26 May 2006

Rough day in the ER

Last night I got my first taste of the thick skin I assume to you need to survive medical school and life in a hospital. It's emotionally tumultuous and on a bad day it's hard to remember that (hopefully) in the end you do more good than bad.
Before my shift we had a 4 hour orientation to the research studies going on in the ER at the moment. Three of them we were already trained on, so it was a complete waste of everyone's time. The fourth was announced as a go-live today, so basically myself and the other associate on duty were expected to march into the ER with the (unedited) forms and just start enrolling. It wouldn't have been a problem if the forms had been designed for a hospital site (as opposed to outpatient clinic) and the PI knew that cardiac patients (her most interesting population) were off-limits because the coronary studies would get priority.
Confusing and draining.
Ok, so paperwork isn't that bad and it can all be figured out. And you can catch up when the board is messy, even if you do feel a little disorganised. And you can eat enough graham crackers to stop feeling like you're going to keel over. But what's rough is when your patients keep telling you they don't want to talk to you, or enrolling and then withdrawing... or the nurse loses/throws out the blood you need.
But then you lose a patient because they walk out of the ER against medical advice and your standing there with the EKG and you know that person really shouldn't have left. Or you do a domestic violence screening and the woman breaks down and tells you all about her monster of a husband and how she's trying to divorce him, but he's lying to the courts about her. Or your neurocog patient who doesn't finish the tests because they are in head CT and on their way up for neurosurgery. Or the kid who fell off his bike and can't stop crying because he can't remember anything. He looks at his hands if they're unfamiliar and his face is splotched with the bright pink of skin that's been torn off.
Just as your finishing all the paperwork and spinning last bloods two doctors come up to you. One gives you a lecture on not approaching the patients too early and potentially causing double sticks. The other looks at your forms and says "What are you still doing here? What? What... you want extra credit or something for staying late?" No. No, I don't. I just want you to fill out the damn form so I can go home.
The next morning you wake up and find an email waiting for you... be sure to approach the patients early so as to get the bloods you need... copied to the whole damn world.
And we're back to frustrating.

Despite the whining... I love it there. Thursday nights are the best part of my week. If I could stay until 2:30 am every week, I would.

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