This call thing is pretty difficult
07/01/08 01:06 Filed in: Medical
So I have been on call twice now since starting
residency, and I have to say it's definitely a
challenge. In many ways, I think being totally busy
all night might actually make it easier than being
sporadically busy at times spaced out just so there
is no way you can actually get to lie down and rest
for a few minutes. I really think that this system
has to change - it's really not good for anyone to
have sleep-deprived doctors presenting information,
placing orders, and signing out critical information
to other people. But that's a project that'll have to
wait for now.
Now that there is a 30 consecutive hour rule (you technically have to go home after 30 hours), it's probably a lot easier than it could be. But still, the other day I was thinking that in one overnight call, I was putting in 75% of what is considered to be a normal workweek by traditional standards. And while I had similar calls as a medical student, it was never as busy as it is now (the pager never stops these days). It's nearly impossible to keep up, since there are so many people who need you to do something all at the same time.
It really hit me around midnight of my first call (when I had been at work for 18 hours), when I felt like I was still feeling okay, but that I still had twelve more hours to go. I've found that I really start to tire out right around pre-rounding time, when I am supposed to working fast to finish my notes and collect all the tiny bits of information needed to present on rounds. It's particularly difficult since it is often the first time I can sit down (at a computer), and then the fatigue totally hits me.
To put things in perspective, my first month is on a critical care unit. As a med student, we only carried one or two patients on our critical care months, since these patients are often very sick with lots of complicated things going on. Well, talk about abrupt transition. Somehow, between being a medical student and intern (really only a matter of days), the workload progressed from two patients to up to eight or even ten critical care patients, which is definitely a challenge to say the least. I keep going in earlier and earlier to pre-round, since it's becoming harder and harder to get everything done by the time we round in the morning.
Anyhow, I've got a few things to work on before going to bed (there is a lot of logging of patients, procedures, dictating, etc.) so I better stop now. I'll keep trying to post as much as I can (but probably not on call or post-call days).
Now that there is a 30 consecutive hour rule (you technically have to go home after 30 hours), it's probably a lot easier than it could be. But still, the other day I was thinking that in one overnight call, I was putting in 75% of what is considered to be a normal workweek by traditional standards. And while I had similar calls as a medical student, it was never as busy as it is now (the pager never stops these days). It's nearly impossible to keep up, since there are so many people who need you to do something all at the same time.
It really hit me around midnight of my first call (when I had been at work for 18 hours), when I felt like I was still feeling okay, but that I still had twelve more hours to go. I've found that I really start to tire out right around pre-rounding time, when I am supposed to working fast to finish my notes and collect all the tiny bits of information needed to present on rounds. It's particularly difficult since it is often the first time I can sit down (at a computer), and then the fatigue totally hits me.
To put things in perspective, my first month is on a critical care unit. As a med student, we only carried one or two patients on our critical care months, since these patients are often very sick with lots of complicated things going on. Well, talk about abrupt transition. Somehow, between being a medical student and intern (really only a matter of days), the workload progressed from two patients to up to eight or even ten critical care patients, which is definitely a challenge to say the least. I keep going in earlier and earlier to pre-round, since it's becoming harder and harder to get everything done by the time we round in the morning.
Anyhow, I've got a few things to work on before going to bed (there is a lot of logging of patients, procedures, dictating, etc.) so I better stop now. I'll keep trying to post as much as I can (but probably not on call or post-call days).
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