Friday, October 3, 2008

How Many Buttons Can They Push...? (And, a meme to get my mind off them)

Let's see if the on-call gods can push every possible button until I die of exasperation.

Button #1: Beeper goes off as I'm driving to work.

I'm coming, y'all, what could possibly be the problem this early in the day?

I make the call-back. The nurse says, "It's about the first patient..."

Button #2: NPO violation

"...He drank coffee with cream and orange juice with pulp and came in chewing gum. What do you want to do?"

I want to turn the car around, crawl back into bed with my loving spouse, and sleep and sleep until my call weekend is over.

"Bump him to the end of the line, please. Next?"

Button #3: Having to explain a clinical decision to uphold safety guidelines to a patient who has violated them.

"That counts?!" He says when I explain. Yup, it counts. That's why they tell you when you're the first patient of the day, please, sir, taking NOTHING. BY. MOUTH. before your surgery.

"But why?" he asks, as if I were an irrational despot about to exile him from fair Verona. So I go into my spiel about the risk of aspiration, increased gastric acidity and fluid volume, etc., etc. and how it's my job to protect his safety during the procedure, etc., etc., etc.

Button #4: Ignorant tactlessness.

The wife or girlfriend pipes up, "Is this the doctor who's going to be working on you?"

And the patient says, "Oh, no - this is just the anesthesiologist..."

That could be interpreted innocently. But he doesn't stop there. He explains. "...All she does is knock me out."

A plague on both your houses. Why don't you just call me "Missy," too, while you're at it?

Button #5: Poor listening and inconsistent discipline among folks who are supposed to be part of your medical team. Don't get me wrong, I appreciate a relaxed atmostphere and overall friendliness in the workplace, but that doesn't mean the O.R. can turn into a social gathering.

Button #6: Add-ons. Endless add-ons. Add-ons after the add-ons. Add-ons at other hospitals, even, that I can't possibly make because I'm stuck at THIS one.

Button #7: The "too tired" state. Finally home after yet another 13-hour day but too tired to enjoy the company of my loving family and dreading the infernal beeper going off again. Exhausted but in that awful "too tired to sleep" state, when your body feels like a truck ran over it but your mind is racing with all the buttons that got pushed today. At least there weren't any mendacious drug-seekers or bellicose aggressors (like a patient from this past week who practically assaulted one of my colleagues because, surprise surprise, she had made a clinical decision to keep him in the hospital based on our profession's safety guidelines...)


Here's what I'm gonna do to try to unwind and relax a little bit. I'm gonna play. I think adults should make play a priority. My game tonight will be a meme Patty from Oboeinsight has tagged me with: to share six personal things that readers might not necessarily know about me.

Hmm...Let's see...

-I played Little Miss Muffet in a school pageant in kindergarten.

-Like Kathleen (see #76 on her list of 100 things), I secretly love Martha Stewart's skills and ideas but you'd NEVER believe it looking at my house...

-It bothers me when the roll of toilet paper is hung so the end of it comes out from UNDER the roll instead of over the top of the roll. Apparently this is a pet peeve I share with Lea Salonga.

-As a child when I really liked a movie I'd watch the video over and over and over and over again. One movie that got this kind of wear (so to speak) was The Red Shoes. I am STILL addicted to movie quoting and probably have a random movie quote for almost anything...

Hmm...TWO more? Thinking...thinking...

-I don't like to call up restaurants and place take-out orders. I have a mental block about making phone calls like that. I don't know why.

-Through Anali's blog I got inspired by this question from writer/blogger/photographer Karen Walrond: "What are some of the things you own that you think are pretty iconic representations of who you are?" I'd have to say, probably my Christmas music collection, my books, and a home-made candle my friend Sheila gave me that's decorated with a cross and an unfolded manuscript.

I don't know if I can tag six more people (Ramona? Oystein? Wanna play? Katy came up with TEN things - how'd you do that?!). I'll just send it out to anyone who might be reading this; consider yourselves all "tagged!"

And if any one has an "EASY BUTTON" out there for me, I'll take that over these other ones! :)


Patty said...

