Feb 21, 2010

Surgical call...


How can I be on surgical call for over 24 hours, two of which we were allowed to sleep, be busy for most of the night, and not see any... surgeries? Honestly, I barely know what was wrong with half the patients, though I certainly know what their labs were. OB-Gyn call could suck in that it was long and hard and you got scutted a lot and you were the definitive vitals/labs bitch, but all that stuff was punctuated with somewhere between 1 and 7 deliveries/c-sections a night which they insisted students be in on, so calling it "OB Call" was as advertised.

But guys, seriously. It's called "COMPUTERIZED CHARTING". For the love of all that is good and beautiful in this world, institute a program with more patient-organizing power than Office 97. That goes for about three quarters of the hospitals in this city. Why progress notes are still being scrawled illegibly on easily lost or damaged charts that have to be fought over by all the attendings, residents, medical students, and nurses who need them at the exact same critical times escapes me. And med lists... freaking... list every single medication a patient is *currently on*, changes to medication with date/time, and electronically attach that data to the patient's name. And to add an extra stage of programming that could be done by a precocious 12 year old with a Warcraft habit and his own 4chan meme, throw up a caution if any drug is prescribed to which a patient has an allergy or if there's a hazardous drug interaction. No, have some on the paper copy of the medlists, some on the computer, some in a different part of the chart (which you often can't check because the nurses, who have to dispense the medications, understandably need that chart as much if not more than you do), confirm by occasionally having medical students check to see what's in the IVs. WTF?

I know this *can* be done, because it *has* been done. Not only is the lack of electronic charting really irritating to medical students (and everyone else) that then has to dedicate hours and hours to rewriting information that is in one place into other places (if they can read it) or hilariously, *typing* information from one excel list to another, but it's unnecessarily hazardous.

Anyway. On the plus side, all the people in surgery I've met so far since I've been on surgery have been really nice, which has been an unexpected surprise. Surgical staff is not commonly associated with uh... social grace, or a particular love of our grimy, wound-contaminating, instrument-dropping ilk so not getting yelled at has been a bonus and I really like the main attending we've been introduced to, so not all bad.

And early in the night, the resident was showing us some bedside procedures which I didn't get in internal medicine, which I think is where I was supposed to. I got to drop an NG tube in ED (which was awesome), but last night I did get to listen for the gurgle to ensure proper placement, which was loud enough to be startling, so I'm finally getting some use out of my stethoscope beyond putting it on a patient's chest, listening intently, frowning, and then lying when the attending asks me if I can hear the murmur. At least I always remember to have the earpieces in.

Feb 10, 2010

Another rotation rolls toward a close

And it's a snow day! It's hard to believe that in two years, I went from this:

to this:

Pretty sweet, eh? Makes me feel bad every time I'm a whiny-butt, which is often.

So the blizzard of the century or whatnot finally hit us after bathing the rest of the east coast in it, and so far, it hasn't been too bad. The salters and plows were out almost instantly, my subway was still running, and it was way less of a pain in the ass than the one that hit right before Christmas. It was also nice that it hit *today* rather than destroying the weekend, as they were expecting, which meant instead of getting stranded in Manhattan, I was peacefully in the pediatric ED discovering that while getting a nail jammed into a foot only causes minimal tears in a child, that tetanus shot that follows it is an act of hideousness Mother Nature herself couldn't concoct. To be fair, those things do burn.

The NYC population seems to have responded to the storm by whipping out garbage can lids, cardboard boxes, and anything else remotely flat and sledding down hills on them, so I suppose the winter horror isn't affecting the public morale too badly. I was way more responsible after work and responded by tossing snowballs at my colleague and then pushing her into the snow after she refrained from doing so to me because she thought I might have a laptop in my backpack (I didn't). It's this level of maturity that's going to make me such a good doctor.

But alas, not all can be snow play since I have my oral exam for peds tomorrow and my written exam on Friday. Then I get three glorious days of reckless winter merriment before surgery begins and my life effectively ends in a blaze of retractor-holding, 4 AM-rising joy.