Oncall again tonight. Q4d. Every 4th night. A quarter of one's resident's nights spent in-house.Not too bad today (touch wood). The surgeons and neurologists pissed me off yesterday. The surgeons called me late in the evening. Wanted me to clear a patient with cholelithiasis for surgery. Spent 30 mins looking at the chart but the story didn't fit. The guy I was looking at was just septic, BP86/40 and tachy. Why on EARTH was he going for a cholecystectomy?? I called them, and the surgical intern apologetically admitted, they gave me the wrong patient to see, so would I please go clear the right patient? The process repeats itself, and I find that THIS guy (right guy) was already cleared for surgery last week as this was an elective laparoscopic chole. Called the surgeon back, in my most patient yet sarcastic tone, guided him to the patient's chart on the computer to the part where it says "... he has been cleared for surgery, another *PAME not required...".And the neurologist. Gawd. "Please *PAME this patient, 68M with CVA, may undergo CEA." You do the PAME, and find that 25% of the patients you clear end up not going for surgery at all. What a waste of your time, resources and the patient's money.*PAME: Preoperative/Preanesthesia Medical Evaluation, CVA: Cerebrovascular Accident or 'stroke', CEA: Carotid Endarterectomy
I think they're all afraid of pissing off the SMR (Senior Medical Resident)(then again, medical juniors call us seniors SMuRfs) again tonight with bad consults... maybe that's why my pager hasn't gone off much today."Think happy thoughts..."At least I have something to look forward to. Planning a 2 week vacation back home. Probably May/June 2005. My very last month of residency. It'll be good to see family again.