Sometimes when I work the overnight shift, my internal quirks blossom in ways that are amusing and hard to understand:
Every day around 5 pm, the day doctors round the overnight doctor before they leave. This means if I am the overnight doctor, each day doctor gives me a rundown on each of their inpatients. It's good to write down the details so I don't have to try to remember them when, later, the dog in ICU 7 starts randomly having seizures (or whatever).
There are usually 25-30 patients staying the night, and I am receiving new ERs while keeping an eye on them. Fun!
Everyone does it differently. I sit down and write a bullet-pointed list of the facts that come out of each day doctor's mouth while she is talking. If a particular day doctor is not here the next morning to re-take over her patient (say, she has the day off), I have to know enough about the patient to intelligently round the new group of day doctors.
If you think this sounds like a game of telephone, it's because it's exactly what it is. Except you cannot let the message mutate. Yaaaaaay!
One morning at rounds, I was talking about a patient when I realized that (for an unknown reason) I had written "to go home banana" on my list of facts.
I'm not sure what that meant. Perhaps I was hungry at the time?
overhead pages, translated:
1. "Emergency tech to reception for triage."
Someone is here to see us!
2. "Emergency tech to reception STAT." (bored voice)
The spaniel who ate a bag of chocolate chips is here, and he looks quite pleased with himself.
3. "Emergency tech to reception STAT!" (frantic voice)
Someone is here and they are dying. Or, the owner is hysterical.
4. "Emergency tech to reception STAT WITH A GURNEY!"
A large dog is here and is actively dying.
5. "Emergency tech to reception for a room 6 triage."
A potentially contagious patient is here.
6. "Emergency tech to reception for a triage. Emergency tech to reception for a second triage. Emergency tech to reception for...four triages."
Everyone has just arrived home from work. Or the football game ended. Also, the next hour or so is going to be awesome.
7. "Emergency tech to reception STAT! Emergency tech to reception for a second STAT! Emergency tech to reception STAT!"
Balls.
8. "Kennel assistant to reception for a cleanup."
Someone has pissed, vomited, or shat upon the floor.
9. "Any available emergency doctor to the ICU."
There is a case that needs a doctor and everyone is busy and/or hiding.
10. "Dr. Raeqe (criticalist) to the ICU, STAT!"
A patient is dying.
11. "Dr. Alacrity to the ICU, STAT!"
Specifically, my patient is dying.
12. "Any available emergency doctor, please call the front desk."
This could be one of three things:
- A person is calling for test results or a prescription.
- A person is calling about a recently discharged pet who is [doing something concerning]. Does the pet need to be rechecked right away?
- A person is calling because their pet ate [something strange] or is [doing something concerning]. Does the pet need to be seen?
13. "Any available intern, please call the front desk."
The front desk has a particularly onerous and/or menial task to assign.
14. "Dr. Alacrity, [your boss] is holding on line 1 for you."
Either:
1. SWEET! She is calling me back with advice on this diabetic dog with a septic abdomen and cancer who I just admitted.
2. I'm about to get scolded for an unknown mistake.
Someone is here to see us!
2. "Emergency tech to reception STAT." (bored voice)
The spaniel who ate a bag of chocolate chips is here, and he looks quite pleased with himself.
3. "Emergency tech to reception STAT!" (frantic voice)
Someone is here and they are dying. Or, the owner is hysterical.
4. "Emergency tech to reception STAT WITH A GURNEY!"
A large dog is here and is actively dying.
5. "Emergency tech to reception for a room 6 triage."
A potentially contagious patient is here.
6. "Emergency tech to reception for a triage. Emergency tech to reception for a second triage. Emergency tech to reception for...four triages."
Everyone has just arrived home from work. Or the football game ended. Also, the next hour or so is going to be awesome.
7. "Emergency tech to reception STAT! Emergency tech to reception for a second STAT! Emergency tech to reception STAT!"
Balls.
8. "Kennel assistant to reception for a cleanup."
Someone has pissed, vomited, or shat upon the floor.
9. "Any available emergency doctor to the ICU."
There is a case that needs a doctor and everyone is busy and/or hiding.
10. "Dr. Raeqe (criticalist) to the ICU, STAT!"
A patient is dying.
11. "Dr. Alacrity to the ICU, STAT!"
Specifically, my patient is dying.
12. "Any available emergency doctor, please call the front desk."
This could be one of three things:
- A person is calling for test results or a prescription.
- A person is calling about a recently discharged pet who is [doing something concerning]. Does the pet need to be rechecked right away?
- A person is calling because their pet ate [something strange] or is [doing something concerning]. Does the pet need to be seen?
13. "Any available intern, please call the front desk."
The front desk has a particularly onerous and/or menial task to assign.
14. "Dr. Alacrity, [your boss] is holding on line 1 for you."
