Wednesday, May 18, 2016

A night on call

Sometime calls are quiet and sometimes they aren't.  Call is a part of life as a doctor, it is something that comes with the initials after the name.  People don't just get sick during the day, they get sick at night too, accidents happen at night and people need a doctor to see them, not just during 8-5.  

Despite that being said, I really like to sleep, and know that when I am postcall, I won't be quite the same doctor.  I will be a little slower mentally and physically, being up all or most of the night takes a toll out of me.   Thankfully, even though I am on call usually between 4 - 7 times a month, most of those are not that busy, but sometimes they are, here is what one of them looked like.  

1615 - Clinic finished, head to check D ward before going home.  Find a lady who hasn't been progressing and needs a CSection (C/S).  Call OT crew to come for the C/S. 
1645 - Called for 3 patients in the ER.  Man with a bad headache, women with Diarrhea and Nausea, and a baby delivered at a Health Center, cold and not breathing well.  Admit them all.
1700 - Head to OT for the C/S.
1800 - Back to the ER to see a patient after the C/S. 
1815 - Get to Susan and Jeff's house for dinner, but get called about a 2nd twin that hasn't delivered.  Off to Delivery Room
1820 - Find one leg sticking out, a 2nd one still inside of the mom.  Quickly get on some gloves and deliver the 2nd baby as a breech.  Two healthy girls.  Examine 2 new mother's both of whom have had a prior C/Section and may need repeats, both in early labor, allowed them to continue to labor. 
1845 - Quick shower due to being covered in various body fluids from the breech delivery.
1900 - Dinner and games at the Myers.  Phone calls from ER and Medical Ward.
2015 - Call from ER, asking me to see a patient.  See patient in ER who had been beaten up, another child with pneumonia.  Go and check on the laboring moms in D ward - doing well.  Check on the patient on Medical Ward.   18 yo, low blood pressure, febrile, very high pulse, screaming in pain.  Examine her, review her chart, do an ultrasound, write some orders, pray with family. 
2200 - Head home
2300 - Phone call from D ward, mom complete, but hasn't delivered, having poor contractions.  Ask our nurses to give her medicines to help her have better contractions in order to have the baby.
2400 - Call from D ward, pt still not delivered.  Go and see pt - not complete yet, still part of the cervix there, I was able to push it back, asked nurses to work with patient in helping her push.
0030 - Call from ER - Bad Chop.  When I get to the ER - I find a man covered in blood - his bottom lip barely holding on, R shoulder exposed, down to bone, lots of bleeding, top of head with large laceration, R scapula with large laceration down to bone. 
0130 - Nurses from D ward come to ER and say pt still not delivered.  Ask them to call OT crew to get ready for a C/S.
0300 - 2.5 hrs after starting Chop repair, I finished it and start C/S.
0400 - C/S finished, to B ward to see patient.  Patient not doing well, adjusted orders, prayed with patient.  To D ward, help nurse sew up a 3rd degree laceration. 
0530 - Attempted to fall asleep.  Called for seizing baby in NSY.  Orders given.
0600 - Called for B ward patient who has arrested.  Attempted CPR, patient died.  Started rounds, another day begins .  . .