A better title would be the afternoon after.... after call. What we call "post call". I have tried various different methods of dealing with the post call day. A day that requires some rest after working for 32 hours, but also a day that pleads for some leisure since you get very little time off. Post call day usually starts about 1pm, after my patient's are tucked in and my consultations to other services all called and arranged. After I type the daily progress notes for the stooper of a morning I just stumbled through. After the medications are all updated and the patient's have had their attention. After I finish updating the signout list. I was lucky, I snuck in an hour of sleep last night between the constant barrage of pages for "potassium of 3.8, should I repleat it?" "Uh... your patient in bed 7 just extubated himself" to which I replied, "If he is breathing comfortably, that is great!".
Post call is sorta nice though. It is a free pass to be lazy. I usually sleep for 2-3 hours on the couch, then wake for a relaxing evening with no expectations. I sometimes go out for a meal or stay in with a DVD. I don't worry about getting things done or cleaning the mess the preceding days have left in the kitchen as I come and go from the house that simply offers me sleep and sustenance. I get to bed early and try to recover some of the lost hours of sleep, 9 hours usually feels pretty good. Today though I have a sore neck that I can't even turn and a headache that is killing me. I think it is from sitting at the computer typing notes all night... so perhaps I should stop sitting here right now making it worse. What is funny is that as frustrating and fatiguing as call nights are I am always comforted by the thought that this is not my life, only 4 weeks. I am learning good stuff about Cardiology despite being too tired to read articles or board exam review (which comes up soon). I like being busy and I like trying to fill the shoes I spent 4 years in medical school earning. Some days I fall on my face, others I manage to stand upright. I will not miss these nights when they are gone though.... today was just an average day. I worked, patients improved, nothing miraculous.
I can say that it was the first time I ever SENT more patients to the ER than I received from the ER! I only had one ER admit and a couple direct transfers, so it was a light night as far as new patients go, but a heavy 'crosscover' night. During the night I had one member of a patient's family have a "syncopal episode" in the hall outside the ICU.... a trip to the ER for her. Later I had another family member of a patient exihibit worese problems than the patient she was visiting! We had someone in the ICU on various drips for hypertensive emergency. For SOME reason the nurse decided to check the daughter's blood pressure and it was in the mid 200's! A trip to the ER for her too..... which reminds me of some more wisdom I am learning from my senior residents.... don't run tests you don't absolutely need because if you do you will just find abnormalities that you will have to track down, treat and explain on rounds the next morning! :-)
0 comments:
Post a Comment