23 May 2007

Saturday Afternoon on Call

Well, it a S-L-O-W call day even though it's a Saturday. Please note that I spell that word and don't write it or (gulp) say it. As soon as I say or write that word, all he-- will break loose and the trauma bay will fill up. I do love a good trauma but I am sitting here after a nice lunch of Pho (Vietnamese beef noodle soup) and there' s a little food coma about to set in. I mused with turning on the TV to see if I could catch an Orioles' game but I just don't want to wrap my head around anything. It would be cool to just nap for 20 minutes and then check a couple of patients.

My junior residents are not busy so I don't feel obligated to micromanage them. All of my senior residents have signed out to me and our services are Q-U-I-E-T (another word I don't say write). My attending on call, has just checked in to say that he's going to afternoon lunch with his wife and would like to let me know that he is on Mobile. I love it when they do that. It saves me the trouble of paging and waiting for a call back. I can go right to the source.

So far, I have rounded on my service and discharged just about everyone who could go. I elected to keep one gentleman over the weekend because no one is home to be with him and he is a 75-year-old recovering from a sigmoid resection. His daughter will arrive on Sunday night and he can go home Monday morning. Besides, a couple of extra days of watching especially since I am not happy with his food intake will be good for his recovery. My attending agreed with my assessment.

I am also contemplating doing a stairwell walk to get some exercise. When I start to feel the afternoon slump, I walk up the 10-stories from basement to top floor and back to my digs on the fifth floor. Then I look for a fresh cup of coffee or grab a diet Pepsi. There are fountain soft drinks on every floor at the nursing station that feature, colas, iced tea, lemonade and water. The coffee has to come from the coffee bar that is in the cafeteria. Since Saturday lunches are usually not too great, I had my fiance bring in some Pho so that I wasn't drowning in grease this afternoon. The bad thing is that I can be pretty hungry around 5pm so I need a good protein dinner.

I am also thinking about the logistics of getting to the White Coat Ceremony that my medical school will be having for the incoming medical students. There is usually a nationally recognized speaker and then the name of each incoming student is called. A member of the physician graduates will then cloak the incoming student. We all take the Hippocratic Oath again just to remind us of what being a physician is all about. It's a great day and loads of fun to see the newest class and catch up with some of my classmates and professors. It's always a good time. This year, I am going to be buff so I really want to go. The bad news is that I will be making the schedule so I have to be totally fair with time off, if I leave town.

I spent an hour this morning preparing one of my pathology review lectures. I am amazed at the depth of information that I can burn out in a PowerPoint in about 60 minutes. My teaching experience has really helped me in putting together presentations. I am hoping to have all of my lectures done just in case something comes up and I am not able to teach n the days that I have been scheduled. Sometimes a case can run later or a complication will develop and thus, I have my work ready to go.

One of my junior residents just beeped me to ask about making a patient NPO (nothing by mouth). Since this patient is low-risk for surgery today, I opted for "sips and chips" meaning sips of clear liquids (no carbonation and limited to 30 ccs per hour) plus ice chips. If we do end up operating emergently, we can do so after "sips and chips". One of my attendings allows hard candy with "sips and chips" but I leave this up to the patient. If there is any hint of nausea or vomiting, back to NPO and I will increase the IV rate.

Well, that's a glimpse of my world at present. I have to get back to studying for my board exams. I have a strict reading schedule that I am adhering to complete with check offs. I may yet do the stairs and take a nice hot shower before the evening rush. On a Saturday night, I can expect some trauma work.


Zippa said...

Are your pathology reviews for yourself or to present to the junior residents? I am impressed that you can complete a presentation in just an hour.


Drnjbmd said...

The beauty of having reviewed this subject matter over and over is that it always comes back faster. I know my time-frame; my audience and what they have to learn.

My reviews are for folks who had problems with Path and are taking USMLE Step I in a few weeks.