Good Times On Call

So the other night I was on call for the ICU. This means that I get called on any ICU patients with problems during the night, and I admit or transfer any new ICU patients.

So we got a call from the ER for a patient who needed to be admitted to the ICU. He had suffered a stroke and was intubated by the ER doctor. He came to the ICU on the ventilator. I was filling out my admission orders and some paperwork for stroke patients, while the nurses were getting the patient situated. I came across a section that asked if the patient needed supplemental oxygen to breath. So I turn around and ask, "is the patient requiring any oxygen or is he breathing on room air?" The nurses paused and looked very confused... "he's on the ventilator" someone said. So yea, he was not breathing, the machine was breathing for him. I've felt pretty stupid in various situations this year, but I think that may be the worst so far. I replied that I'm allowed at least one stupid comment at 2AM and we had a good laugh.

So that's not a real mistake, just a moment where I was not thinking straight and asked a ridiculous question! Fortunately I have not made any real on call mistakes. (Though if I had I would not advertise that information to the world wide web!) I definitely have moments when I'm dead tired and it takes me twice as long to do things because my brain is just working a little more slowly. I think approaching patients the same way helps avoid potential problems, for example always asking if the patient has any allergies, or always looking at the date the x-ray was taken first. When I'm on call I try to sleep when I can, even if it's just for a half hour it helps. I do not use coffee or rock star or monster or red bull or full throttle, which I believe helps in the end. I would rather yawn occasionally than be artificially awake. Eating helps too, when you’re up for 30+ hours you require more calories.

Things are better now than in "the old days". In the old days residents worked over 100 hours per week and might stay at the hospital for days (hence the term resident). Now, by law, we cannot work more than an average of 80 hrs per week during the month. When on call, we cannot work more than 32 hours straight, and we must have a minimum 12 hours off before returning to work again. It is also required that we take an average of 2 days off in each two week block. It's still a lot of work, but it's do-able. Family practice is still way better than surgery! I definitely would not want to work this hard for the rest of my life, but it's only for a few years and supposedly the hard work will pay off in the end....