The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Wednesday, June 28, 2006

Things I would like to get off my chest...

In honour of my last day of my internal medicine rotation, I would like to air some grievances. So here, in brief, are a few things that I've wanted to say at some point during the past two months.

To the nurse who paged me at 3:30 in the morning, 10 minutes after I had managed to drag myself to my call room for the first time that night-- you seriously called me to clarify a TYLENOL order from someone I'd just admitted from emerg? Are they in dire need of Tylenol RIGHT NOW? No? Then leave me alone.

To the woman who gives out the call room keys at the information desk of the hospital-- I am aware that it is 4:45pm. I am also aware that we aren't supposed to pick up call room keys until 5pm. But this might be the only chance I get to get down to the information desk before the keys become fair game to other services at 1am. So unclench and give me a freaking key.

To the patient who told me that the reason she was feeling better was because my attending was such a good doctor and that she really respected and valued his medical skill. My attending couldn't pick you out of a lineup. I am your doctor, for all intents and purposes. I am the one who has visited you daily, managed your care, fought on your behalf for tests and spent time looking up information on alternative treatment options. He visits you for about 10 seconds every second day or so. Not that I'm looking for a medal here, but seriously!

For the rookie nurse that just started on the floor-- I don't envy your position. You must feel overwhelmed. But if you call me in the middle of the night wanting something ordered, please at LEAST know what the person was admitted for, what other meds they're on and what allergies they have. When I have to sit there holding the phone while you say "um, I'm not sure" and look through the patient's chart, I am not amused.

To my senior, who knows a helluva lot of internal medicine and very little about people-- that's really something you need to work on. Yelling at a patient's family member because she doesn't understand the difference between "intubation" and "resuscitation" when clarifying code status will not win you Humanitarian of the Year awards.

To the infection control people, whomever you are-- my patient has been in the hospital for three days with a COPD exacerbation. I have no idea what posessed you to decide that he needed to be in isolation with droplet precautions AFTER we discharged him home (for the 15 minutes he was waiting for a cab) but that may win the prize for the most ridiculous hospital policy ever.

To my attending-- don't manage my patients behind my back. Particularly not if you're going to decide, with the help of the urology attending, what the right treatment is for my patient when you've never taken the time to actually meet her. If you'd spoken to me, you'd know that putting a percutaneous nephrostomy tube in a developmentally delayed woman who yanks out lines as fast as we can place them is a recipe for disaster.

To the entire Interventional Radiology department-- what the hell makes you so special? Why can you get away with not answering phones, not returning calls and not answering pages? Why do we need to actually go down to IVR and seek you out in person and beg you to perform procedures on our patients, like you're doing us a big, fat, favour? IT'S YOUR FREAKING JOB!

To the nurse on 4Z who paged me 4 times in an hour because I hadn't come to pronounce her patient yet-- as I've told you three times already, I am dealing with someone crashing on the floor. Your patient is unlikely to get any deader. The one I am treating right now is a very different story. So no, pronouncing your patient is not my priority right now.

To the chief medical resident who made up the call schedule for the month of June-- was scheduling me for 4 call in 8 days a punishment for taking vacation at the beginning of the month? Or are you just trying to kill me? And I know that someone has to be on call on the last day of the rotation... but why does it always seem to be me?

Sigh. I feel better now.

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Blogger Blog-o-licious said...

OH MY GAWD, there's not enough money in the world to make me want to be a hat's off to you sister! Kick ass!

12:54 AM

Blogger Medstudentgod said...

Profound statements about IM. I am dreading that rotation whenever I have it - I'v almost always heard bad things about the experience...congrats on making it through.

9:14 AM

Anonymous Anonymous said...

I'm afraid it doesn't and won't get any better, my dear. Welcome to the real world. As you climb up higher on the ladder, the landing gets tougher and the fall harder.

10:51 PM

Blogger Kungfukitten said...

