Dashing to the codes, with a one-button white coat, down the stairs we go, hoping someone else gets there first! Ho ho ho!

I'm working in the ICU/CCU at the VA hospital through next Sunday. If you're not familiar with any of the VA hospitals, they are hospitals for military veterans. The VA's motto can best be described as: "Military veterans, thank you for serving our country, please let us serve your health care needs," and also, "It's only a matter of time before your COPD/alcoholic liver cirrhosis is diagnosed."

Why do I love the VA system so much? Most of the veterans I like well enough, but the electronic medical record is truly one giant, steaming, patriotic turd. It is a system whose organization is bizarre, the program for notes and labs is completely unconnected to the program for collecting vitals (WTF?), and trying to navigate it wastes a LOT of time.

Also... for some reason there seems to be a very low threshold for calling codes. I ran to two "codes" today- one ended up being for a man who NEARLY fainted after he got up from a blood draw at the outpatient lab downstairs (ie, was not coding), and the second code was for someone who was sitting in bed, breathing fine with a steady pulse, but was just very shaky because his calcium was low. Who the hell is calling these codes?!? "Code blue!"....you keep using that word; I do not think it means what you think it means. (Princess Bride reference!) Maybe I should start calling codes whenever I feel like it. "Code blue, I can't get the printer to work!" "Code blue, the chicken in the cafeteria is overcooked!" "Code blue, I just dropped my pager and it fell down 2 flights of stairs while running to a fake code!!!"

Today the highlight of my day was eating steamed zucchinis for lunch, heavily seasoned with Mrs. Dash. The sole purpose of my life may be to help other people feel better about their lives in comparison. Does my life suck right now? In the sage words of the magic 8 ball, "all signs point to yes."

Last CCU Call: The Last Straw

Dear night time nursing team: thank you for making my last CCU call one of my bitterest. Special thanks go out to...

... the 4am page by the CCU RN who was "just thinking about planning ahead" which nurse was going to babysit which patient in the morning, and wondering if there were any plans for transferring a patient that I was just cross-covering on out of the unit? "Not at 4am." Dude, unlike you who is paid a six figure salary to babysit and blame all your unpleasant or alarming discoveries on me ("Egad! Blood pressure of 65/42 after I gave the metoprolol outside of holding parameters! Quickly document 'MD Intern for Life notified. No new orders given.' Then page the intern and hand off the baton of liability ASAP! Whew that was a close one.") within an 8-12hr shift, I am working 30 hour shifts in 80 hour weeks, with no special protected "lunch" or "break" times. So please THINK before you page with inanities at 4am!!!


...4:30 am page from floor nurse on another patient I was cross-covering: "I noticed that this patient's sputum culture was contaminated from the other day. Do you want to get an induced sputum sample by RT?" "NOT AT 4:30 IN THE MORNING. It's a good idea for a normal time in the day though, please tell the day shift nurse so they can coordinate with the primary team."

Thus the whole night went with pages approximately every 20-30 minutes. Yay cross-covering, yay.

Goldilocks and the Three Interns

When you're "on call" in the hospital, there is a room (or a set of rooms) that are designated for the on call house staff to sleep (if by some miracle you actually get a chance to sleep). These call rooms are gross because (a) most surfaces in the hospital are gross, (b) the arrangements are shared rotating between whoever else is on call (or finds your call room first), (c) they are cleaned, theoretically, sometime during the day, when no one is around to witness this event.

Tonight, by some miracle, two other interns and I found ourselves done with most of our work and ready to retreat to our call rooms by midnight! We were almost happy, but then we remembered-

"My call room is so cold..." - Intern A

"Yeah, my call room is really cold too!" - Intern B

"My call room is freezing! AND somebody already slept in it!!!" - Intern C

Groin Check Mega Fail

Of note: this is a delayed entry.

On my second to last CCU call, as per usual, the post-call team had a lot of things they needed followed up on for their new patients, including several groin checks for patients who were going to get cath'd. As you well know, I lump all my groin checks into either 10pm or midnight rounds. One little problem; one of the patients they signed out for me to groin check, WASN'T ACTUALLY SCHEDULED TO GET A CATH. So when I did my evening rounds to do all the groin checks, I go check on this elderly lady, and guess WHAT - nothing on the right side of her groin; that's odd. NOTHING ON THE LEFT SIDE EITHER. WTF?!? Does she have some kind of magical groin? Where is she hiding her cath site??? The weirdest part, in retrospect, is that she didn't seem phased by any of this; like it was normal that I was asking to inspect her groin for "the cath site", although she must have known that she didn't have a groin-based procedure that day....wtf?!? While I confusedly look from one groin side to the other, she asks, "Here, is this what you're looking for?" and shows me the PICC line in her arm. Uh... no. But it's very nice. Once again, thanks for the shitty sign-out, post-call team!

Have you ever been in that position, where the post call team just takes a shit on you? They go, oh hey, we're post call- can we take a dump on you? Because we haven't slept in 30 hours and we don't care about ANYTHING anymore. Here's a list of a bunch of things we forgot to do, didn't have time for, many things for you to follow up on, and some problems that we gave up on trying to solve. Best of luck...