Being on call is rough, especially when it's something you're not interested in. I think the system of being on for 30+ hours is a little insane, especially with a lot of acutely ill patients.
Sure, the continuity is good, and you get to see how "episodes" of patient illness play out. It just takes a toll on you physically. I stay up all 30+ hours because going into a call room on a hard bed with sandpaper sheets is awful and actually ruins my morale a little.
I hate sleeping in a call room and feel much better just staying awake, working and reading articles. The hospital is my home away from home now, and is going to be from now on. Rough, but I'm determined to find a way to make it less awful.
A way to make call better is rounding probably around 10 or 11 pm and talking to the nurses and seeing if they have any concerns. I think being proactive helps a lot. I know some nurses who know about a problem or an issue and don't tell you right away. Asking them before you round helps a lot.
It helps a lot too if you're cross-covering on patients who aren't yours. I like to catch up on patients a second time (first through the covering doctor) as I start the night, then if things are quiet, go see what I can do to help the nurses.
The worst parts of call are waiting for the attending to show up and waiting for rounds to start when you've already spent 28 hours on service.
Maybe things will get better as I get better at taking call. I'm not sure if I'll ever condition my body to do well with call, but there's always hope
Last time I had over 20 hours without any rest :(
ReplyDeleteHey there,
ReplyDeleteI thoroughly agree with everything in this post! I just finished my month of ICU as a 2nd year resident. I found that rounding on the patients with your intern a couple of times through out the night during down time was extremely helpful, not only in alleviating any of the nurses concerns, but also anticipating any potential disasters that may occur later on in the night. It also helps reiterate the over all plan of each patient.
Oh, and yes, there's nothing worse than waiting for the attendings to come round in the morning and presenting complex cases to them after you've been up for 30+ hours! None the less, I think it'll get better for the both of us as we spend more time doing it.
Great post,
Hirsh