Friday, August 31, 2007

Off Service

When I switched to the ICU I did so very deliberately. I knew that I wanted a surgical unit. Medical and cardiac just wasn't me. In neuro we do our fair share of trauma patients as well as get plenty of surgical ICU overflow. Unfortunately, an ICU is an ICU and when the shit hits the fan we can get whatever they send us. We are lucky in neurosurgery that we don't get interns. All of our residents have at least a year under their belts and can be trusted not to kill the damn patients.

However, when we get overflow ICU patients you NEVER know what will show up! Neurology is the worst. Most neurology residents do not speak very good English and are downright scary. I have heard the neurology "class photo" described as the terrorists. None of them smile... its kind of creepy. So neurology could fuck up a wet dream. I had a confused old lady that answered 'yes' to every question. The resident asked if she was having chest pain.... 'yes'

does it hurt when you take a deep breath?
are you short of breath?
does it go into your neck and back?

after a few minutes of this the resident and his intern approached me, very concerned. They asked how soon we could get granny to the cardiac cath lab. (its 3am)I gave them the "what the fuck" look, having watched her ekg all night and being more concerned if the coffee was fresh. They explained that she was having symptoms of an acute MI and needed to go to the cath lab as soon as I (?!?!?) could get the cath team together. OK, I have to see this for myself....

Are you having chest pain?
are you short of breath?
are you pregnant (she's 77)?
do you fly a helicopter under water?

ok, have a good night. I did get an apology from the resident, which was surprising. It would have been funny as shit to see the interventional cardiology attending rip the resident a new asshole. I could have sold tickets.

So off service residents give me chest pain. It is hard to trust people with very little experience that I rarely work with.

PS: Princess Di died 10 years ago today. I was a sophmore in college and my boyfriend had come up to visit. I can't believe it has been 10 years.


Blogger Angry Nurse said...

Interesting comment about neurology residents with language barriers!

Same problem at my hospital actually, I had to inform one resident awhile back that perhaps the reason why the patient appeared confused is that she didn't under stand the questions he was asking.

It was very gratifying to watch his confused look fade as I repeated each of his questions to the patient and unlike him got the appropriate answers...

Guess his ability to communicate or the lack thereof was ignored in this guy’s interview for the program…

11:53 AM  
Blogger jeepgirl said...

Our Psych residents are just as bad! Imagine being CCFCP (coo-coo for cocoa puffs) hearing voices in your head and some damn doc tries to talk to you like he is selling a squishee at Kwik-E-Mart.No wonder people are so fucking crazy!

8:12 PM  
Blogger Michell said...

I'm just in the last few months getting to experience the wonders that are part of a teaching hospital complete with residents. Oh my I never knew how lucky I was when I was not at a teaching hospital. They are seriously enough to make you crazy sometimes.

3:22 AM  

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