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Addenda: - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
Z let me know that the DNR patient did finally die...this was accomplished by the expedient measure of arranging for her to go home with Hospice. It's a rule of residency: If you want someone to die in the hospital, arrange for them to go home with Home Hospice. They will die on the day before discharge, but after the equipment has been delivered. Usually, when their family have gone to get the first hour's sleep in the last week.

Other Rules of Residency:
- Really Nice People on Staff Medicine who have an unclear diagnosis have a Bad Thing wrong with them and will die.
- Cocaine saves heart cells. You can do cocaine when your heart is pumping at 1/5 its recommended capacity and stay alive for years. If you are a clean liver, you will require Home Hospice.
- The crazier you are, the less likely Psychiatry is to recommend you be admitted to their hospital when medically stable.
- All pill ingestions which result in survival could not possibly have been serious, so don't expect Psychiatry to tell you your patient is really suicidal.
- The code siren only goes off when you are on the extreme opposite end of the hospital from the trouble in question, unless you are not required to respond, in which case you are Right Next To The Room.
A side note: Our code siren sounds exactly like the 'sandwich is done!' bell on the panini maker at Starbucks on the second floor.
- Alcoholics come in two varieties: Very Nice People who are genuinely sorry for their problem and eager to accept any help you offer, just like the last 345346094534 times they were admitted, and Complete Jerkoffs who will require doses of benzodiazepines sufficient to anesthetize most of the San Francisco zoo just to satisfy their craving for a high. The latter will force your cross-covering resident to interrupt a night of unexpectedly blissful silence in order to explain at length that people die of alcohol withdrawal before leaving anyway against medical advice. See Cocaine entry.
- When you enter the Emergency Department, people who were ready to walk out and go home happy suddenly develop crushing chest pain or fall over screaming, Just For You.

Tonight, I am feeling cynical. It may be because I had a patient today tell me that she couldn't possibly go to her Psychiatry appointment (which we have arranged three months in advance) because her bangs were too long and she looked like "Fluffy the dog".
This, too, shall pass.

now feeling:: cynical cynical

12 whispers echo . o O ( ... ) O o . whisper a word
surgeonufo From: surgeonufo Date: January 31st, 2008 08:47 pm (UTC) (etched in stone)
When sitting in class and listening to lectures about the length/tension graph, and active tension curve of cardiac muscle, I wish I was doing that.
ayradyss From: ayradyss Date: January 31st, 2008 10:34 pm (UTC) (etched in stone)
It gets better ;)

I hated Physiology.
pwwka From: pwwka Date: February 1st, 2008 01:00 am (UTC) (etched in stone)
A side note: Our code siren sounds exactly like the 'sandwich is done!' bell on the panini maker at Starbucks on the second floor.

Ding! Your pastrami is getting cold!

From: broken_onewon1 Date: February 1st, 2008 01:24 am (UTC) (etched in stone)
Sounds like you deal a lot with people who end up at the hospital due to self inflected wounds so to speak fluffy girl being a prime example. I don't see how you have the patience for it.
ayradyss From: ayradyss Date: February 1st, 2008 02:17 pm (UTC) (etched in stone)
Oh, "Fluffy the dog" would never hurt herself. She's just plumb crazy :P
winktwice From: winktwice Date: February 1st, 2008 01:51 pm (UTC) (etched in stone)
starbucks ding, heh

Psychiatry--how does it work? Do you recommend that patients you know or suspect inflicted their own injuries, or do all hospital patients get evaluated?
ayradyss From: ayradyss Date: February 1st, 2008 02:16 pm (UTC) (etched in stone)
We call a psych consult - basically, we let the Behavioral Health nurse know that we want a psych doc to see the patient, then she calls their Secret Number, and supposedly someone will see them within 24 hours or so.

Anyone who has suicidal ideation expressed mandates suicide precautions and a consult, no matter how ludicrous it seems. Otherwise, we use our own judgment.
jays_princess From: jays_princess Date: February 6th, 2008 04:29 am (UTC) (etched in stone)
i have to add one more...

the ER physicians know exactly when you make it to the call room. there must be a camera in there because then, and only then, is when the pager goes off. they don't bother to let you know about the waiting patient while you were down admitting the last three patients, they wait until you get to the call room.

at least, they do where i am.
ayradyss From: ayradyss Date: February 6th, 2008 01:10 pm (UTC) (etched in stone)
Around here, it's more like "Hey B! I got another for you!"...as they're wheeling someone in from the ambulance bay on a gurney.
From: (Anonymous) Date: March 3rd, 2008 03:46 pm (UTC) (etched in stone)

patients have feelings too!

Hi patients struggle someimes and we are all human!

See my blog loving life and living but with "peggypeg" for company!

No I am not going crazy!

See for yourself..!


ayradyss From: ayradyss Date: March 3rd, 2008 05:06 pm (UTC) (etched in stone)

Re: patients have feelings too!

Good luck - chronic illness is hard.
vvalkyri From: vvalkyri Date: April 1st, 2008 06:16 pm (UTC) (etched in stone)

A side note: Our code siren sounds exactly like the 'sandwich is done!' bell on the panini maker at Starbucks on the second floor.

This made me laugh aloud.

(found you via turnberry)
12 whispers echo . o O ( ... ) O o . whisper a word