ICU
I just finished trauma. I am now beginning an ICU month at the local VA hospital. I had my first call night on Friday--it wasn't nearly as bad as I was afraid it would be. All our patients were stable and I was able to deal with all the issues that arose without having to page anyone higher up.
This month is particularly intimidating for me as 1) these patients are much sicker than any patients I have dealt with before and 2) when I am on call I am the only surgery resident in house (as opposed to last month when I had a chief in the hospital with me whom I would run things by ever couple hours) which means I have to page the fellow at home if I have a question about something. On the positive side our patient census is very low (I only had three patients to worry about).
Another negative thing about this month is that it is at the VA. While I think the VA here does provide good patient care, it is, to put it delicately, a "no-frills" kind of place. For example: my main hospital has a couple decent cafeterias, one of which is open 24 hours a day. When I don't get a chance to eat until 10pm, I can still go down and get a hot meal. The VA has a cafeteria that is abysmal (yet more expensive than my main hospital's), and that closes around 4:30pm. On surgery, one doesn't eat dinner by 4:30pm. There is nowhere else to get food. You can see my dilemma. Fortunately, on Friday there was another resident who had to stay late, so I was able to drive to McDonalds and get dinner there. This will not always be an option. Continuing on the "no-frills" theme, the whole hospital just has this atmosphere that is impossible to describe. Getting logistical things done takes 3-4 unneccessary steps (it took me hours to get my computer access straightened out despite the fact that they gave me a login just over a month ago--and getting meal tickets for call nights [that I may theoretically be able to use some day] was almost impossible). All the employees from clerks to nurses have a "this is the way we do things around here and nothing short of a presidential order no matter how logical or efficient your request will make me deviate from protocol in the slightest" attitude which can really get annoying. That all being said, I'm going to learn a lot this month, which makes it worth it.
This month is particularly intimidating for me as 1) these patients are much sicker than any patients I have dealt with before and 2) when I am on call I am the only surgery resident in house (as opposed to last month when I had a chief in the hospital with me whom I would run things by ever couple hours) which means I have to page the fellow at home if I have a question about something. On the positive side our patient census is very low (I only had three patients to worry about).
Another negative thing about this month is that it is at the VA. While I think the VA here does provide good patient care, it is, to put it delicately, a "no-frills" kind of place. For example: my main hospital has a couple decent cafeterias, one of which is open 24 hours a day. When I don't get a chance to eat until 10pm, I can still go down and get a hot meal. The VA has a cafeteria that is abysmal (yet more expensive than my main hospital's), and that closes around 4:30pm. On surgery, one doesn't eat dinner by 4:30pm. There is nowhere else to get food. You can see my dilemma. Fortunately, on Friday there was another resident who had to stay late, so I was able to drive to McDonalds and get dinner there. This will not always be an option. Continuing on the "no-frills" theme, the whole hospital just has this atmosphere that is impossible to describe. Getting logistical things done takes 3-4 unneccessary steps (it took me hours to get my computer access straightened out despite the fact that they gave me a login just over a month ago--and getting meal tickets for call nights [that I may theoretically be able to use some day] was almost impossible). All the employees from clerks to nurses have a "this is the way we do things around here and nothing short of a presidential order no matter how logical or efficient your request will make me deviate from protocol in the slightest" attitude which can really get annoying. That all being said, I'm going to learn a lot this month, which makes it worth it.
posted by Chris Emlyn at 3:35 PM
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