Wednesday, March 9, 2016

Stages of weekend call


Stage 1: I'll get something healthy, maybe a salad, in the cafeteria.

Stage 2: Are there any bagels left in the doctors lounge?

Stage 3: There are Graham Crackers in the nurses station galley.

Stage 4: I see old Cheetos under the ICU fridge.


Stage 1: I'll take the stairs up to 5. I need the exercise.

Stage 2: I'll only use the elevator if it's more than 2 floors up.

Stage 3: I'm taking the elevator to go down 1 floor.


Stage 1: Ordering an MRI and a few carefully selected labs to narrow the problem down.

Stage 2: Ordering an MRI, MRA, labs, and an echocardiogram to start by covering the bases

Stage 3: Ordering an MRI, MRA, CTA, echocardiogram, EEG, VNG, EMG/NCV, CT-myelo, pneumoencephalogram, and every lab in the book... figuring your call partner will sort it out on Monday.

New consults

Stage 1: I'll be right in to have a look at her.

Stage 2: Can I see her in the morning?

Stage 3: Call Dr. Brain after 7:00 a.m. tomorrow.

Signature line

Stage 1: Thank you for this interesting consult.

Stage 2: Thanks for this consult.

Stage 3: Scribbled name.

Handwritten chart note

Stage 1: A neatly written paragraph summarizing the key history, pertinent exam findings, and your impression and orders.

Stage 2: A brief note listing your impression and orders.

Stage 3: "Patient seen, note dictated."


Packer said...

Toe Tag

Note for all patients.

Don't go to hospital on weekend

Moose said...

Feeling a bit burned out, are we?

Anonymous said...

Busy weekend and not enough Diet Coke on the planet...

Mary Hood said...

Pneumoencephalogram!? You even know what that is? Amazing!

Anonymous said...

This is so, so incredibly accurate. I mean, we've taken pizza out of garbage (still in the box though) and didn't blink an eye. And my long last name gets progressively shortened to a scribble as the night goes on (don't worry, humorless people, I always leave the nurses my full name, pager, and scribble signature at the nursing desk).

I think one of my "favorite" emerg consults will forever remain the "dizzy lady for the last three months" at 5am.

Anonymous said...

Mary Hood, I'm only just finishing residency and I know what a pneumoencephalogram is. It's not an unusual term to find in a neurology textbook. And Dr Grumpy has, ahem, a looooot more experience than me.

clairesmum said...

And the rate of progression along these stages is directly proportional to the number of consults and the degree to which on call stuff is interfering with your fantasies of doing anything other than work and sleep on the weekend.
Maybe some hot shot MD PhD candidate could do a research project for you, to help develop Grumpy's theorem on the rate of decline in quality outcomes for medical consultations provided outside of normal business hours.
Or maybe not - then the bean counters would decide to pay even LESS for those services, if quality outcome measures aren't met....

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