*beep*beep*beep*.....

Q-Optics, surgical ergonomics - redefined
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ExtraCrispy

ExtraCrispy

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Just for giggles, what are some of the memorable/ groan-worthy / laughable / unbelievable pages that have come through on that little plastic beeping bastard during your residency?

I'll start with a recent one of mine:

*BEEP*BEEP*
"Come to OR 6 to drain butt pus."

Wahoo! :thumbup:
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My buddy is a PGY-3 optho and he has had 2 memorable run-ins.

1. Consult to the newborn nursery for "Does this baby have eyes?" Answer: "Yes, but you have to open the lids."

2. Consult from Ortho resident: "My dog has a hyphema. Can you come by the house and take a look?" My friend actually went and took a look.

My friend answered each page curteously despite however pathetic the consult. I guess you can never be too nice to your collegues.
 
ok, i'll play.

beep i answered this week. "this is attending soandso from the ER, we consulted your resident on a lesion in the coccyx. he said to get a CT."

i say, "ok. why are you consulting us (ortho)?"

er attending "well he has back pain after being hit with a chair in his back."

i say, "ok. but does he have ass pain?"

er attending "well i don't know."

i say, "well you do know that the 'cockix' is near the dingus?"

er attending (pause), "well we just feel someone from ortho should see him."

i say, "no problem, we will examine him for you since you haven't bothered to examine the patient and are going off a radiographic reading that has no relation to the actual clinical complaint."

in the end, he had back pain from being hit in the back by a chair. everything including rectal exam done by orthopaedics, normal.

(i love when another attending tries to get my residents in trouble. my resident is always right until proven otherwise.)
 
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PediBoneDoc said:
ok, i'll play.

i say, "ok. but does he have ass pain?"

er attending "well i don't know."
Click to expand...

I always thought that general surgery owned the "does he have @ss pain?" line of questioning. It's nice to see Ortho having to deal with some butt stuff.:D
 
beep. beep. (at 2:30am)

"I was just going through your patient's chart and realized that he is not getting the colace he usually takes at home. Can I get an order for that?"
 
beep beep beep (at 3:00 am)

RN:"I just wanted you to know that your patient had a headache so I gave him so Tylenol."

Me: "Huh...do you need a verbal for the Tylenol?"

RN:" No I just wanted you to know that I gave it to him."

Me: "Yeah, gee thanks. MD aware.":mad:

beep beep beep (at 5:15 am, last 15 minutes of sleep before 530 rounds)

RN: "just calling you to give you Mr. So and So's labs. Blah blah bla--"

Me: "are any abnormal?"

RN: "No, but I just wanted to..."

Me: "thanks but you don't need to call me 15 minutes before rounds, especially with normal labs, unless the patient is dying."

RN: "Fine, I'll never page you again..."

Yeah...right!:laugh:
 
Oh wow...I have a ton of these. It seems like the pages just get better and better as the year goes on.

From a floor nurse (at 3 AM) - "Doctor, the patient's troponin just came back. It's < 0.05."

Me - "Uh...okay. Thanks."
Nurse - "But normal is 0.05-0.5. So...isn't that low?"
Me - "[afraid to say anything]"

And then, a true classic, from a frantic-sounding medicine intern,
"IS THIS COLORECTAL SURGERY?!"
Me - "Yeah."
Med Intern - "I'm calling about a patient who you saw last week and signed off of...we got a new CT scan and it shows that his tumors are still there..."

Me - "Uh-huh. He's got a belly full of unresectable tumor. That's not news."
Med Intern - "No, but that's not why I'm calling you. The radiology read said that there's HEMORRHAGIC FECAL MATERIAL in the colon!!"

Me - "Hemorrhagic fecal material."
Med Intern - "!!!!"
Me - "So his feces are bleeding, huh? Yeah, someone should probably do something about that..."
[The radiology read said nothing about hemorrhagic feces, by the way. I think some bored radiology resident was just screwing around with her.]

