Being on call overnight gives an intern a great idea how strong his fellow interns are. The weaker of my fellows will have signed out patients who lack pain PRN meds, have restraint orders that need to be signed, or a host of other administrative issues guaranteed to keep me awake.
It also demonstrates some of the odder quirks of humanity. I was paged by one of my favorite nurses a few nights ago "because one of the patients up here has a present for you." I tried cajoling the nature of the "present" out of her, but she insisted I come and see it for myself. She's one of the nurses I know fairly well, and more importantly I know she doesn't page me unless it is necessary, so I headed up four flights of stairs to see what was going on.
When I got there, the nurse dropped a small white object into my hand and told me the story. Mrs. Culloden, a pleasantly demented, frail lady in her 80s who is constantly threatening to leave AMA to go smoke, had become convinced that the vancomycin in her PICC line was "invading her body." Her logical response, rather than asking a nurse for help, was to take the plastic knife from her dinner tray and cut the port off her PICC line. So the vancomycin was on the bed, and the wanderingly apologetic Mrs. Culloden was one step further back on her cellulitis treatment. Clamp, wrap, and place on 1 to 1 monitoring. All in a day's work.
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life, the universe, and medical residency
Nathan
All names have been changed to protect the innocent and guilty alike.
Comments and questions welcome at jollycompany (at) gmail (dot) com.
Pretty much anything in italics is quote. Ask me if you'd like a source.
Without faith, without poetry, without music, medicine is pointless, for why save a life which is not special, and why dedicate so much effort to a cosmic accident? It would be worse than pointless, it would be cruel.
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All stories about patients follow HIPAA guidelines regarding personal information, and nowhere are the names of hospitals, schools, or other locations given. All text copyright [insert my real name]. Most pictures shamelessly borrowed from the internet.
1 comment:
Oh, that's wonderful. That's one of the best dementia stories I've heard. Usually they just fall out of bed.
For me, if the night float guy isn't good, it's painful too. I come back in the morning to find people's urine output nonexistent, and nothing done about it, and people who've been in pain all night (despite my previous arrangements) and nothing done to help them. That's no fun either.
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