i CANNOT believe they left us alone

1:01 am
I graduated as a physician assistant 4 months ago. I was hired by a prominent private inner city hospital 7 weeks ago here in the city that never sleeps and that's exactly what I'm doing right now; not sleeping. It's my first overnight shift, 7pm to 7am and my partner in crime is 3 weeks senior to me. We are like tweedle dee and tweedle dum, except I call her wingnut and she calls me window licker -yes, out loud. Our chief PA watched over us until midnight, everyone on the unit seemed to be "in for the night" and we had finished 2 admissions each. When the chief left, I looked over at my partner in crime and said "I CANNOT believe they left us alone" and we both started laughing like madhatters.
We are currently the medical professionals in charge -effectively the "docs" on the cardiac telemetry unit. Telemetry = heart problem . All I can think is, seriously, what the hell were they thinking; 'they' being the powers that be, our bosses. I can hardly believe they deem us capable of handling any dilemma which could consist of elevated blood pressure, maybe some unexpected vomiting, or maybe a BIG FAT HEART ATTACK. Really, what would I do if one of the lovely nurses came to me and said "Mrs D is having chest pain and she feels like she's GOING TO DIE! What would you like me to do?". At that point, I might start by taking my own pulse. I mean really, we're just sitting here waiting for something to happen. It's a bit like holding your breath, except that you're not allowed to pass out. You're in charge. So here we are....waiting for 7 am.

2:11 am
I can't effin believe James Brown is dead!! What the hell am i talkin about? the last time i saw him on some awards ceremony he could barely walk to the podium, and he looked like an old leather baseball mit. But he did say some smart thing about the young people need to stop using such eff'd up language in their lyrics and we need to share the love. Right on brotha, right on. Me and wingnut are chowing down on pb & j's and carrot cake. I am currently wiggling vigorously to 'get up offa that thing'. Go on James, say it like it is. UH, Uh, OOwwwwww, Uh, yeah, get up offa that thing. The chief just called to check in on us. When I told her everything was fine, she didn't really believe me. I wonder if she'll sleep at all. We have two more admissions coming on. Poor bastards. Damn this pb&j is good. I wonder how many neurons are actually firing in my brain right now.



4:46 am
know what happens at 3 a.m? well most people are sleeping, even here in the hospital they are sleeping, but not if I ordered labs on them to be drawn at 3am. Then they come wake the patients, stab them and take blood from them. What did my chief say earlier "this is the hospital, don't expect to get rest here. you want to rest, go to the hilton." nice, right? it seems at times, like they're trying to beat the patient care attitude out of me. I told her that won't work; they tried to do it in EMS for 4 years and were unsuccessful - i still care.
Orrrrr, they don't come; even though we tell them to. We order the labs for 3am and the lab people don't answer the phone, and then when they do they tell you they don't know where the phlebotimist is and you can't page them. The phlebotomist is mysteriously walking the halls, diligently doing his or her duty, or napping somewhere, or who knows. But the labs don't get drawn. It's making wingnut very unhappy. she's actually trying to track the phlebotomist right now. Poor bastard.

I have a patient, a frequent flyer, come up from the ER where they did emergency dialysis on her because she had SOB (that's shortness of breath, not that other thing you're thinking) so after being dialyzed for 4 hours from 11am to 3am they brought her here and paged me to admit her. But I'm upstairs having carrot cake and listening to james brown and my labcoat is hanging on a hook where my pager (which is on vibrate) is trying to tell me this. So i miss the page by 10 minutes - no big deal right? WRONG. The patient is dead asleep now and I have to wake her from her exhausted state to ask her a mess of questions. nevermind that she's 82 and mildly demented. When I can't wake her I have to write that she is unable to answer my questions. I ask the nurses if she had been coherent. They say yes. Is that good enough. I stress it, I wonder, I delay calling her doc - after all she's sleeping.
And now she's not. It's now 4:58 am and she has just been wheeled in a humongous chair in front of the nurses station because she's AWAKE and they don't want her to wander. She said her holiday was lousy and she won't let anyone touch her and she's yelling she wants to go home. She won't let the nurse check her sugar and she hates everyone except wingnut who offered her a sandwhich instead of a discharge. She poo-poo'd the sandwhich idea, but wingnut is persistent because she can't find the phlebotomist and needs something to distract her - plus she is a well meaning PA. Well who can blame her. At least I know my screaming lady is stable and she likes corn flakes. Why did I take this job???? (I can't believe I'm still awake)



6:50 am
T minus 10 and counting. We survived and all I feel is lucky, tired and hungry. Oddly, it inspires me to so and extra shift maybe twice a month for some extra dough, to tack on another 12 on 12 for a 24 shift as my last. Am i insane or what? Clearly. I chose medicine.
peace out~