Monday, October 09, 2006

tips for being on call....

it's now 1:30am and I'm two thirds of the way through my thirty hour "day(night)day" on call.

I know that if I try and climb into bed it will only invite my pager to chirp and disrupt my dreams (leading me to ponder which is worse: being punchy and tired or being woken from a sound sleep and 100% disoriented) and so I'll tempt fate by trying to post.

It's been several months since I last played the on'call'game, and I thought it was time for me to make a few notes for the next time (a few days from now) because I seem to forget just what being on call is all about...

- Change into scrubs as soon as possible. It doesn't matter how comfortable my dress pants are, nothing beats feeling like I'm wearing pj's around the hospital.

- the chocolate milk in the doctor's lounge is better when mixed with skim milk, and the combo of the two is easier to chug when being called to a floor.

- nice handwriting is worth the extra seconds it takes. Spending many minutes on the other end, trying to figure out what something says is the #1 reason why mine is now legible.

- do not try to knit when on call. Even if you are working on a sweater that you are hoping to wear to a very large fiber event in two weeks. Do. Not. Knit. On. Call.

- the cafeteria closes at 6:30. Sharp. Even if nothing looks good, having a ________ (cookie, apple, orange, cookie, english muffin, or cookie) for later is worth swinging by.

- for heavens sake...if you disregard the above and knit, do not try to fix the "little" mistake. Because then it will become a big mistake.

- we want patients in the hospital to do three things: sleep, eat, and poop. We seem obsessed with how often they are doing these things, and ask them on a daily basis when the last time they did each was. What are the only three things the patients will be unable to do? sleep, eat, and poop.

- don't try to fix the big mistake either. Just don't knit.

- the DunkinDonuts across the street is open all 24 hours of the day and night.

- instead of sneaking off to said DunkinDonuts, take orders from those you are working with. Not only will they know where you are, they'll be nice for a good 10-15 minutes after you get back.

- if you do try to sleep, leave your sneakers on. Either of two things will happen: 1. you'll be ready to jump out of bed when the pager goes off, and it saves time with tying laces (and leaves more time to figure out where you left your glasses...) or 2. Because you are more prepared, it won't go off. You'll wake up wondering why you are asleep with your shoes on.

There is, as always, much more to say. I've had some fairly intersting conversations with doctors about my future in medicine, and had to stand up for myself more than once. This rotation, an "acting internship" or "sub-internship" is putting me in the role of a first year resident - sort of like playing a doctor on tv. It's been quite an experience to see how hospital based medicine differs from outpatient services, and, again, I find myself having to read the minds of whomever I am with.

(doctor A wants me to list all of the meds, doctor B thinks that is a waste of time but wants me to number the problems sequentially and keep them in order while doctor C thinks all of the above is a waste of time and I should shorten everything I can (which includes not writing basic abbreviations because the reader will know what I mean. And I take too much time to write neatly.) I think they mean well. I hope they mean well. I'm learning how to nod and smile.)


Anonymous Laurie said...

We always summarized it similarly:
1. Never refuse a chance to sleep.
2. Never refuse a chance to eat.
3. Never refuse a break.
4. Never refuse a chance to pee.

Knitting has never been in the equation. Just sayin'.

I won't have a Rhinebeck objet either.

1:41 AM  
Blogger Kellee said...

Luckily, that nod and smile thing? Very, very useful outside the hospital as well. It's a good thing to learn.

9:17 AM  
Anonymous Anonymous said...

I will have to forward this to dh who is in his 3rd year and has yet to do a subinternship. Hopefully things won't be overly painful.

12:28 PM  
Blogger Cari said...

But why doesn't the knitting work out? Is it a lack-of-sleep thing? Or does it tempt the pager?

5:50 PM  
Blogger Theresa said...

I wish I could tell you that you didn't have to adjust to Doctor A, B, and C all the time. But you do. All the time. Everybody has their pet issues (i.e. Vitamin D deficiency, starting Coumadin at 5mg vs 10mg, etc.). You'll develop yours, too ;) (My personal mission at the moment is to give all adults their Tdap. Stamping out pertussis, one clinic day at a time!) See? We all get weird!

9:53 PM  
Anonymous elisa said...

OH man. I'm tired FOR you. :)

It sounds like Laurie's summary is a sound one (I mean, it is LAURIE), and Kellee is right - nod and smile is a terribly valuable skill...

7:47 AM  
Blogger J. said...

you poor girl, it will be over soon... I am sure that some days it feels like not soon enough. Enjoy Rhinebeck, I will be drooling from my computer here in Ontario, sad that you are making it this year and I'm not - boohoo:(

8:30 AM  
Anonymous mia said...

I'm with you on most of those things! I'm doing my SubI right now too, with the Family Medicine Hospitalists...that's right, they have those here. So far very good and educational but EXHAUSTING and I just had the worst post call day ever. Long story, just trust me. How are your apps and interview schedules coming along??

10:41 PM  
Blogger maryse said...

i'm with you girlie. stay strong.

i'm not very good with the nod n smile. i should work on that.

6:54 AM  
Blogger Lucia said...

The knitting doesn't work out because if you are 1) already sleep-deprived and 2) interrupted every couple of minutes you can't help making a mistake. (Your answer may be different, of course. My experience comes from having just one or two very small, very demanding patients.)

From a patient's perspective it is extremely annoying to have people constantly asking if you've pooped lately, especially when it seems they want you to poop already so they can send you home.

4:32 PM  
Blogger mf said...

Stay strong! Get little naps whenver you can toO!

9:08 AM  
Anonymous Anonymous said...

Better yet, do an ER residency, never be sleep deprived for the rest of your life (well, I do have a 3 week old baby so nix that thought), be full time at 12 shifts per month, which leaves you 18 DAYS OFF PER MONTH TO KNIT. In fact, I am knitting a cupcake right this very minute! Trust me...I'm a you know what.

10:52 PM  
Blogger margene said...

I'm sad, sad, sad!! You were right the lobby. I probably looked at you spinning and smiled but my brain was on overload and didn't register. You should have tripped me, banged me on the noggen and given me a good wake up call. I would have loved to hug you and see you again. Darn it all! :-(

11:26 AM  

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