Thanks for playing along, T!

When our daughter had to have surgery on her hand (she was in middle school I think ... roller blading injury. Sigh.) I gave her OJ in the morning. They had repeatedly said "clear liquids". Me? I thought OJ was clear. How stupid could I be? Well ... obviously THAT stupid! They sent her home and had her come in the next day, poor thing.

Oh ... and they kept the needle in her hand, because she's not an easy one to stick. I didn't know it at the time, but it totally freaked her out. Double sigh.

I did some dumb things as a mom. I think she survived, but I still feel bad about 'em.

And now off to bed in my lonely, lonely house. Everyone is gone. I'm going to go feel sorry for myself. Because I can.

T. said...

Wow, was it still a needle IV back then? I had one of those in the Philippines when I got typhoid in 1978...I wonder when the needle-less IV cannulas we use now were invented...

As for the OJ - happens ALL. THE. TIME. Don't beat yourself up about it!

Isn't it therapeutic to do just that - allow a little moment of feeling sorry for oneself, just a moment, to get it out? That's what this post was. I felt like whining, so I did. Roll music: "It's my blog-gy and I'll cry if I want to, cry if I want to, cry if I want would cry too if it happened to you...!" :)

rlbates said...

-It bothers me when the roll of toilet paper is hung so the end of it comes out from UNDER the roll instead of over the top of the roll.

Me too!

Dragonfly said...

"just the anesthesiologist...". My goodness. Just the person KEEPING YOU ALIVE!

Anonymous said...

Brilliant post! So many times, I've felt that I'm *inconviencing* a patient because I delay the case after the patient drank coffee with milk. How is that clear fluids?

And an actual conversation with a patient waking up from sedation for a colonoscopy:
Patient, groggily: How did things go?
Nurse, pushing the stretcher with me: Don't ask him; he's just the anesthesiologist!
Patient: Anesthesiologists are very important! What they do is just as important as the procedure!

I felt like kissing her.

T. said...

Thanks, Jonathan! BTW, I just read and LOVED and linked to your post "Maybe I should get a desk job." And NO, you shouldn't, because the WONDERFUL job you did with that bougie suggests to me that our profession needs docs like you to stay. Nice work! :)

Anonymous said...

Add-ons...UGH!! Now there's something I don't miss.

Um, did I know you knew of Lea Salonga? I'm such a fan!! In fact, I was just listening to Miss Saigon the other day. She's incredible.

I've been sort of in and out of the blogs lately...busy with my show and also a little blue about my Sweet Pea. But please don't mistake my absence for any lack of love!!

BTW, I was thinking about you this morning (can you think about someone you don't even know?) and wondering if the fall colors are gorgeous where you are. Someday I'm going to travel up that way in for a little autumn tour.

Have a great week!!

T. said...

Lea and I were in school together! (She was a grade ahead of me - and we were even in a school play together, so I could say I've been on stage with Lea Salonga...she's a total sweetheart.)

If you're up in New England, you gotta let me know! (Been thinking of visiting my two San Antonio friends some time myself...)\

And funny you mention thinking of people you don't even know. I was JUST thinking the other day that there's a whole new category of acquaintance/friendship, and I actually do think of my blog friends too, either by picturing their blog pictures or what I imagine from their blog posts...

Patty said...

Gee, T ... maybe I'm wrong ... but whatever they sent her home with ... something was in her hand! I know about as much about medical stuff as I know about ... oh, anything but oboe, I suppose. And right now (speaking of whining!) I'm in my "crisis of confidence mode" which means I feel as if I know nothing about oboe either.

(When a student of mine fell apart entirely and sobbed, "I'm not getting any better! I sound awful!" I wanted to say back "ME TOO!" and then cry along. But I guess teachers can't do that, can the?!)

Anyhoo ... I continue to appreciate your blog and love what you write. And every time I see an anesthesiologist (oh heck, how come I can't spell that ... I had to cut & paste to get it right!) I think of you and of just how important all of you are. Thanks!