About as close to losing it as I've been since starting residency. This rotation is awful. I'm the enemy. No one wants to hear they have a new patient on their team, especially not at 2AM, and I'm spending most of the night listening to arguments from the other residents about why this patient is too critical / not critical enough to be on their service. "He should be in the ICU." "She should be discharged." Fine, I get it, I was in their shoes three months ago, and I'll be back in their shoes next month, and I'll be fighting my hardest not to get slammed with more patients too. But we're all low on sleep, we're all here to serve the patient, why do you have to make me feel like I'm personally doing something to you? It's just the job, and we all rotate through it. I hate feeling like the bad guy. I'm just doing the job.
I had to call someone in at 3AM off the emergency backup team-- I had no choice, we couldn't handle the number of patients coming in, and that's what the emergency backup team is there for. I got called in in the middle of the night when I did emergency backup, and I was absolutely annoyed to be paged in the middle of the night-- and then realize when I got there that in the 30 minutes since they called, they took care of their backlog and didn't really need me after all. So I tried really hard not to call someone in. I waited until we were absolutely maxed out, no question. I probably waited too long. I probably should have called at midnight, but I hoped things would slow down. And then we had a rapid response and two codes and it was 3AM and I had 4 patients on beds in the hall waiting for someone to do their admissions... so I had no choice.
I call, I get an argument (of course) from the resident on emergency-- a friend, or at least a friend until I woke her up-- and then she comes through the doors right as her assigned patient's heart stops. She joins us mid-code, I'm leading a team of 9 people trying to do CPR and push drugs and get this patient's heart beating again. The family is in the hall, pissed that their mother/daughter/sister has been laying on a cot in the hallway for hours, untreated-- she was stable when I got her, she was stable throughout-- and we couldn't get her back. 45 minutes we're trying, finally I have to call it. I don't think there was anything we could have done-- the attending told me there was nothing we could have done, this was going to happen whether she was in the hall or in a room, whether someone had taken her full history or not, whether I'd called in backup at midnight or at 3AM. These things just happen. People come to the hospital and die. Unfortunately.
And the first thing my friend says to me as I'm calling to get a death certificate to fill out--
"You woke me up for a f[***]ing dead woman? Go to hell." And she storms out of the call room.
As if I planned this. As if I thought, hey, I know, I'll play a great trick on the poor resident on backup by calling her in just before the patient I need her to write a note on suddenly dies. That'll be a great plan! Really mess her night up. Awesome.
I'm supposed to let the backup person go at whatever point the backlog is handled and we can do without her. Of course the backlog wasn't handled-- we'd just spent 45 minutes trying to bring someone back to life, and the other patients didn't disappear during it. So she still had 2 or 3 admissions I needed her to do. But she didn't. She sulked through one admission in 5 hours before I freed her at a quarter to 9. Now this case with the woman in the hall is our big M&M (morbidity and mortality) case for the week. So I have to come up with a presentation to explain what happened and what we could have done better. With slides. Can't wait.
And then today a nurse blamed me for using all the paper towels. Excuse me. To clean up a patient's blood. I'm sorry I grabbed a ton of towels and threw them down. I figured it was better than having people slip and fall. Guess not.
I am not the enemy. I don't think I'm the enemy. Ugh.