And finally, from my urology rotation, at 10 PM on a weeknight (not on call, just trying to get done with a horrendous day)

Medicine Resident - "[chirpy] Hi, I'd like to call in a consult?"
Me - "You do realize it's after 10 PM, right?"
Med Resident - "Yeah, but we'd like you to see this patient tonight."
Me - "So this is an urgent consult?"
Med Resident - "Yes. This patient is a pregnant lady who came in with hyperemesis gravidum, and our med student did a rectal and found a prostate."
Me - "A prostate. So did you confirm this?"
Med Resident - "Oh yes. There is definitely a prostate."
Me - "Well, either she's pregnant or she has a prostate, but..."
Med Resident - "Well, she's definitely pregnant and definitely has a prostate. Can you please come see her now?"
Me - [getting irritated] "Let me get this straight. You palpated a rectal mass. Can you kindly explain to me how you came to the brilliant conclusion that it's a prostate?"
Med Resident - "I mean...what else would it be?"
Me - "I am NOT coming down to see a pregnant lady with a rectal mass, you idiot."
Med Resident - "But...I mean, she has a..."
Me - "DID YOU GO TO MEDICAL SCHOOL OR DIDN'T YOU?! I changed my mind. I'm coming down there and we're discussing this in person."

I stormed down to the patient's room to find, not a justly terrified medicine intern but the entire trauma team sitting at the nurse's station laughing their asses off :laugh: ...that was weeks ago, but I still haven't lived it down....
 
MediCane2006 said:
Medicine Resident - "[chirpy] Hi, I'd like to call in a consult?"
Me - "You do realize it's after 10 PM, right?"
Med Resident - "Yeah, but we'd like you to see this patient tonight."
Me - "So this is an urgent consult?"
Med Resident - "Yes. This patient is a pregnant lady who came in with hyperemesis gravidum, and our med student did a rectal and found a prostate."
Me - "A prostate. So did you confirm this?"
Med Resident - "Oh yes. There is definitely a prostate."
Me - "Well, either she's pregnant or she has a prostate, but..."
Med Resident - "Well, she's definitely pregnant and definitely has a prostate. Can you please come see her now?"
Me - [getting irritated] "Let me get this straight. You palpated a rectal mass. Can you kindly explain to me how you came to the brilliant conclusion that it's a prostate?"
Med Resident - "I mean...what else would it be?"
Me - "I am NOT coming down to see a pregnant lady with a rectal mass, you idiot."
Med Resident - "But...I mean, she has a..."
Me - "DID YOU GO TO MEDICAL SCHOOL OR DIDN'T YOU?! I changed my mind. I'm coming down there and we're discussing this in person."

I stormed down to the patient's room to find, not a justly terrified medicine intern but the entire trauma team sitting at the nurse's station laughing their asses off :laugh: ...that was weeks ago, but I still haven't lived it down....
Click to expand...

:laugh: :laugh: :laugh:
Thanks for making my call night!
 
When I was an intern covering Thoracic, CV, Vascular and Neurosurgery on overnight call:

Beep! Beep! Beep!

Extension to Thoracic floor on beeper. (It's 4AM.)

I call the extension.

Me: "Drnjbmd, What can I do for you?" (In my cheeriest voice)

Nurse: (Panic in voice) "Mr. W has cut his chest tubes, stabbed the nurse and took off running. We need you to come out here and chase him right now."

Me: (Question in voice) "Be right there but how far do you think he can get with one lung?" "Which way did he go?"

Just as I open the door to my call room...

I come out of my call room just in time for my patient to collapse in a heap in wheelchair that I grab just as he starts falling. He had the chest intact but had cut the rubber tubing. The nursing staff had left scissors at his bedside. I wheeled him back to his room, replaced the Pneumovac, checked a chest film and sat with him while I spoke with the attending. An earlier dose of steroids had caused the brief delerium and now the poor gentleman was in tears.

The nurse in question, was taken to the ER with a minor laceration on her forearm but spent one week out because of the "trauma" of the attack.

The next day the attending bought deli trays for the floor and gave me two days off that week for quick thinking.
 
beep beep beep (on a busy night)

Me (after being put on hold for WAY too long): "Hello?"

RN: "Doctor, Mr. soandso spiked a fever two hours ago."

Me: "How high?"

RN: "huh?"

Me: "How high of a fever?"

RN: "Ugh...let me look. Ugh...99.8. Do you want me to give some tylenol?"

Me: ...click.
 
ExtraCrispy said:
Just for giggles, what are some of the ... unbelievable pages that have come through on that little plastic beeping bastard during your residency?

*BEEP*BEEP*
Click to expand...

I will never forget this one, in the middle of two unstable trauma alerts (which are called overhead):

RN: Dr. Tigger, we can't read Dr. Not-a-surgeon's orders. Can you come read them for us?
 
