acting psychotic. We didn't know what was going on, ran a whole battery of tests, called in the attending, thought he was having a reaction to something, that maybe something serious was going on... and then he had a moment of lucidity and told us he forgot to mention he was on a couple of medications that we didn't know about and hadn't given him... and so this was just withdrawal from those. Awesome. When you're in the hospital, please tell your doctors all the medicine you take and not just some of it. Otherwise we think we've done something wrong when really you're just a moron.
The new rotation seems better. Different hospital-- private instead of public; my first time doing a rotation at this one. There's a big difference as far as the nursing staff. It's really quite crazy. I didn't realize there would be such a difference, but these nurses actually know things, and actually do things. One of them entered the patients' overnight lab results before I got in-- I was floored. They know what lab results are? They know how to use the computer system? Incredible. Not to disparage the nurses at the other hospital, because, hey, they've probably just never been told to do any of this stuff, and are short-staffed and some of them work hard, but it's night and day. They actually hire enough nurses here, with enough training and education, that they seem truly helpful. Maybe I'll be able to go a whole month without having to collect any urine samples on my own. I can dream, can't I?
Monday, December 14, 2009
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welcome to the civilized world!
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The worst of your experiences are identical to something you might find unexpectedly similar: caring for a baby! I am a single parent of a baby I adopted at birth (he's 3 now). I had to fly to another state to get him, stay in a hotel with him (with nothing except diapers and formula) while the paperwork was clearing, then take a cross country flight with a 5-day-old. (You think the airline was nice to me, under the circumstances? Think again). (My family lives in another state, so I was really on my own. The working 12-15 hour "shifts" while sick? Been there. Having to listen to the smug nonchalance of other mothers (whose kids are older now)? Been there. Having no one to help me with menial things so I can take care of the urgent things? Been there. Wondering why it is this way when I can envision another, more effective, more efficient way? Been there. Not "liking" or even caring about my "patient" (baby) and feeling shameful about it? Yes, those moments too, which I have come to find out comes with sleep deprivation (sleep deprivation makes you switch into survival mode -- your own survival, that is). Being left to figure out eveything myself while dreading if one mistake will have dire consequences? Been there, too. But, time passes, my child is now 3, perfectly behaved (except for the whining) doesn't require these extreme things of me anymore (just when I got good at it) and I look back and think, DAMN, I'm good. You'll feel that way, too. Remember, you ARE already succeeding at it. Hang in there.
ReplyDeleteIt's pretty much an open secret that a major difference (certainly not the only difference) between hospitals has to do with the quality of the nursing care.
ReplyDeleteso I must say that as a cardiothoracic ICU nurse in a large, public, teaching hospital, we have been told not to put in the orders for the physicians....why because it is not our job! It is you as the physician/resident to take care of and manage the patient. We used to put in all the labs and sometimes we still, however, take responsibility and order your labs. Whatever isn't ordered can not get done.
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