Monday, October 29, 2012
Friday, October 26, 2012
Differences in opinion
There is always a bit of tension between a few staff members. It's present in any large organization and hospitals are no exception. This holds even more true in the ER, where the usual interpersonal relationships and disagreements are set against a backdrop of tragedy, loss, pain, crisis, and high emotion. So when differences in opinion migrate towards verbal disagreement or actual arguments, no one is too surprised - this isn't condoning the disagreements, just acknowledging that sometimes shit gets real.
So imagine my surprise the other night when shit got reeeaall.
An on-call resident pitched an absolute fit when he was dragged out of bed at 0400 to consult on a perfectly legitimate patient. He whined over the phone for a few minutes and then said he would be in shortly - I thought the story ended here. No, sir. It did not. When he showed up thirty minutes later he went absolutely ballistic in front of the patient, yelling at the ER attending for what he considered a BS consult and how it was the epitome of all things awful to have called the consult in the first place. The attending took it pretty well. He maneuvered the resident into the hallway for some privacy, and then proceeded to tear apart the resident for thinking himself so arrogant.
A few highlights of the new asshole-ripping the resident received:
"I've been an ER attending for 18 years. You've been a resident for two. Come back to me and decline a consult when you're actually a real doctor."
"I'm friends with your attending. I'll be sure to mention this gross absence of professionalism when I see him next week."
"If you ever, ever act that way again in front of a patient of mine, I will see to it that you are out of this residency program so fast you'll wonder what the hell happened to your life. Are we clear?"
I'm telling you folks, it was one of the most epic things I've ever witnessed.
**I should note that this is probably not an unusual scene to those who have worked at a teaching hospital before, but I've never worked with residents before this assignment. Thus, epic.
So imagine my surprise the other night when shit got reeeaall.
An on-call resident pitched an absolute fit when he was dragged out of bed at 0400 to consult on a perfectly legitimate patient. He whined over the phone for a few minutes and then said he would be in shortly - I thought the story ended here. No, sir. It did not. When he showed up thirty minutes later he went absolutely ballistic in front of the patient, yelling at the ER attending for what he considered a BS consult and how it was the epitome of all things awful to have called the consult in the first place. The attending took it pretty well. He maneuvered the resident into the hallway for some privacy, and then proceeded to tear apart the resident for thinking himself so arrogant.
A few highlights of the new asshole-ripping the resident received:
"I've been an ER attending for 18 years. You've been a resident for two. Come back to me and decline a consult when you're actually a real doctor."
"I'm friends with your attending. I'll be sure to mention this gross absence of professionalism when I see him next week."
"If you ever, ever act that way again in front of a patient of mine, I will see to it that you are out of this residency program so fast you'll wonder what the hell happened to your life. Are we clear?"
I'm telling you folks, it was one of the most epic things I've ever witnessed.
**I should note that this is probably not an unusual scene to those who have worked at a teaching hospital before, but I've never worked with residents before this assignment. Thus, epic.
Friday, October 19, 2012
Adventure #2
I'm getting close to the end of my first placement - which is bittersweet because this has been both a challenging experience and one of the most rewarding. I can honestly say that I am immensely glad I chose to uproot myself and go traveling. I've been pushed in many ways for this first assignment - forced to jump right in and learn a new computer system, new order tracking, and a new department layout amongst navigating the politics of the staff. There were a few miscues, and I think there is one staff member that doesn't like me all that much but overall I think I did pretty damn well.
I was offered an extension on my placement, which I politely declined in lieu of keeping the adventure going. A few weeks later I put in a request for a new assignment. I got a new contract, which I will be starting the second week of November. Drumroll, please...
I'm going to Texas!
Never been, heard some good things, heard some bad things. However it turns out, it will be a fun ride.
"And now Harry, let us step out into the night and pursue that flighty temptress, Adventure." -Dumbledore
I was offered an extension on my placement, which I politely declined in lieu of keeping the adventure going. A few weeks later I put in a request for a new assignment. I got a new contract, which I will be starting the second week of November. Drumroll, please...
I'm going to Texas!
Never been, heard some good things, heard some bad things. However it turns out, it will be a fun ride.
"And now Harry, let us step out into the night and pursue that flighty temptress, Adventure." -Dumbledore
Tuesday, October 9, 2012
Boo dayshift
I went in for a day shift yesterday, and it reminded me of how much I hate dayshift sometime. I had a crazy group, of all ICU/PCU-type patients. Seriously. I had a GI bleeder, a bleeding fistula with a pressure of 70, a resilient epistaxis on plavix with a falling Hgb/Hct, and an empty bed. The other two nurses were in very similar situations. Charge Nurse came by and asked how we were doing. We all gave her a look of "seriously, woman?!" and reported that we were drowning. I thought we got the point across pretty well. And then I see the ambulance stretcher headed down the hallway towards my empty bed.
They offloaded a septic patient. Not just any septic patient. A diabetic one with bilateral mastectomies less than a year ago AND NO LEGS! Also this ER doesn't do central lines except in dire situations. Well, to me this was a dire situation. I pulled the doc in to the room and was like central line set up now, yes? He said "well no, just keep looking for a peripheral line. And make sure you get cultures, too."
I was not happy. You can guess how crappy my shift was from there. Moral of the story? Never ever working dayshift there again. I'll stick with the BAMF'n night crew.
They offloaded a septic patient. Not just any septic patient. A diabetic one with bilateral mastectomies less than a year ago AND NO LEGS! Also this ER doesn't do central lines except in dire situations. Well, to me this was a dire situation. I pulled the doc in to the room and was like central line set up now, yes? He said "well no, just keep looking for a peripheral line. And make sure you get cultures, too."
I was not happy. You can guess how crappy my shift was from there. Moral of the story? Never ever working dayshift there again. I'll stick with the BAMF'n night crew.
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