"Doctor, the patient is on a clear liquid diet....what are the ice parameters?"

"Doctor, is there aspirin in tylenol?"

"Doctor, the patient is complaining that his urine is grapefruit colored, but thicker."

"Doctor, patient so and so is from Bangladesh...don't they speak Spanish there?"

After getting STAT overhead paged by the floor: "Doctor, the patient needs something to sleep."
 
You guys at least get the intresting ones, I just get ******ed pages.

We can't find the scrips for the patient you wanted discharged.

Um, did you check the front of the chart. The scrips are bright pink and are physically attached to the first ring on the chart.

Oh, there they are. I didn't think to look there. Sorry to bother you.

or

You ordered laxative of choice for this patient, but I can't find that particular brand in the computer.

or

You had ordered tylenol, but all the pharmacy carries is acetominophen. No, I am not kidding.

-Mike
 
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Tater said:
"Doctor, the patient is complaining that his urine is grapefruit colored, but thicker."
Click to expand...

Hey, I'm just a soon to be intern, but this one sounds somewhat legit. No :confused:
 
Doc Ivy said:
Hey, I'm just a soon to be intern, but this one sounds somewhat legit. No :confused:
Click to expand...

Believe me, there was no hematuria there. He was just being creative in asking for dilaudid.
 
Just as I'm sitting down at 3 PM to lunch, on a Saturday call...

BEEP BEEP BEEP
(It's a number from the neuroscience hospital 3 blocks away)

Neurosurg - "We pulled an endovascular femoral sheath on this 85-year-old, and now she's lost pulses in that foot. It's turning purple, too."

Me - [annoyed, but this sounds legit] - "Okay, get a doppler to the bedside, I'll be right over."

So I ran three blocks, in the rain, arrived at the patient's bedside to find a nurse calmly charting and the patient fast asleep.

Nurse - "Oh, hi. You're from vascular surgery?"
Me - "Yes. Can I get the doppler - "
Nurse - "Oh, don't worry. As soon as Dr. Neurosurgeon took the Fem-Stop pressure cuff off the leg, the pulses came right back..."
Me - "Get me Dr. Neurosurgeon's pager..." [Dr Neurosurgeon calls back] "THERE'S A REASON THEY CALL IT A FEM-*STOP*, GENIUS!
 
njbmd said:
When I was an intern covering Thoracic, CV, Vascular and Neurosurgery on overnight call:

Beep! Beep! Beep!

Extension to Thoracic floor on beeper. (It's 4AM.)

I call the extension.

Me: "Drnjbmd, What can I do for you?" (In my cheeriest voice)

Nurse: (Panic in voice) "Mr. W has cut his chest tubes, stabbed the nurse and took off running. We need you to come out here and chase him right now."

Me: (Question in voice) "Be right there but how far do you think he can get with one lung?" "Which way did he go?"

Just as I open the door to my call room...

I come out of my call room just in time for my patient to collapse in a heap in wheelchair that I grab just as he starts falling. He had the chest intact but had cut the rubber tubing. The nursing staff had left scissors at his bedside. I wheeled him back to his room, replaced the Pneumovac, checked a chest film and sat with him while I spoke with the attending. An earlier dose of steroids had caused the brief delerium and now the poor gentleman was in tears.

The nurse in question, was taken to the ER with a minor laceration on her forearm but spent one week out because of the "trauma" of the attack.

The next day the attending bought deli trays for the floor and gave me two days off that week for quick thinking.
Click to expand...
Lol. I think that that is why I'm drawn to surgery. They just seem to know what to do and usually never seem panicked. Lol, there was a little overexaggeration though on the nurses part.
 
There may not have been exaggeration... one of my colleagues was chased into a closet by an elderly man who chased her and tried to assault her with his crutches. Needless to say, he had just had his femur rodded, and it required re-operation.
 
MediCane2006 said:
Oh wow...I have a ton of these. It seems like the pages just get better and better as the year goes on.

Me - "DID YOU GO TO MEDICAL SCHOOL OR DIDN'T YOU?! I changed my mind. I'm coming down there and we're discussing this in person."

I stormed down to the patient's room to find, not a justly terrified medicine intern but the entire trauma team sitting at the nurse's station laughing their asses off :laugh: ...that was weeks ago, but I still haven't lived it down....
Click to expand...

