Showing posts with label call. Show all posts
Showing posts with label call. Show all posts

Saturday, November 08, 2008

Make sure you know what you are getting into... [part one]

One of the pieces of advice I was given as a pre-med, and that I frequently give to pre-med students (it's #7 on my Top 10 list of advice for pre-med students) is,

"Make sure you know what medicine is like before you sign up for it."

That was ringing quite loudly in my mind when I started my call shift the other night. I had had a busy week in surgery. There were some really long days of showing up on the ward at 7am then a full day of office then going straight to the hospital at 5pm and seeing emergency patients and eventually taking them to the operating room and getting home well into the wee hours of the morning... with a full day in the office after that.


Most of the surgeries were routine, but some came with the emotional stress of having to tell a patient and their family they had a 50% chance of dying on the operating table, and a 50% chance of us opening them up, finding that we could do nothing, and closing them up to face their death within the next few days. (One patient's response to that speech? "Bloody hell." Yeah, no kidding.)

I also had a long academic half-day full of lectures on things that I need to know but had no energy to learn, that also went late into what was going to be my evening relaxation time.

I had to try and fit in studying for my two upcoming exams in between all that, and then on top of that I tried hard to make time to get some exercise and spend some quality time, either on the phone, online or in person, with the people in my life who mean a lot to me. And no, there was no time for going to my buddy's poker game, watching the Leafs get their butts kicked (I haven't watched one game this season!), an afternoon round of golf, or any of the other things I would have enjoyed doing that resemble this "having a life" thing I've heard so much about.


As soon as I finished work in the surgeon's office for the last day of this tough week, I headed to the hospital to get my pager and start call - and within five minutes of my call shift starting, my resident and I had five patients to see, all of whom were pretty sick. Just as we were trying to figure out who to see first, the pager went off two more times. We didn't get a break longer than ten minutes until 2am, when I got a bit of sleep before the pager started going off again (getting a bit of sleep means it was a lucky call night).

I'll admit when all those pages were coming in right at the start of the shift, I was feeling the stress of the whole week on top of having a lot on my plate all at once, and I fell into a rut I find myself in once every year or so when all the negative thoughts come rushing to me. I find myself seriously asking if I am in the right place, if I made the right career decision, if I will ever be able to treat patients on my own, if I really knew that medicine was like this before I invested all that effort and money into pursuing it.


Fortunately, the five minutes the resident gave me before I had to meet up with him on the ward was just enough time to break down, almost re neg on my no-crying policy, and beg for some strength from heaven.

Fortunately, God was listening and obliged. And all in all it ended up being a really good call shift. For me, that means a night with some varied, useful cases that are important for me to learn how to manage, and with some good opportunities for me to see patients on my own, evaluate their situations, and develop a plan and present it to the resident for their approval and questioning. We triaged those first cases well, and got through them and all the other calls throughout the night, and put off studying for just a few more hours in order to do those therapeutic things like write this post and sleep in late for the first time in a while.

::: part two to come... :::

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Monday, October 06, 2008

If this post ends abruptly...

Note - I'm writing this in the hospital as I'm on call, so if it ends abruptly it means I got paged and have to run and was up all night and didn't get the chance to finish it.

While most of my call shifts have been pretty interesting, tonight seems to be very slow. So far, I've just been sitting around in the library, doing noth

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Saturday, September 13, 2008

Join me on my first on-call shift, and find out why I slept so little

For the future (and pre-clinical) medical students out there who are wondering what being "on call" is, I have just completed my first call shift. Therefore I am now a reliable source for information about what being on-call means. Here's how my night went:

5:00 pm ::: Start of on-call shift. On the phone with a friend in residency asking for some on-call tips. #1 tip: While on call, eat, sleep, and pee when you can. You don't know when your next chance will come.

5:21 pm ::: Fell asleep on the toilet while eating a granola bar.

5:36 pm ::: Woken up by a patient who claimed I was sleeping in his bathroom.

5:37 pm ::: Patient's claim corroborated by nurse, who is kind enough to explain to me what an "on call room" is, and where I could find it in the hospital.

5:41 pm ::: Changed out of my scrubs into pyjamas. Realized scrubs are more comfortable and changed back. Fell asleep.

6:12 pm ::: Woke up. The pager they gave me is making weird, loud beeping noises and has stopped showing the date and time. Now the display was just showing "911" and a few extra random numbers. Must be broken.

6:22 pm ::: Finally figured out how to make the pager stop malfunctioning and making such loud noises: take out the battery. Able to sleep again.

9:38 pm ::: Woke up abruptly. Some dude is banging on my door and shouting something about being "my resident" and how they have called me "100 times" in the last two hours. Must've had my phone on silent. Turned up the TV so I couldn't hear him, going back to sleep.

10:26 pm ::: That same dude got hospital security to unlock my door and wake me up. He is telling me to go to the sixth floor to "see a patient" with "delirium." Not sure what that means. Not sure what delirium is, either.

10:34 pm ::: Saw the patient - turns out the he is actually just a really nice guy who is a government agent, and he explained to me that he is being held against his will and that the nurses were trying to poison him. Helped him find his way out of the hospital so he could get back to being a secret agent.

11:17 pm ::: Back in the on-call room. Spent an hour propping all the furniture against the door so that my resident and the security guard couldn't come wake me up again.

12:19 am ::: Jumping on the bed.

2:54 am ::: Removed the pile of furniture from my door when I started getting hungry. Roaming the hospital looking for unconsumed foodstuffs on patient trays.

3:19 am ::: Found half a brownie and some cold soup on a patient's tray, and drank some apple juice that a patient thought they could hide from me by putting it in a pan under their bed. The apple juice wasn't very good, but it was free.

3:40 am ::: Running from the paediatric nurse who caught me drinking all the infant formula.

4:51 am ::: Back in the on-call room - can't sleep. Damn ambulances keep going by my window.

7:36 am ::: Woken up by security, who came in through the window this time, clever fellows. They told me to get out. Figure that means my call shift is over - going home to bed.

Turns out this call thing isn't so bad. It's basically watching TV, eating and sleeping. I think I could get used to doing this every fourth night.

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