Oh man, will things be easier this year for you? Or at the very least will you get money - more money? I applaud the fact that you have not actually throttled any of your co-workers. Although for a small price...

3:44 AM

Blogger M. Dyspnea said...

loved the post. very funny.

9:02 AM

Blogger Couz said...


I'm still trying to figure out if "anonymous's" comment was intended to be condescending or just extremely bitter.

12:33 PM

Anonymous Anonymous said...

Speaking from a nursing viewpoint, we do page doctors when we catch errors otherwise it will be easy to forget and medical errors can occur. We cannot "SAVE" clarification requests until we think it's a better time for you, we have a million things on our scut list too.

1:40 PM

Anonymous jojo said...

Ha ha! I can't help but laugh. It's all soooo familiar.

4:31 PM

Blogger Fat Doctor said...

I feel better now, too. :)

5:28 PM

Anonymous Glenna said...

Ahhhhh....thank you. Your frustration is my frustration. I've just spent the last year 3 days a week as a student in the hospital seeing all kinds of stuff liek that. Now I'm a real live RT orientating into adult critical care. You make me feel so much better about my experiences and wonder why were weren't all born independently wealthy so we wouldnt' ahve to work for a living.

12:41 AM

Blogger shrimplate said...

As a nurse, I myself would not page anybody at odd hours for a Tylenol order. But let me explain:

In my hospital, as in many, the medications including Tylenol are all locked up in a computer-controlled "dispenser."

Most of the time it doesn't dispense anything. It just keeps these locked up so we *can't* dispense them, and Pharmacy needs an order to put into the computer to allow the damn thing to give out the effing Tylenol.

So we HAVE to call to get orders, which we must fax to the Pharmacy, or we can just make up the damn order ourselves (illegally) and scrawl some indeciperable alleged name of a resident on it and fax *that* to the Pharmacy.

I could walk out of the hospital and go a couple blocks to a local drugstore and buy the stuff myself faster than the Pharmacy will computerize the order.

Anyways, that's probably one of the reasons some of you get those stupid calls in the middle of the night. Nurses don't like to be put in illegal situations just to hand out over-the-counter meds. We have no choice but to call you.

Yes it sucks but I don't make up these stupid laws and rules.

10:29 AM

Anonymous Anonymous said...

Wow.........maybe you weren't cut out for this. As a nurse reading your blog I was somewhat offended. As an ICU nurse myself, the reason that you get called for clarifications on orders is that our butt is on the line when the order isn't correct. We are the the ones who get called and chewed out by the pharmacy department. We aren't out to make your lives miserable, we are there to DO OUR JOB! As a result of US doing OUR job, YOUR butt gets covered! Thank you very much! We are the ones that spend 12 hours at the patients side, we are the ones worrying about every little thing going on with the patient. I realize Tylenol isn't a life saving drug, but come on!!!!

8:58 AM

Anonymous Anonymous said...

A few clarifications for you...first your job is to take care of patients through the night not to sleep in your physician lounge. sorry about your luck.
Second your attending is YOUR BOSS and I would love to hear the physician's take on this situation.
Third you should really make the nurses your friends not your enemies or you just might make you life a little harder later.

9:38 AM

Anonymous Anonymous said...

Ok little girl pick a new profession! You are not cut out to deal with people. I think maybe you should go into radiology and sit in a dark room and not interact with the human race. Your attitude sucks! You are the reason women are looked at differently in the medical field. It's the nurses' license that get taken away when a wrong dose or wrong med is given to a pt. Yes the pt is dead but we need the bed so your dumb ass can admit another 89 year old with CA mets! And then expect our ass to take care of it. We as nurses are the ones at bedside taking care of the pt. We do everything! We should get the freaking medal you wish was pinned to your ass! Your attending is more special than you and you will feel the same way when you if you do get to be an attending. So shuve that up your internal ass if you can get your head out of it.

10:05 AM


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