MediCane2006 said:
Just as I'm sitting down at 3 PM to lunch, on a Saturday call...

BEEP BEEP BEEP

Me - [annoyed, but this sounds legit] - "Okay, get a doppler to the bedside, I'll be right over."

Nurse - "Oh, don't worry. As soon as Dr. Neurosurgeon took the Fem-Stop pressure cuff off the leg, the pulses came right back..."
Me - "Get me Dr. Neurosurgeon's pager..." [Dr Neurosurgeon calls back] "THERE'S A REASON THEY CALL IT A FEM-*STOP*, GENIUS!
Click to expand...

I really hope the last part of both of these stories is just intern fantasy. If you actually spoke to another resident (or to a neurosurgery attending) in that manner, then you need a serious attitude adjustment.

Way to treat people like crap and propagate the surgical stereotype.:thumbup:
 
"STAT: Dr., please call right away, I made a BIG mistake with this patient's Mg order." (thankfully, she was mistaken about making a mistake, and all was well)

At 4am: "Please call: This patient is on call to the OR, and there's no consent in the chart?"
Me (calling back): I don't understand, I obtained the consent two days ago.
Nurse: Well, YEAH, that's in here, but where's the consent for today?
Me: (blanking) What do you mean?
Nurse: Well there's one from two days ago, but there's none from today!
Me: That consent is for today's procedure.
Nurse: But it doesn't have today's date on it!
(Arrrrgh!)

At 2am: "Please d/c this patient's thiamine order. Our records show he doesn't take thiamine at home. Also, can you write him for vitamin B1? He takes that, but it wasn't ordered."

During rounds (interrupting): "Larry the pharmacist says this patient takes Depakane, not Depakote. Please change it, I don't want to give the wrong medicine."

From the Pedi ER (sadly, this is a common one): "Please consult on 13 y/o M with abdominal pain."
Me: Hi, this is surgery, what can I do for you?
ER resident: Thanks for calling back. We have a kid down here with abdominal pain.
Me: Okay, sure. Tell me more about him.
ER resident: Well, I haven't seen him yet. He just rolled in here.
Me: Okay, where is his pain?
ER resident: I don't know.
Me: Do you know anything about him except the fact that he has abdominal pain?
ER resident: Not yet.
Me: Then what makes you think surgery should be involved?
ER resident: Well, we just wanted you to know that he's here.
(These encounters usually end with me examining & interviewing the patient before anyone else, w/ the ER resident peering over my shoulder and copying the findings of my H&P. I"m not joking.)

"Patient is complaining that his crotch itches really bad. Can you please come see him...or maybe just order something? I'm sorry." (this nurse was at least sympathetic)

"Patient complains that his gas smells bad. I don't know what you can do with this information, but I promised him I'd tell you."

I know I'll think of more......
 
ExtraCrispy said:
From the Pedi ER (sadly, this is a common one): "Please consult on 13 y/o M with abdominal pain."
Me: Hi, this is surgery, what can I do for you?
ER resident: Thanks for calling back. We have a kid down here with abdominal pain.
Me: Okay, sure. Tell me more about him.
ER resident: Well, I haven't seen him yet. He just rolled in here.
Me: Okay, where is his pain?
ER resident: I don't know.
Me: Do you know anything about him except the fact that he has abdominal pain?
ER resident: Not yet.
Me: Then what makes you think surgery should be involved?
ER resident: Well, we just wanted you to know that he's here.
(These encounters usually end with me examining & interviewing the patient before anyone else, w/ the ER resident peering over my shoulder and copying the findings of my H&P. I"m not joking.)
Click to expand...

Sadly, that is not uncommon as you note. Our ED was notorious for it...as a matter of fact, I was seen there once and when getting copies of the notes for my records upon moving, saw an entire H&P written despite the fact that the attending and resident NEVER once laid a hand (or stethoscope) on me. Glad they could easily divine that my lungs were clear and that I had normoactive bowel sounds. Kinetic used to complain about it quite loudly...one of the reasons, so he says, he got fired from residency there.

