My opinion is more and more that the point of internship is to push us to our breaking points. And then a little more. I’m fairly convinced that it won’t stop even at the breaking point. I’ve already seen a few people hit that wall and it hasn’t been pretty. Especially since after all the tears, all the screaming, the work is still there to do.
I don’t know, has anyone who has done this or is in it now, ever had the thought, “I’m only ONE person”? I have that thought like 50 times a day. Today it was like a thousand times. I tweeted today that I felt like I was gonna cry. The old school doctors are all about telling us residents how weak we are, etc. but the fact of the matter is the amount of work that needs to get done hasn’t decreased since the introduction of work hours, etc. In fact, it has probably increased. The expectation is just that now we’re expected to get it all done in a limited amount of time. And that’s it. Get it done. Don’t ask, don’t make excuses, just get it done. I got des-troyed today. A huge service, discharged 7, admitted 3. Plus anything that could go wrong did. Patients changing their minds about wanting to take their medications, patients who were doing great yesterday were feeling like crap today or having intractable pain. And of course I’m the one all the nurses come to. Pages all fucking day. My favorite is the two-fer. That’s when two pages come in at the same time and the pager makes an especially high-pitched squeal. It’s good stuff the way that a rusty nail is good stuff to step on.
I mean some of the stuff that comes my way is ridiculous. I was dealing with a patient who wanted to do harm to himself (without getting too specific) and received 3 pages from one nurse, each increasingly angrier than the last about giving an other stable patient something for gas. And then when I went to call back, I got a ton of attitude. I gotta tell you, on some level that hurts. I really think that the worst is when you kicked while you’re down. For me personally, that’s why I always try to be nice. You just never know when you’ll run into someone who is having a miserable day and that niceness will actually do some good. Attitude, meanness and being an asshole do not Mudphudder a happy camper make when he is getting crushed. But, what can I do? It’s not my style to really retalliate or get into it so I just do my thing and hope that my work gets done.
So back to my original point, I really think that each day things are made a little tougher than the previous day just to see if that’s what pushes me over the edge. I know that’s really paranoid sounding and I don’t believe it either but it sure feels that way. I got some help down the stretch today from some students on our service in getting things ready and together for evening rounds. And we just barely made it. Not only in time for evening rounds but also making it through evening rounds. After rounds I thanked the students (you gotta do that–they work so hard and you just can’t forget what it was like to be a med student) and I expressed how I felt that today our little team was very much like a rickety old boat held together by duct tape and with bubble gum plugging the leaks. We were seaworthy, but just barely, and we wouldn’t have made it without every single little contribution. It was close. Sometimes I wonder how one person can be expected to do everything in one day. Sometimes it can be ridiculous. But somehow it (usually) all gets done.
I don’t know, maybe I’m just whining too much. I’m definitely learning a lot. Not so much through active effort (too little energy and time) but because I have to do the same crazy stuff so many freakin times that it’s hard to forget. I’ve actually started dreaming about my patients and discharging them. It’s so sad–I used to dream about other things. Right now I’ll just settle for some sleep.
Well, now I can go and get some sleep. This weekend I work over saturday night, so I can at least sleep in tomorrow. Hopefully it won’t be too bad but it probably will be. Whatever, though. If I didn’t cry today, I won’t cry tomorrow either–probably because I won’t have the time to.