Thursday, October 07, 2004

It's schaDENfreude, asshole!

Confidential to Denise: I really, really do know how to spell 'schadenfreude'. It's just that I can barely type in English most of the time, let alone German.

Some nice person sent me an email asking "What's a typical day like for you?" Herewith, A Typical Day In The Life:

0420: Awaken to the dulcet tones of a BBC announcer soothingly reporting the latest casualties from the Gaza Strip.

0423: Pour first cup of coffee.

0424-0440: Mindless circumambulation with said cup of coffee gripped tightly in paws.

0440-0520: Shower, try to apply eye makeup without ending up in traction, dress, decide on lunch. Leave for work.

0610: Arrive at work. Eat yogurt while sitting in car, listening to the dulcet tones of Carl Kasell totalling up the latest casualties in Iraq.

0625: Stumble in to the breakroom with another cup of coffee, prepare for report.

0640: Report until 0700. Pee if possible.

0700: Start waking up patients. Most of them are grumpy, since they've been awakened every two to four hours for days on end. Check lab results from earlier in the morning. Inform the neurosurgery nurse liason if there's anything amiss. Send people to surgery, CT scan, and echo.

0800: Start charting. Morning assessments are done; all that remains is putting them on paper and hoping that I haven't charted Patient X's assessment on Patient Y's chart.

0803: Think longingly of eggs and bacon in the cafeteria downstairs, then remember latest scale numbers and cholesterol results.

0825: Five minutes for bran muffin.

0830: Begin passing morning medications. Deal with, at a minimum, six new orders and four new crises. Receive patient from ICU.

0915: Finish passing medications. Start calling residents, consults, specialists, the housekeeping people, the guest services staff, family members, and wound care/ostomy care/urology people for help or with information.

1006: Morning routine of physical therapy, bowel programs, and incoming phone calls begins. Take time to pee if possible. Change dressings, check ins and outs, empty drains. Retrieve six new orders from box. Discharge two patients home. Charting.

1128: Begin passing noon medications, hanging antibiotics, giving Decadron, and checking blood sugars and every-six-hour lab reports. Do noon assessments on neurology/neurosurgery patients. Call report on patient going to rehabilitation unit. Chart.

1230: Finish above. Begin to think longingly about sandwich. Retrieve six new orders from box. Send patient to rehab.

1240-1315: Various crises, lunch preparations, and phone calls.

1315: Sit down with sandwich. Take first lustful bite, be called away for lift help or because Patient Y has just had explosive diarrhea that covers the entire back wall of the bathroom.

1330: Return to lunch, if fortunate. If *extremely fortunate*, have time for another cup of coffee and a quick pee break.

1400: IV flushes, any dressings I didn't get to in the morning, afternoon rounds of tests start. Assess non-neurology patients again. Catch up with respiratory therapists for progress reports. Check box for new orders. Find new order written by chucklehead from any one of several services and call for clarifications. Hang new bags of tube feeding. Check ins and outs, empty drains, calculate total IV drips for the last seven hours. Check box for new orders. Hang potassium, magnesium, or calcium drips. Chart.

(Optional: four new crises.)

1530: Look at clock, realize there are only three-and-a-half more hours in the day. Fail to mourn this realization. Start 1600 assessments on neurology/neurosurgery patients. Get two new admits from surgery. Discharge late-home patient. Plow through group of new residents taking tour of unit. Be almost rude to hospital administrator taking group of investors through unit and thus blocking the entire damn hallway so I can't get a bed through. Field call bells from patients with problems ranging from inability to breathe to their fruit basket not containing enough grapes.

1700: Neurosurgery rounds start. Stare dully at wall, wishing I worked a ten-hour shift rather than a twelve-hour. Wonder what to have for dinner.

1745: Neuro rounds end. Reassess patients. Retrieve six new orders from box. Direct men who are impersonating Birnam Wood to various rooms for flowers/potted plant deliveries.

1800: Last push of the day. Hang evening medications, pass evening medications, check IV bags. Long for strong drink. Fill out report sheets. Do quick rounds of rooms, picking up dirty linens and trash, changing water in vases (yes, we really still do that). Check to see that evening labs have been sent. Sometimes, if very fortunate, practice French with Cajun patient or discuss politics with Political Heavyweight Patient over dinner. Chart.

1845: Report to night shift. Give up beeper. Hope I haven't forgotten anything.

1908: Punch out. Go home. Fall over.

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