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Saturday, February 19, 2011

A Physician's Closest Enemy...

... is actually the patient's lifeline. That brilliant little invention called a Beeper or Pager that's designed and built to keep you alert and reachable,  and without which the phrase "on call" would have no practical meaning whatsoever.
That's all very nice. I mean it's really hard to conceive of a hospital functioning without pagers. Every single attempt at communication would invariably take longer, cost more, and be more burdensome on staff and patients alike. So here's how it should work:

1- Patient need something
2- Patient calls nurse
3- If nurse can handle it, stop here.
4- If nurse can't handle it:
5- Nurse picks up a phone and pages Dr. Fixit
6- Dr. Fixit shows up happily within minutes and sorts things out.

Great stuf right? 6 easy steps towards better patient care! Right? Well, only when it works!

BUT... (hehe) what happens when you mix needy and naggy patients, an incompetent nurse, and a doctor worn out by 14 hours of floor work during the day, and 3 hours of the same after sleeping hours? well things turn out a bit different... like so:

1- Patient needs attention = Patient nags about the lighting in the room
2- Patient calls nurse
3- Incompetent nurse prances in and freezes at such an impossible task as putting the patient to ease
4- Incompetent nurse freaks out, picks up a phone and pages Dr. Wornout at 3 AM
5- Dr. Wornout is bummed that the stupid pager's ringing again but humbly picks up a phone and responds
6- Incompetent nurse tells the story
7- Dr. Wornout cannot believe he's been woken up for such a lame story
8- Dr. Wornout screams and cusses out incompetent nurse
9- Dr. Wornout still might have to come over and talk to the patient or prescribe sedatives across the floor to get some peaceful sleep.

Ah, yes! This is perhaps a more accurate description of many of the calls we get on a night's duty. Thinking about it is funny. It really is! I can remember being paged for the dumbest stuff! And I swear all of these are true stories!

BEEP! 2:00 AM, 10 South: Doctor, doctor! The patient in 1026 refused to wear the face mask that was keeping him alive. He says it's too bulky, and his oxygen saturation went down to 70. But don't worry I called Inhalation Therapy and they convinced him. - "Wow good job, stupid male nurse! Thanks! "

BEEP! 5:00 AM 8 North: Doctor, Doctor! The patient in 823 Just called me and said she just had her period. - "OMG are you really calling me at 5 in the morning for this?! What do you want me to do, bring pads!?! Is this an emergency? Is she hemorrhaging?! - No - Well?!!? - ok thank you Doctor.

BEEP! 12:00 Midnight 9 North: Doctor the patient in 922 is ready for his blood transfusion, if you could bring up that unit? - Ok on my way - I get to the floor - Here's the unit, start the transfusion - Oh but Doctor the patient was taken down for his CT scan. - Is he coming back soon? - We don't know so we can't keep the blood unit here, in case it takes longer than expected; you have to take it back to the blood bank and check it out again when the patient comes back. - !@#%#$^$%&*^%$#!@#$#$@%@# You stupid MORON!!!!!!

BEEP! 1:00 AM 10 South: Doctor? I was wondering why the patient in 1036 is taking Methotrexate? - Ok I'll go along with this, He has scleroderma, to satisfy your hunger for knowledge at this hour of night... - Ooh ok, and Why are you giving him Tazocin? - For his pneumonia honey what's up? - Oooh true but why not Tavanic? and since he has pneumonia, why didn't you order him an incentive spirometer? - Hmm are you really calling me to suggest medical management is incorrect? Can I !@#$ing go back to sleep now?! Promise we'll talk in the morning!

No disrespect to nurses, but please help us out with our crazy duties! There are things you can handle, and things you can't, know which is which!
It's funny remembering all this stuff and I'd like to take a moment to say that not all nurses are like this! I've worked with a few nurses who had excellent judgment, knew how to talk to patients and resolve issues like lighting and air conditioning, but also comforted their patients for a peaceful night's sleep without the need for Lexotanyl! Some admittedly knew more about medicine than I did and they have my full respect and admiration. You make our lives easier.

Cheers to a completed Internal Medicine rotation! 

Comments (4)

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I'm sorry, but you missed the most important words that they begin all conversations with:
1am: Doctor," just to let you know", the patient is having her period
2am: Doctor," just to let you know", the patient farted
3am: Doctor, "just to let you know".... (you get the drift)

Translation of "just to let you know": in case anything happens from now till my shift ends, I have zero responsibility for any of it, its off my back and onto yours .....
True... True... how could I forget! "Just to let you know" hehehe
ok... i will be taking the nurse's side:
1- just to let you know, in case you forgot already, when a person becomes a doctor, he/she will be ON CALL for the REST of his/her life. No law specifies what the reason behind the paging should be (stupid or serious). GET USED TO IT
2- just to let you know, usually (and here it depends on the country you live in, where docs are always right) nurses take all the blame in case anything wrong happens to a patient, (form the stupidest to the most serious stuff). This is why it's understandable that they look for a way to take off some of their responsabilities and put them on the doc (who is ON CALL and should GET USED TO IT)
3- just to let you know, or please let me know, which party earns more money??? and don't give me a lecture on how you (doctors) spend you life studying, nobody forced you into anything, you took a choice, GET USED TO IT!!!!
4- just to let you know, you can always switch to dermatology, there's less paging there....
and finally just to let you know, i still luv you, Dr. Fixit!!!
Well Nad when did you become a nurse?! hehe Now listen up. Listen up GOOD:
1- I am on call for the rest of my life. Indeed. However, settling a brawl between 2 patients fighting over air conditioning (again, NONE of this is made up, I Promise!) is NOT in my job description, nor am I qualified to do it as a physician. And you and I both know I will take the side of whoever wants to keep the AC freezing anyway!
2- Like Dr. L said, the only reason a nurse pages a doctor over the stupidest stuff is BECAUSE she wants none of the responsibility. But WOW I didn't know that a nurse could get in trouble and lose her licence because one of her patients HAD HER GODDAMN PERIOD!!!!!!!!!!!!! oh my GOOodD!!!
3- At AUH, at the present time, a nurse earns some odd 150$ MORE than a resident every month. So there goes that argument! and do I need to mention the fact that I'm actually PAYING the hospital money so they'll let me be their slave? Please keep the money argument until I'm the attending on call... then we'll talk hehehe
4- Dermatology is for the weak minded :) hahah

So there. I still despise useless late night pagings and so help me I will always do.

Love you too nad :)

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