I never thought I would enjoy lectures this much. When I was interviewing, I was rather incredulous about the residents professing vast enthusiasm about how many lectures they had. Now, the chance to take time away from the constant issues on the floor is always welcome. So is the opportunity to concentrate on learning. There is so much I
don’t know, and need to know *right now*, that I’m glad of any chance to learn it. Plus, M&M can always be counted on for some fireworks. Whether it’s our one particularly fierce attending interrogating a senior, or an argument where the vascular attending decides to tell the trauma attending how to handle a trauma code, or a chance to dump our frustrations on the computer specialists who come to explain how to use the new system – academic days are always exciting.
It would be both difficult and dangerous to tell a surgery attending that you appreciate him, so I’m going to use this as an outlet to repeat how much I like my program. The hospital is good, most of the nurses are good, the food is edible, there are plenty of computers around (whether for checking labs, or playing with email). I like and respect the majority of the other surgery residents. The attendings are mostly much nicer than I had hoped for, and all seem to be enthusiastic about teaching. This program is as good or better than I could have hoped for, and I’m happy to be here. (No matter how grumpy I get sometimes.)
A couple of times every day I need supplies for patient care, and every single time I have a reason to smile: the nurses gave me a secret code to get into the supplies. Like most hospitals, this one keeps not only the medications locked up, but also all the basic supplies, like needles, syringes, gauze pads, wound dressings, lubricant, stitches, cotton swabs, steri-strips – you name any useful article, and it’s locked up. Which for most residents means that every time they want to do anything more advanced than touch a patient, they have to interrupt a busy nurse, get her to go into the locked room, open the locked cabinets, find the hidden items, and sign them out, before they can do anything. Towards the end of last month, whether because they now trusted or me, or because I had made myself so annoying, one of the nurses gave me a secret code. I had thought it would take me a couple of years to arrive at this, because so far I’ve mostly seen chiefs entering the supply rooms alone. But now I have a code (I have a code!) and I can get supplies for myself. I can do things on my own, and I don’t have to bug the nurses. I’m still thrilled every time I do it, because I hated asking the nurses. (It was always a dilemma: ask the one who’s already in the room doing something, the one who’s closest, the one at the other end of the station who doesn’t look too busy, or go find the nurse for the patient you want to take care of right now?) Now I can take out drains, sew incisions, change dressings, take cultures, and several other small jobs without having to waste time finding a nurse and wasting her time, too.
I’m also slowly starting to understand exactly how draining it is on the neurosurgery residents to be on overnight call q4 or q5, forever, and never leave the hospital before noon the day after. They don’t sleep on call nights, either. They’re responsible for an ICU full of sick patients, a floor full of post-op patients, and there’s always something in the ER. Usually there’s at least one emergent surgery overnight. I really can’t blame them for getting as irritable as they do, whether it’s their call day, and they’re contemplating the coming night, or the day after, when they’re exhausted, but have too many jobs to do to leave the hospital. I try to help, but there are some things that I’m no good for: placing ventriculostomies, for example.
September 19, 2007 at 11:22 pm
That schedule sounds a heck of a lot like mine. After this month without call I am q4 or q5 for the rest of my intern year, and for 9 months of my second year. Except when I’m q3.
But congrats on the supply code. I was told by a surgery intern while I was a third year med student that the key to being a good intern was having all the supplies, all the codes for the pyxis (our supply lockbox), all the phone numbers for like the radiology call room, all the codes for the secret doors and back passages, copy machines, etc. I carry them in a book, which I never let out of my sight.
September 20, 2007 at 7:32 pm
Yes, exactly. The back door codes were one of the few things they told us on June 30, and I did indeed write them down. The copying machines are another matter. Here they’re so tightly supervised that even the iconoclastic nurses refuse to give the codes out (which is kind of ridiculous; but surgery rounds don’t depend on photocopied notes as much as, ahem, medicine rounds do
).
September 21, 2007 at 4:24 pm
I was a bit devious in getting the copier codes. It involved seeing the book the head nurse had them written down in, and then pretending to write down vitals on a patient while waiting for her to step out of the room. I should feel guilty…
September 22, 2007 at 9:38 am
Yes, you should feel guilty.
I’m developing a very low regard for rules which hinder efficiency for no good reason. I have taken to abstracting hospital scrubs now, because they don’t let the surgery residents have any. How silly is that?
September 23, 2007 at 7:32 pm
Alice,
You’re learning to game the system! How refreshing.
I hate the constant codes for everything. At least my badge will open most of the things I need to open. I’m not looking forward to the new pyxis system that’s coming soon.