Dictations

this is the first rotation where we have to do dictations. since this hospital does not have electronic medical records, we have to call a phone service and dictate all of our admission H&Ps and it gets typed out by a service. i discovered on my 30 hour call tonight that its really hard to dictate a note when you have worked all freaking day and are falling asleep on the phone. im pretty sure the person that typed out my note thought i was a complete moron because i stutter and cant spell when im tired. just picture me trying to read and talk fast while trying to keep sense of what is going on with the patient. oops.

Mrs. G

2 code blues this morning.

Another eventful patient I have been following is Mrs.G. A 40-something-yo with no PMH who also has no health insurance and barely speaks English. Shes really sweet and has a very bad case of gallstone pancreatitis. well, this lil lady has been in the hospital for about a 5 days now and had a lap chole to remove her gallbladder. everyday i come in in the morning and say out loud "Mrs G is still here??" she should have gone home a long time ago but her laps just werent right and then surgery didnt want to sign off. after being on a constant drip of dilaudid for her entire hospital stay, I am convinced that we have gotten her addicted at this point. sending her home on vicodin will be interesting.

ps its Saturday December 31st and I had to come in to work at 6am for a half day. lame. at least we get new years day off.

another code blue to start out the day. it seems like they usually occur in the morning between 6 and 8. kinda like earthquakes how they usually happen at night. pt survived.

1 down, 1 to go

i went in to the hospital at 6am yesterday. i left the hospital today at noon. that, just in case you cant count [or are just in disbelief] is a 30 hour shift. i got to sleep for about 4 hours. how did i end the shift? the best possible way...had to do a rectal exam right before i got to go home. like i always say, theres no better way to end a 30hour shift that to stick your finger in someones...

Code green

i heard "code green" over the PA system and asked the nurse next to me what that is...she laughed and said it means a patient went AWOL. apparently its the code you call if your patient is missing.

an hour later in the residents lounge we were sitting with our interns and one of them got a phone call. after he hung up he said: "that code green was for our patient Mr. X. hes gone, i guess they found him running towards firestone blvd."

Fungi

was sitting in the resident's lounge when two interns walked in.
 one said to the other, "wow, that presentation was pretty good." [this was referring to Tan's presentation he had just given them on an assigned topic.]
when i heard this i said, "thats nice, im gonna tell him you said that" [thinking i was being nice, i know how hard Tan works on his research presentations.]
next thing i know the intern is looking at me laughing saying, "you know what, just for that im going to assign you a presentation. is that ok with you? [turns to my intern who says yeah sure why not because she thought he was joking--he wasnt.]"

know i have to do research on different systemic fungal infections just for opening up my big mouth.

i need to stop talking.

another one of my patient's died today. i swear its not me, they are just really sick!

one that isnt really sick is my 60yo pt who checked himself into the hospital for alcohol withdrawal symptoms. this can get pretty serious if your body is used to alcohol at all time, you can have a seizure and thats not good. Originally, i thought 'wow, good for this guy. he wants to clean up his act.' FALSE. after talking with him, i found out the guy had a stomach flu and was vomiting for 3 days and he couldn't drink because of it. so he started having tremors and felt like crap so he checked himself into the hospital to get IV fluids. we call it a banana bag because it really does look yellow. its normal saline with supplements that most alcoholics dont have beacuse of their poor nutrition. rumor has it that they cost around $1,000 because of all the calculations to mix one up [complete bullshit i think to cost that much...]. so we were forced to check him into the hospital because of his withdrawal symptoms. your tax money hard at work [medicare patient].