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9th July 2006

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9th July 2006

now I know that I can fly alone….

I survived my first week of internship. And my first night on call all night last night, crossing covering all 4 teams’ patients for the night. It wasn’t too bad, comparing it to the other intern’s experiences. My pager was going off nonstop from about 3 pm on (at the same time I was trying to get blood cultures draw…6 sticks later, I had to admit defeat and get another intern to come and help. So frustrating. I’ve done IVs before, but apparently, drawing blood is a slightly different technique. And can I just say how ridiculous it is, in a hospital, to not be able to have labs drawn on weekends? If you want something, you have to draw it yourself, which is a complete and inefficient waste of time. I did have two patients who spiked a fever overnight and I needed blood cultures on them. Luckily the IV nurse took pity on me (I think I looked pretty frazzled by that point) and offered to draw all of the labs that I needed last night, which saved me a lot of headache and stress. I could have hugged her.

Our team took five admissions yesterday (we were supposedly on divert because the ICU was full. Didn’t stop the ER team from allowing a woman to be transfered from one of the local hospitals for no reason what so ever…. and then admit her. Nice lady, but I was really frustrated that I had to work her up and admit her, when she really didn’t belong in the hospital), two were mine. That was probably the hardest thing, trying to admit and balance the numerous pages from all of the nurses and try to figure out what to do with patients that I know very little about (it’s hard enough figuring out what to do with my patients!), In addition, there was a fluke in the call schedule, which meant that while my resident was supposed to accept sign out and cover one of the medical teams, everybody signed out to me, which meant my load was heavier.

Things calmed down at around 11… the pages stopped, allowing me to write up my two admissions and then get some sleep. I got about four hours of sleep, which since everybody else that I’ve talked to has only gotten about 30 minutes, I was extremely blessed. It wasn’t good sleep, because I kept waking up in a panic that my beeper was going off and I was sleeping through it (I wasn’t). Or it really would go off and I had to figure out how to manage things in my sleep deprived mind. Fun, fun.

I came home and promptly went to sleep. Or tried to, as my pager kept going off. It’s true that it’s very difficult to leave the work behind at the hospital. One patient’s wife had come by, and as she was power of attorney, wondered why she hadn’t been informed of her hsuband’s transfer to our service, so I talked to her for a bit. Then, as I had basically give everybody the go ahead to transfer him back to the other service, I then got a call from that admitting physician, wondering why I was transferring him back when the cardiology consult said that he wasn’t stable in their note (completely opposite of what they told my team in person, btw). I think I got most of that fixed–I’ll find out tomorrow morning of whether or not the transfer actually went through.

So, I survived. I might be on call again on Wednesday (our schedules got messed up, as I said, so I have no idea anymore), which I’m hoping not. I need a couple of days to recover, and as I’m not getting a day off anytime soon (13 days, and counting), well, I’d rather not be on call again until Sunday.

I am loving my internship. Despite the hard work and the constant feeling of inadequacy (does it ever go away?). The vets that I work with are very sweet, especially the little old 80 or 90 year old men. I get very sad when they come in, very sick often, but always very patient with what we can offer them. They vets are some of the most appreciative patients you’ll see, and our VA system offers them so little sometimes. There are great things about the VA… their computer system and their clinics, but when it comes to hospital care… where they are really really cared completely by residents (great for residents to get experience, maybe not so good for the vets) and can only get PICC lines on Tuesday and Thursday (and not after 3 on those days, making them stay in the hospital until the next Tuesday or Thursday), or the million other ways that the system breaks down (and sorry, folks, I don’t think it’s because of evil socialized medicine. The VA could be providing some of the best care, It’s more the inefficiency of the system in place and the laziness/unwilling of those in the system to change), it saddens me.

So that’s my life, busy, tired, but generally happy. What’s going on with you?

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