The surgical consult for abdominal pain in a patient who hasn't been seen by anyone is a well-known one. For some reason, there is the belief that all abdominal pain is surgical.:rolleyes:
 
Kimberli Cox said:
Sadly, that is not uncommon as you note. Our ED was notorious for it...as a matter of fact, I was seen there once and when getting copies of the notes for my records upon moving, saw an entire H&P written despite the fact that the attending and resident NEVER once laid a hand (or stethoscope) on me. Glad they could easily divine that my lungs were clear and that I had normoactive bowel sounds. Kinetic used to complain about it quite loudly...one of the reasons, so he says, he got fired from residency there.

The surgical consult for abdominal pain in a patient who hasn't been seen by anyone is a well-known one. For some reason, there is the belief that all abdominal pain is surgical.:rolleyes:
Click to expand...

wow...unbelievable..every SINGLE time I've called a consultant I give them the appropriate and pertinent H&P, exam, my impression, and why I am calling them...I think that's the bare minimum professionalism you should give a colleague...I would frankly feel like a complete idiot and embarrassed if I called a surgeon with a half assed consult
 
SLUser11 said:
I really hope the last part of both of these stories is just intern fantasy. If you actually spoke to another resident (or to a neurosurgery attending) in that manner, then you need a serious attitude adjustment.

Way to treat people like crap and propagate the surgical stereotype.:thumbup:
Click to expand...

Please. Stereotype? I define the stereotype. I wake up in the morning and spend ten minutes gazing at my reflection in the mirror, contemplating my awesomeness. When I get to the hospital, I make all the other residents get off the elevator so I don't have to tolerate the stench of mediocrity that surrounds them. Medicine interns flee when they hear the sound of my tread, and if they don't flee fast enough, I step on them. I don't discuss patient care with anyone below a senior resident level, and if an intern or medical student has the gall to speak to me, I scorch them with my rapier-like sarcasm. I don't need to eat, I don't need to sleep, and when I'm thirsty I drink scotch. I'm the hardest-working, hardest-partying, smartest damn resident in the whole hospital. Who am I? I'm a surgical intern. FEAR ME.

In all seriousness, though, interns at my program pretty much all know each other and most of are friends. So there's definitely a lot of tongue-in-cheek smack-talking between services, especially when consults are called. It's all in good fun.
 
Kimberli Cox said:
The surgical consult for abdominal pain in a patient who hasn't been seen by anyone is a well-known one. For some reason, there is the belief that all abdominal pain is surgical.:rolleyes:
Click to expand...

Yeah, we pwn the belly. :thumbup: :rolleyes:
 
GMO2003 said:
wow...unbelievable..every SINGLE time I've called a consultant I give them the appropriate and pertinent H&P, exam, my impression, and why I am calling them...I think that's the bare minimum professionalism you should give a colleague...I would frankly feel like a complete idiot and embarrassed if I called a surgeon with a half assed consult
Click to expand...

This is one of my biggest pet peeves....I think it's just a breach of professional courtesy when fellow residents call (or have a med student call) a consult when they either have never seen the patient or have no idea why the consult's being called. What really gets under my skin is when I ask a question about the patient and am told, "I don't know, I'm sure it's all in the chart" or "I haven't seen the patient, you'll just have to come examine them."

The other line that gets my blood pressure up is, "The patient really doesn't have any acute surgical issues, we just want surgery/urology/vascular/etc on board...":mad:
 
GMO2003 said:
wow...unbelievable..every SINGLE time I've called a consultant I give them the appropriate and pertinent H&P, exam, my impression, and why I am calling them...I think that's the bare minimum professionalism you should give a colleague...I would frankly feel like a complete idiot and embarrassed if I called a surgeon with a half assed consult
Click to expand...

One of the worst moments of my M3 year was when an intern that I didn't particularly care for had me call for a consult on one of her patients. I hadn't seen this particular patient before (it was the weekend so we were covering the whole service and not just my team), and the intern just threw the chart at me and told me to call the consult. This particular service doesn't have any fellows/residents at my hospital, so that meant that the M3 was calling an attending at home on a weekend for a consult for a patient that I had never seen and wasn't being allowed to see. I was mortified, and no, I didn't have all the information the attending wanted. It was so embarrassing.

Fortunately, this particular intern was famous for pulling that sort of thing and the attending on call ended up being someone that I knew and he calmed down once he realized what was going on. The intern got chewed out for it, not me. But oh that was so inappropriate for that intern to make me call. :mad: It did, however, teach me what not to do next year.
 
