ICU rounds post-call ought to be banned by the Geneva Convention.
Come to think of it, really they’re already covered under the Fifth Amendment – cruel and unusual punishment.
If the computers weren’t so heavy, I would have been throwing them at the end of rounds. I hate it when the attending asks you the same question three times, and then makes a decision based on the information you told him not existing. Or when, on post-call rounds, he starts explaining in excruciating detail why you should never do – what his senior colleague did two days ago, and it’s now somehow my error.
It was funny to start with, but now I’ve had enough of this business of six different attendings each laying down the law to me about something, and then turning around and calling me a fool for having gone along with their colleague’s plan. Also it was a bit of a let-down, having kept a patient so sick we didn’t expect him to last three hours alive all night (honestly, by not touching him at all), and being a little pleased with myself on that score, to have the attending show up and be angry about the only single order I made on him all night. Come on, the guy is still alive. Isn’t that worth a little tolerance? Did you really expect me to cure him, too?
August 13, 2009 at 9:29 pm
“Reminding Us Why” by rcentor
http://www.medrants.com/archives/2461
August 13, 2009 at 9:45 pm
THIS. You have summed up my entire week. I got lectured for SIX HOURS on how sedation lead to long intubations and was wrong and evil and blah blah blah. You would think at the end of the first hour, the attending would have gathered that his precedent had a different philosophy, but apparently not. And it’s true: the patients weren’t on the vent for very long once they weren’t sedated, mostly because they all self-extubated that evening, leading to a very stressful night on call.
GRRR.
August 14, 2009 at 11:43 pm
I enjoy reading about your quest! Have you ever read “The Making of a Surgeon” by William Nolen?
(I think you may mean the Eighth Amendment.)
August 16, 2009 at 2:00 pm
Attending vs attending, with me caught in the middle, used to drive me crazy as a resident too. Now that I am an attending, though, I see it as valuable…learning 2 ways to do (or not do) something. Your personal angst will pass and you will be left with multiple tools for your future patients. Now all you have to do is wait! Enjoy your blog.