Medicine and Snowstorms

This month I'm back on wards, but fortunately I was assigned to a relatively laid-back service that started the week with 8 patients and ended on 2 (I am not kidding). For the first few days there was a psych intern working with me so we split the work, and when she pulled from our team to do a neurology rotation instead, the work was still more than manageable. I even had time to go to morning report (which is almost unheard of for interns on wards). I had a great resident (future nephro fellow) and two med students, a sub-I and a MS3, and together we worked extremely well. When we only had 2 patients, however, I think I became too relaxed, and actually became less efficient with my work. My resident picked up on this when he called me from his clinic and asked why a patient's BNP still wasn't back yet (our attending had wanted it since 10:00 a.m.) I told him that I'd asked the nurse to draw it, and he said, "It's your job to make sure it gets done. And it's not like we have 14 patients, we only have 2." Then he told me not to leave the hospital until the BNP results came back (we were trying to figure out whether one of our patients had SOB b/c of heart failure or COPD) *sigh* Although I was annoyed to have to stay later (I was trying to get home before the snowstorm started, and fortunately made it just as the snow started falling), I could understand his reasoning. I had grown soft. I think I was more on top of things in the PCU when we were almost always capped. At the very least, my sense of responsibility was greater. I'll get a new resident next week, and hopefully we'll be able to work well together. Just as interns chat amongst themselves about which residents are good and bad, residents compare interns, too, and I'd like to think my past residents thought favorably of me (unlike 1-2 interns whom the residents think are lazy and sloppy)

One big adjustment is having 2 med students around (a luxury I haven't had since August). We get along pretty well and can find things to teach each other; my sub-I had to teach me how to put a Foley in a woman since she's going into obgyn and had done it many times previously. Instead of textbook knowledge, I've been teaching them real-life lessons, i.e. how to call consults, mistakes not to make on call, and more. My MS3 takes calls with me so I have her see the patient first before going in after her. We were working on orders together in the ED when a schizophrenic patient suddenly began screaming obscenities and threatening to kill the nurses and security guards trying to hold him down. ("Frank Sinatra is not dead! **** you mother ****ers, I'm gonna **** you all," you get the idea) At one point I accidentally clicked "Uric acid" instead of "Urinalysis" because I got so distracted by his screaming, and while my MS3, another intern, and I couldn't keep a straight face during his tirade, the ER attending nearby kept a poker face as he yelled, "Someone give him from Versed" and then, when the patient was still screaming 5 minutes later, "Did it go in yet?" Eventually the patient got knocked out completely before his transfer to the CCU (they're gonna have a field day with him), but this only reinforced my reasons for not wanting to specialize in emergency medicine (no offense)

There was a huge snowstorm that started last night and went on until around 2 pm today. I had been poorly prepared for the last snowstorm (no shovel, no waterproof clothes), but this time I was ready. I'd purchased a shovel weeks in advance and I also had a pair of ski pants and gloves that I'd bought for a ski trip to Blue Mountain. Shoveling was much easier this time around, and even better when one of my neighbors offered to help me shovel one side of my car. After that one of the ground caretakers offered to plow my parking spot with his truck (and snowplow), so everything was cleaned up within 1 hr. All in all, things were much better this time around.