EM Senior

Another July has come, and with it an upgrade in my rank and nominally in my salary. I make a whole $2.75 an hour now!

In the third and fourth years of this program, I’m considered a “senior” resident. Senior residents have some additional responsibilities over those of juniors: we are supposed to keep an eye on the entire emergency department, make sure everyone is pulling their weight, lead resuscitations, and teach novice learners. Continue reading

Second Year Is (Almost) Over

In a little more than a month, the new interns will arrive. Much like last year when I wrote “Intern Year is Over,” I greet this milestone with joy and relief – not because I am thrilled and excited for the interns to roll in, but because I am thrilled and excited to be DONE. WITH. SECOND. YEAR.

getmeouttahere.gif

“Why?” the interested reader/grandma may ask. After all, if intern year is when you learn the byzantine system that is medicine at two different academic centers, second year is when you focus on your actual medical knowledge. Your procedural skills. Your team-based communication. Continue reading

Not My Hill

The journey through second year of residency is an interesting one. As I’ve mentioned before, we are tasked with two major, new responsibilities: performing most procedures and seeing a much greater volume of patients. We’ve all gone through a substantial adjustment period. It’s been hard.

One of these journeys is toward two, or greater, patients per hour. I hit this milestone rather infrequently. In fact, it is about as likely for me to achieve this as I am to win a game of Oregon Trail. It is far more likely that I will die of dysentery, or make it no further than Fort Collins before my oxen quit on me. Continue reading

Of NARH and NARS

The title will make sense later. Trust me.

As I’ve mentioned before, I split most of my residency training time between two hospitals: a large tertiary care center that has all the bells and whistles, and an understaffed county hospital that on occasion struggles to perform basic functions of a healthcare facility, such as checking routine vital signs or (spoiler alert) admitting patients.

Continue reading

Discharge to Home

When you go to the ER for medical care and are discharged home, almost every ER will send you home with “discharge instructions.” In a perfect world, this would contain information that is actually relevant to the patient’s medical condition and cover what was done in the ER, the results of lab tests and imaging studies, and “return precautions” – when to come back to the ER. Continue reading

BUFF and TURF

I am now done with my ICU month. I would just like to reiterate, again, that being on 30-hour call every third day for an entire month is total and complete bullshit that ruins your body and soul and no one should have to do it.

I have also been advised by legal counsel, also known as one-half of the Bringers of Life, that in my previous post I apparently ran a small risk of getting in trouble. I am not sure why; perhaps this is because I reference in somewhat pointed terms that one of my hospital sites (the Not A Real Hospital one) is run about as efficiently as a traffic jam. Continue reading

The Nights Watch

Hi. I have just completed a stint of night shifts – twelve in the last fourteen days – and I feel like a moldy, rotted potato.

As I write this, I’m trying to “flip back to days” for a regular day shift tomorrow, as the cruel scheduling gods have elected to grant me one day of work during normal people hours (albeit on a Saturday) before switching back to a third week of uninterrupted nights. Continue reading