Day 315 How do I Kill my Beeper ?

Every few times a week the following happens to interns. I would have to say that it happens maybe 1-2 times a week. There is a time during the week where you start getting paged non stop by the nurses and attendings and you are bound to make 1 person un-happy. Its like a juggling act. It gets very hectic to say the least. I will tell you a true scenario of one of those moments.

I would say it started at around 3:30pm

3:31 page 1: "Hi Dr. I just letting you know pt in 205b is upset and want to sign out AMA. Can you come and talk to him?

3:33 Phone call from other intern. "Hey you know that guy in 205b he was in a.fib before but I repeated EKG and he is in sinus now. See if you have a chance to talk with the cardiologist who wanted me to start dig. I gave you a copy of the EKG show it to him if you have a chance . bye"

3:34 Paged again. "hi Dr. can you sign the med rec on the patient you are discharging. Thanks."

3:35 I start walking to the telemetry to see the pt that wants to leave.

3:36 arrive at telemetry. I walk over to the room 205b. Start talking to pt to see what it the situation. While I try to find out why he wants to leave I get another page and 3 cellular phone calls from intern that left.

3:42 I polite interrupt my conversation with the pt. to answer page and phone calls.

3:43 page from e.r wondering if pt can go without monitor for a test.

3:46 As I walk back to try to talk to pt , the nurse taking care of 205b comes up to me and says "did you talk to him? I think he has psych issues. By the way that's the cardiologist behind you. We have been paging him all day. He is an A#$% H_le. "

3:47 I 'm kind of relieved to know that he is an A H_le so that way I can avoid him as best as I can. I wait till he goes to the other room. I answer phone from intern. "You wont believe this. I brought the wrong papers to my appointment. Did you bring papers to your appointment?" I polite say no, but I tell him to call me back if he needs anything.

3:49 I stand a few seconds out side the doctors room deciding whether to talk to the "psycho" attending. I say to myself , let me do it for the pt. I swallow my pride. and show him the EKG. He rarely looks up and says fine. I tell him pt wants to sign out AMA. He says good and keeps writing another note.

3:53 I'm on the phone with the attending of 205b to let him know pt wants to sign out AMA. attending tells me he has psych history. I better check with psych to see if they will clear him to leave AMA.


3:56 I'm on the phone with crisis. "we will try to send someone out to you. But they left for the day. the evening psych might be able to help. the Family resident is standing next to me. "I think I saw him in the other floors."


3:58 I get phone call from my friend again . "Hey sorry to bother you man. Yeah I have to come back and do this again. I didn't bring the paper work. I came for nothing. " (I guess i'll be covering for him again for the third time!)


4:02 I'm walking around the floors to see where the psychiatrist is to ask him about pt. I find him and he tells me that the guy is delusional.

4:04 paged by nurse. whats the story with the 205. I tell her he cant sign out. "Strap him if you have to. do the soft restraints. but better to tell him that psych will come to see him, to see if he can be discharged."

4:06 paged by er again about septic pt. You guys coming to help with the med rec?

4:08 I get to e.r I walk over to nurses station. "there is family members of septic patients that want to talk to me. Nurses supervisor comes up to me and tell me that I should sit down and review 20 medications to see if she is getting the right ones. Other senior comes up to me and ask me about siging line of site of pt that was admitted in the e.r. in the morning for polysubstance abuse. While I sit down to discuss the meds on the septic pt. Other intern stand next to me to sign out his list of patients. I get beeped as I sit down to review septic pts meds. "hi sorry you have and admission. where r u ?" I tell her I'm in e.r

4:10 I read in the progress notes of septic pt that vanco and cancidas were d/c. I go to the computer and delete vaco and cancidas and mistakenly delete 15 other meds !! Now I have to input them before I go to next admission. I sit down and try to do as much of the meds in the computer as I can. another beep comes in from amu to tell me to replace a low magnesium on a pt. As I finish up the list of meds. I realize that the admission I got is from an attending that enjoys having a 1 hour admission talk over the phone. he even wants to know when his patients had the 5th bowel movement when they were 9 yrs old and what color was it. And whats her favorite beverage? what does she eat for lunch? Is she a vegetarian? better check vit b 12.

4:14 I get to bedside of pt that I'm doing admission. the cardiologist is their. I hear something about a murmur. diastolic or something like that. I talk with the cardiologist for a few seconds we did cath on her 5 years ago. Her 2 d echo has worsen. she might need replacement. look up and study indications for valve replacement in asymptomatic pts. I agree to give him a short review later.

418 I sit down with the senior. She is kind of looking at me with a puppy face. you ok? you seem tired. I start looking up labs of patients.. I ask her if she knows the story? she says nothing much just systolic murmur. Maybe some abdominal pain. But she tells me better get orthostatic vitals on her before I call attending. Or try to do a rectal. But she will probably refuse.

420 I walk over to lady who refuses rectal. She denies any abdominal pain on palpitations.

423 "psycho" attending calls back and basically questions every single order that we wanted to do. I say black he says white. I say orange he says apples. I give a brief history of what she told me. He goes into 5 minute story of what he knows about her. Since he's been taking care of her for 110 years and by the way he saw her this morning in the office and last week and had dinner at her has on Saturday. So I finish taking down the orders for the admission. Completely exhausted and upset that I had to end the night talking with this arrogant attending. TO calm myself down I google quotes on patience and wisdom. I find some that make me laugh .

"You are educated when you have the ability to listen to almost anything without losing your temper or self-confidence."
Robert Frost

Patience is something you admire in the driver behind you, but not in one ahead.
Author: Bill Mcglashen

Patience is the greatest of all virtues.

Cato the Elder (234 BC - 149 BC)

"One moment of patience may ward off great disaster. One moment of impatience may ruin a whole life."
Chinese Proverb

4:30 the storm of pages stops for now. After reading quotes on patience, I realize how little I have. I tell myself that its unrealistic to expect all doctors to be the same. There is one bad apple in 100 Its a fact of life and residency. II guess its me that lacks understanding and patience.

SO much for qoutes.

7:30pm 3o minutes to go before I go home. I'm tired

God Bless

Dr.Mike