Thursday, July 26, 2007

First Night of Call as Intern

What did I get myself into? It is 6pm and I just got home from my first night of overnight call at the hospital. Yesterday was the first day of this rotation -- inpatient wards, which will be the bulk of my internal medicine training -- which means I was on call my first day. I guess I spoke too soon earlier when I said they hit you fast and they hit you hard.

Starting off the horrible day/night continuum was the fact that I took over the five patients the previous intern had. Taking on patients that you do not know is always difficult, especially medicine patients who have many problems to manage. Then throughout the night I picked up four new patients, each of whom takes awhile to admit because of admission H&P’s (history and physical exams) and admission orders. On top of this was the difficult task of cross-covering every other teams’ patients, which means getting paged randomly throughout the night by nurses about patient X’s tachycardia or patient Y’s diarrhea or patient Z’s itchiness. Itchiness? Come on, just scratch it yourself! When your team is being slammed with patients, prescribing Immodium is hard to take seriously.

On top of all that, add the grueling struggle of trying to keep my eyes open since it had been months since I was last on call -- last November, precisely, in medical school.

And then, post-call, dead tired, and zombie-like, I had to churn out notes for all my patients, none of whom I knew too well. It took me quite late into the day ... so much for the ACMGE mandated 30-hour limitation.

Again, what did I get myself into?

4 comments:

MedStudentGod (MSG) said...

Sounds about right. Next year for me.

Ladyk73 said...

Aww...I know it sucks...especially the first day. I am not going to try to compare the stress of my job to yours (other than it is less mental), my job (while a full time grad student) has been finding me exhausted due to lack of sleep.

I work at a residential aide with the MRDD population. Our residents are all have co-occuring disorders. Examples:

MR, Blind, and autism
MR, schizoeffective teenager
Severe MR, bipolar
MR, CP, Autism

And! many of these clients have trauma histories.

Not only do we have to worry about being bitten, peed on, or having to determine if someone is manic, or in pain.

But we have to worry about med errors (we are med certified and can give drugs), and the constant threat of being brought up on abuse charges.

From my experience, There is a mutual respect between residental aides at my agency and the medical providers who treat them. And everyone works together as a team ("something doesn't seem right," is taken seriously)

After experiencing the joy of being called in to do a double, after notice in which you have the opportunity to get five hours of sleep, having an unpredictable swing shift, and if you fall asleep for 10 min on 3rd shift, you can be charged with abuse....
For the lovely $10 an hour...

But it is worth it...when you see the clients learn and live happier lives.

I can feel your pain. It really sucks (for both of us).
The first day, yikes....It will get easier. I am rooting for ya.
(and my blog has the same sort of venting)

Anonymous said...

I love your blog! I've been reading it for a while now... I want to either go into nursing or pre-med and reading about your experiances is very helpful. Please write again soon!

Thanks,
Katie

Amir said...

msg and katie -- get out now while you can. go to law school!

ladyk73 -- first days DO suck. I am certainly hoping it gets better.