In the middle of three train wreck code traumas on this years interns first night, 3:30 am. Picu Nurse "ms !!!'s vulva is swollen". me "yes I know did you see that in my problem list on my notes for the past 5 days?". Nurse "well her mother is wondering if this will prevent her from reproducing". "NO!!!!"
 
GMO2003 said:
wow...unbelievable..every SINGLE time I've called a consultant I give them the appropriate and pertinent H&P, exam, my impression, and why I am calling them...I think that's the bare minimum professionalism you should give a colleague...I would frankly feel like a complete idiot and embarrassed if I called a surgeon with a half assed consult
Click to expand...

You WOULD think so, wouldn't you?!! And it has happened to me at more than one hospital, so I know its not an isolated geographic problem. The worst tends to be at a local community hospital where the consults are fee-driven - ie, some of the surgical attendings have no cohones and say nothing to the ED docs (very few of whom are actually EM trained...but rather tend to be FM) when they call inappropriate or unworked-up consults. I guess they're afraid if they anger the ED, the consults (and potential fees) will be directed to other surgical groups.

While professionalism is expected (and I do not expect to get a phone call from the medical student, the nurse or any resident who has not SEEN the patient. Those calls are the worst; I don't really care who calls, although I do prefer it to be a physician, but at least do me the courtesy of knowing SOMETHING about the patient. I should have listed the consult page I got where the idiot intern didn't know: the patient's NAME or ROOM NUMBER. Magic 8-ball says my chances of finding the patient she is calling about [from the patient's floor] is doubtful. She ended up getting a Derm position which PO'd me even more.), medicolegally you would think physicians seeing patients would have the forethought to actually examine the patient if they are documenting in the medical record that they are. And that they would not copy the consultants notes...I've seen that happen more times than I care to count, along with copying of previous days/weeks notes when the patient's clinical condition/diagnosis/etc. has clearly changed, yet the medical team is still writing notes based on info from days ago.

Fortunately, most physicians take pride in their work and do as you.

Back to the topic at hand...sorry for the hi-jack.
 
That crap doesn't just occur in the ER. I was called to do an ABG that the respiratory therapist couldn't get. I was drawing it at bedside when a nephrologist walked in to see the patient. He presumed I was respiratory obviously, because he glanced at the unresponsive patient and left. He wrote a full physical exam in the chart!

beep beep
RN: Doctor! The patient's daily scheduled ABG is 7.40/40/90/24 98%sat !!!
Me: Yes, I saw that. Good.
RN: What are you going to do?!
Me: Uhhh, nothing.
RN: Are you coming up here? Aren't you going to DO SOMETHING??
Me: .....

beep beep
RN: The patient is unresponsive and blue and not breathing!
Me: CALL A CODE!

beep beep
RN: Doctor! The ER just sent up a patient and the d dimer level is LOW! Do we need to order a supplement???
Me: .......

I could go on forever.
 
*beep*beep*beep*

Hospitalist: Can you please clarify the orders on Mr. X?

Me (this is 3 months after I wrote the orders transferring Mr. X out of the ICU, at this point, I'm in the lab and not involved in ANY pt care, let alone Mr. X's): Uh, I haven't taken care of him for a really long time--which orders are you talking about?

Hospitalist: There's an order that says "Do not page (LaCirujana's pager number)--for any questions, please page Urology resident on call."

Me: Yeah. And? *click*

The dumscheiss actually paged me AGAIN! I hate it when people who were interns when I was a PGY-3 are now "attendings"--using the word VERY loosely.
 
jmattwilson said:
In the middle of three train wreck code traumas on this years interns first night, 3:30 am. Picu Nurse "ms !!!'s vulva is swollen". me "yes I know did you see that in my problem list on my notes for the past 5 days?". Nurse "well her mother is wondering if this will prevent her from reproducing". "NO!!!!"
Click to expand...


Hey Jmattwilson! Great to hear from you.

I always love the phone calls that go something like this. I am coming in from an outside service to cover overnight call.

NURSE: Doctor, Mr/Mrs So-and-So's family is here and they want to talk to a doctor.

Me: What are the issues that they would like to discuss? I am heading into the OR to start a case and won't be done for three hours.

NURSE: Oh, they wanted to know which nursing home you were sending her/him back to.

Me: Tell the family that I am going into a case that will be minimum of three hours and that they might better get that information from their loved one's primary team in the morning since I am not directly involved with this patient's management.

NURSE: But they want to talk to a doctor right now and you have to come.

