shadowing a doctor on a 48 hour call {part ii}

// mauve dresses below //

//outfit deets//
dress, similar
leggings, exact one
boots, exact one

For part I, head here.

at 3:30a, I was so tired I fell asleep right away.

beep beep. My pager again. It's 634a.
It's about consult 2. Could we please have a gameplan {ie I am post call and I need to get out...} said the night-float intern.

7:13a oh by the way, let's rehash that plan. said day-time intern.

This consult 2 was taking a lot of time and this patient was not even the sickest one.

What happened to changeover people?
What happened to good communication?

It was a starbucks vanilla latte kind of morning. With only three hours of sleep,  needed that dose of caffeine.

8a  I met with my resident in the workroom and "table rounded". Table rounds - when we run down the list and discuss the patients briefly and look at images before going to the patient rooms.

8:30a we were out the workroom to see patients.

Rounds went smoothly. We saw the hospital patients. We were only disturbed twice for outside hospital calls. I call that a win!

Rounds - history taking, getting updates from nurses and family members at bedside or  the patient themselves if they can give the history.

Physical Examination - are there any changes? Is the patient ready to go home?

Data -  if the labs were not back during our table rounds, we checked the charts once more to help us guide our plan for the day.

Plan - we gave recommendations to the primary team as we went around specially the sick ones. We did not wait until  the end of rounds to make phone calls or type our notes.

I went home after rounds. I had a resident on call with me who was "in-house." The in-house resident stayed in the hospital  for the full call shift. Resident-on-call took cross cover calls (calls from other services). So I just took care of  outside hospital calls. I only received a couple.

I was so tired from only getting 3 hours of sleep. Hubs watched the kids and I was able to nap from 415p-5p. I was awoken by another page.

Hubs was serving at Vigil Mass so we went to church. Usually, he asks for my weekends on-call as nights off for serving. But this was an oversight. I had a bad feeling about going to Saturday Mass since I was on call. I was right.

I was on the phone from 5:10 until 5:25p. I lagged behind in the car while the rest of the fam went inside the church.

I went inside but the phone calls were not over. The OR charge nurse was going to call me back.  We had to have a plan before 8p.

I stepped out to take a few more calls during Mass. Oh I hated it. It was so disrepectful of me.
I was hiding behind the huge outside column, blocking the cold wind as I made those phone calls.

I was outside for a good amount of time. These are the stories we do not learn in medical school. The phone calls, the networking ~ all to help the patient.  It's a  "learn-on-the-job" type of education.

After Mass, the night went by a little smoothly than the night before. Besides the usual transfer calls and overnight admits, nothing was "out of the ordinary." I was not paged from 1a to 5a. That's the prime hour to get good sleep.

Beep beep
It was time to get up  Sunday morning and round.

At this point, the happiness of call ending in less than 12 hours gave me another ooomph to keep going. As I checked off the patients and to-do list I was getting closer and closer to that 4p mark. Our 48 hours call ends Sunday at 4p. The magical time when I change over the consult pager to the Sunday night neurologist.

Different groups handle weekend calls differently. Before we went to the 48 hour weekend coverage, the pediatric neurologists actually took call from Friday at 4p until Monday at 8a. As the hospital got busier and busier, that was just torture. Three consecutive nights of sleep debt and then a full week either at the hospital or full week of clinic was not do-able long-term. We changed that set-up a couple of years ago. It made such a big difference getting off of call at 4p.

I don't think there's a doctor out there who's rejoicing that he/she is on call for the weekend.
But call is call. It's part of the job.
It has to be done.

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