Either:
1. SWEET! She is calling me back with advice on this diabetic dog with a septic abdomen and cancer who I just admitted.
2. I'm about to get scolded for an unknown mistake.
intern adventure day:
Our boss gave the interns all the same day off one day in January, at approximately the midpoint of the internship. The other doctors in the hospital (kindly) chipped in to ensure that we all got to leave a little early the day before.
This was so we could drive to a local resort casino, where we had rented rooms for the night.
The surgeon instructed the surgery intern to leave early after all the surgeries were done. This happened:
Surgeon: "Okay, get on your way. I'll finish up here. Thanks for your help today."
Intern: "Thanks! I SOAPed everyone and hung the treatment sheets for tomorrow. All that has to be done is rounding the overnight doctor when she gets here."
Surgeon: "Rounding the overnight doctor?"
Intern: "...yes?"
Surgeon: "Okay...wait, who's in the hospital?"
This was so we could drive to a local resort casino, where we had rented rooms for the night.
The surgeon instructed the surgery intern to leave early after all the surgeries were done. This happened:
Surgeon: "Okay, get on your way. I'll finish up here. Thanks for your help today."
Intern: "Thanks! I SOAPed everyone and hung the treatment sheets for tomorrow. All that has to be done is rounding the overnight doctor when she gets here."
Surgeon: "Rounding the overnight doctor?"
Intern: "...yes?"
Surgeon: "Okay...wait, who's in the hospital?"
you know what's fun? calling for help is fun:
1. The right time to call the on-call surgeon is highly surgeon-dependent.
Dr. Fox wants to be called when the dog is 15 minutes from being in the OR, fully cleared for surgery, deposit paid, anesthetized, and not a moment before. He has no time for your "so...I might have a back dog" bullshit. He only cares if he needs to put on his scrub pants in the next half an hour.
Dr. Roman wants to be called when you miiiight have a septic abdomen. Then he wants to be called when the dog is an hour from being in the OR.
Do not mix this up.
2. "On call" is a flexible term:
Got a surgery? Call the on-call surgeon. Sometimes this person is an ER doctor who is comfortable performing emergency surgery.
Unless it's a back dog, a septic abdomen, or an open chest. Then you have to call the actual surgeon, who is whichever surgeon was scheduled in the OR that day.
Unless the third year resident is on call. That guy can cut whatever.
I'm not sure what you do if the on call spot is blank on the schedule. That's fun.
3. "On call" is a flexible term, redux:
You can call the exotics specialist, the criticalists, the surgeons, and sometimes the ophthalmologist in the middle of the night. The neurologist wants you to call the criticalist instead.
The criticalist wants you to call the ECC resident. Unless the first year resident is on call, then she wants you to call the resident first (so she gets the experience of being called at 3 am) and then her. Unless it's really busy, in which case you can just call her. Or if it's about one of her cases. Or you can call the third year resident who is essentially always on call anyway.
YAAAAY!
Dr. Fox wants to be called when the dog is 15 minutes from being in the OR, fully cleared for surgery, deposit paid, anesthetized, and not a moment before. He has no time for your "so...I might have a back dog" bullshit. He only cares if he needs to put on his scrub pants in the next half an hour.
Dr. Roman wants to be called when you miiiight have a septic abdomen. Then he wants to be called when the dog is an hour from being in the OR.
Do not mix this up.
2. "On call" is a flexible term:
Got a surgery? Call the on-call surgeon. Sometimes this person is an ER doctor who is comfortable performing emergency surgery.
Unless it's a back dog, a septic abdomen, or an open chest. Then you have to call the actual surgeon, who is whichever surgeon was scheduled in the OR that day.
Unless the third year resident is on call. That guy can cut whatever.
I'm not sure what you do if the on call spot is blank on the schedule. That's fun.
3. "On call" is a flexible term, redux:
You can call the exotics specialist, the criticalists, the surgeons, and sometimes the ophthalmologist in the middle of the night. The neurologist wants you to call the criticalist instead.
The criticalist wants you to call the ECC resident. Unless the first year resident is on call, then she wants you to call the resident first (so she gets the experience of being called at 3 am) and then her. Unless it's really busy, in which case you can just call her. Or if it's about one of her cases. Or you can call the third year resident who is essentially always on call anyway.
YAAAAY!
cardiologist, emphatically:
"If you remember just ONE thing that comes out of my face during this internship, it should be this: 99% of murmurs discovered in cats are due to dynamic outflow tract obstructions."
overheard in the surgical wing:
Resident: "So I've been wondering..."
Surgeon: "Hmmm?"
Resident: "You know how you can have a 'hummer' with a blow job? What would the equivalent modifier be for the same action with a rim job?"
Surgeon: "Huh. I don't know."
Resident: "Right?"
Surgeon: "What about a 'rummer'?"
Surgeon: "Hmmm?"
Resident: "You know how you can have a 'hummer' with a blow job? What would the equivalent modifier be for the same action with a rim job?"
Surgeon: "Huh. I don't know."
Resident: "Right?"
Surgeon: "What about a 'rummer'?"
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