Me: Can you put one of them on the phone. (I speak to family member) This is Drnjmd, I am covering your loved one's care for the evening but I am not directly involved in the day to day management.

Family Member: Oh Doc, we didn't need to talk to you but this nurse kept insisting that we HAD to talk to a doctor.

Me: I will pass your concerns along to the primary team in the morning.

Family Member: Thanks so much. (Hands phone back to nurse)

NURSE: Since you didn't put your long term plans in the patient's chart, I though you would tell the family and I could write it down.

Me: Have a good night.
 
Just happened at the VA:


VA Nurse: Yes, Dr. BamaFlip, this is nurse so and so. I just noticed that your patient Mr. D is NPO. Did you want him to have something to eat?

Me: No ma'am. He just had a transverse colectomy yesterday and is NPO for a reason.

VA Nurse: Well I just wanted to know what you are going to do because he can starve if you don't feed him?

Me: Well, I don't think that he'll starve ma'am. We are giving him IV fluids to keep him hydrated and we will feed him as soon as he begins to have bowel function.

VA Nurse again: Mr. D. also wants to know if he can anticipate going home today or tomorrow.

Me: No ma'am. He can't go home until I know that he can tolerate a diet and his pain is under control. He is still on a PCA and he is NPO. This should take a few days.

VA Nurse: Well we were just wondering so that we could tell the patient.

Me: Ok thank you. *Click*

There I stood dumbfounded :scared:


Thank God for our nation's veterans. They are hard nosed and it takes a lot to hurt them. Think of all the odds they have overcome, including this nurse that wanted to feed him and send them home on POD 1 after a transverse colectomy
 
BamaFlip said:
Just happened at the VA:

Thank God for our nation's veterans. They are hard nosed and it takes a lot to hurt them. Think of all the odds they have overcome, including this nurse that wanted to feed him and send them home on POD 1 after a transverse colectomy
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I have gotten the EXACT same page and was just as appalled as you, although I gave a "mini-lecture" on starvation to my nurse (who apparently had never gone more than a few hours without eating).:scared:
 
I'm not sure if it's reassuring or scary that things are the same across North America!
 
My personal favorite

4am page from Vascular ward where i am cross covering patients.

Nurse: I was bored and was just flipping thru patient X's chart and was just wondering what the long term plan is for him.
 
tussy said:
My personal favorite

4am page from Vascular ward where i am cross covering patients.

Nurse: I was bored and was just flipping thru patient X's chart and was just wondering what the long term plan is for him.
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That sounds like a "let's make his/her life hell" page. Did you piss this nurse off?

Of course, you're cross-covering, so she might not even know who you are....then I have no explanation.
 
Ah, the "long term plan" page . . . I never got that page at 3 AM, but I did get it several times at 10 PM on Saturday night. "Yeah, I'm the intern covering Vascular, General, Colorectal, and Onc. Sure, I'd love to give you a detailed rundown on Mr. X's cancer care. Why don't you come down here to the ER and I'll be happy to give you the full story. I'll even draw a few pictures for you."
 
I actually tried once to convince the charge nurse to let me give all the new nurses an inservice on what "call" actually is. To explain to them that i am not simply working the "night shift" like they are. Some of them actually think we are just on an 8 hour shift like them, except we get a call room to sleep in.
 
tussy said:
I actually tried once to convince the charge nurse to let me give all the new nurses an inservice on what "call" actually is. To explain to them that i am not simply working the "night shift" like they are. Some of them actually think we are just on an 8 hour shift like them, except we get a call room to sleep in.
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EXACTLY! I have been amazed at the number of veteran nurses who think we work 8 or 12 hour shifts like them. They are horrified to learn we work 30-40 hours at a time.
 
MediCane2006 said:
Please. Stereotype? I define the stereotype. I wake up in the morning and spend ten minutes gazing at my reflection in the mirror, contemplating my awesomeness. When I get to the hospital, I make all the other residents get off the elevator so I don't have to tolerate the stench of mediocrity that surrounds them. Medicine interns flee when they hear the sound of my tread, and if they don't flee fast enough, I step on them. I don't discuss patient care with anyone below a senior resident level, and if an intern or medical student has the gall to speak to me, I scorch them with my rapier-like sarcasm. I don't need to eat, I don't need to sleep, and when I'm thirsty I drink scotch. I'm the hardest-working, hardest-partying, smartest damn resident in the whole hospital. Who am I? I'm a surgical intern. FEAR ME.

In all seriousness, though, interns at my program pretty much all know each other and most of are friends. So there's definitely a lot of tongue-in-cheek smack-talking between services, especially when consults are called. It's all in good fun.
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:laugh: classic
 
tussy said:
My personal favorite

4am page from Vascular ward where i am cross covering patients.

Nurse: I was bored and was just flipping thru patient X's chart and was just wondering what the long term plan is for him.
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So common as to almost be a classic page. Its generally not mean spirited but rather either:

- family who won't let the nurse off the hook when she tries to tell them that the primary service will be back in the morning (and the "family" is always some second cousin twice removed who has just flown in from Outer Mongolia and is only going to be at the hospital for 7 minutes but absolutely need to know how and when Uncle George is going to be dead/discharged/suitably incompetent so they can get his money)

- nurses who don't realize we didn't just come in at 11 pm like they did. I always thought they knew what hours we worked, or at least figured it out when they would see me at the beginning of their shift on Monday and the same on Tuesday, except that now I look a tad more tired than they do. Turns out they don't know how long we work or for how little pay.

- sometimes the call is just because the resident is a real PITA and the nurse pages because she can...but I think that's generally pretty rare
 
Got another good one from my last call....

BEEP-BEEP-BEEP
Me - "Hi, it's surgery returning a page
Non-Surgical Intern - "Hi, I'm calling about Mr. Jones, he's NPO for surgery tomorrow
Me - "Uh-huh"
NSI - "So, what time should I turn off his TPN?"
Me - "His TPN?"
NSI - "Yeah..."
Me - "Uh - is he drinking the TPN?"
NSI - "Drinking it? No...it's going in through his IV."
Me - "Well, make sure he doesn't DRINK any after midnight, 'kay?:smuggrin:
 
In the office, any patient who says (when told that surgery is not currently indicated) "But Dr. ER/Family/IM said that I have to have an operation. Why am I here, then?" or, my other favorite, "But Dr. ER/Family/IM said that this is definitely my gall bladder, and that you will take it out." The gall bladder is the most maligned organ in the human body, IMO. :rolleyes:
 
Tigger14 said:
In the office, any patient who says (when told that surgery is not currently indicated) "But Dr. ER/Family/IM said that I have to have an operation. Why am I here, then?" or, my other favorite, "But Dr. ER/Family/IM said that this is definitely my gall bladder, and that you will take it out." :
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On a related note, I get patients referred from their family physician or even an Ob-Gyn with in-situ carcinoma who ask, "Why do I need an operation? I don't have cancer!"

Seems like there is a plethora of people describing in-situ disease as "pre-cancer", "non-malignant cancer" or "not a cancer". Makes it REAL easy for me when I tell patients that:

a) biopsies do not sample all the tissue
b) biopsies can be inaccurate
c) staging and margin status cannot be done on non-surgical biopsies
d) they need an operation
 
Tired said:
Isn't it funny how you can work with people day after day, and they still have no idea how much you work? Despite my venting, I really love 99% of the nurses I work with, and end up making friends with them on every rotation I do. Invariably, two weeks into every rotation I do, I will see them on the wards after taking call, and they will say, "Wow, you're in early today. What time do you have to get here?" Darling, I love you, but I've been here for 30 hours, and won't go home for another 8 - 10hrs.
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I LOVE the look on their face when you respond that way...sheer shock.

But you're right...a lot more sympathy, cookies and kindness do come your way when they realize what demands there are in residency.
 
This is a page I received last night, verbatim:

"Hi, consult in ER on 11 y/o w/ MRSA post-op 3 weeks ago for same thing. Please call. Thanks."

Um......yeah.
 
Sorry, just have to vent.

Why is it that the nurse can call me at 4:30 in the morning to ask if a patient really needs another serum osmol before he gets his mannitol and fails to mention that his left pupil was blown.

Made for an exciting morning and not the good kind of exciting.

Then I find her sitting on her rear end and she tells me that pharmacy will have the mannitol here in about twenty minutes.

I just lost it and I don't usually do that. I know that she is a new nurse, but damn.

-Mike
 
Just got this one:

"Please Call Pt: xxxx No void. Pt. reports had 'pipe for peepee' @ rehab. Shall I place a pipe? thanks"

another life saved...
 
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