Wednesday, October 20, 2004

The Nurse's Guide To Specialists

Internal Medicine:

Fit, well-dressed, with a cholesterol of 130 and the oddest prescribing habits you've ever seen. If you need electrolytes repleted or your INR brought to its proper level (that's a measure of clotting time that's influenced by coumadin), the internal med specialist is your gal. Or guy. If you're a nurse, having an internal med consult means that you'll be cutting tablets into quarters and giving 7.5 milligrams of something that comes in a 25-mg dosage, but only on alternate Thursdays during the dark of the moon.

Neurosurgery:

Brilliant, with a necessary arrogance. Would you want somebody suffering pangs of self-doubt while their fingers are in your brain? Didn't think so. Usually underfed and underslept. Will eat anything that's moving slowly or standing still. Very nice people, overall, since they have to deal with people who can't talk, walk, or make a lot of sense. (Those are the nurses, not the patients.)

Neurology:

Sweet, but from Mars. Odd senses of humor. Usually strange facial hair (on the men, not the women). Sometimes they have a fascination with Bach or zebras or rowing. Older neurologists tend to be courtly in the extreme and wear bow ties.

Orthopedics:

The jocks of the medical world. They are carpenters and craftsmen--and I mean that as praise. A good orthopedist working on your hip will leave you with the equivalent of really good Art Deco woodwork: functional and beautiful, with nothing extra added. If you see a muscular young man or woman of few words striding down the hallway with a tiny box containing magnifying eyeglasses in his or her hand, that's your orthopedist.

They also have very strange senses of humor. A few months ago the C group at our facility had "Talk Like A Pirate Day." "Shiver me timbers! Swab the deck with that dressing, matey! AAARRR!"

Cardiothoracic Surgeons:

I do not work with any of those folks and so have no clue what they're like.

Plastic Surgery:

Artistic, with the emotional lability that comes with artistry. I'm personally uncomfortable with plastic surgeons, as I wonder if they're casting a covetous eye on my double chin.

Urology:

How much does that suck? Proctologists are probably the only people with a more-misunderstood specialty. Urologists, however, have the benefit of access to the scariest-looking pieces of medical equipment in the entire hospital.

General Surgeons:

If you see a resident asleep in a chair at the nurses' station, chances are it's a general surgery resident. They're horribly underslept but have a solid working knowledge of where everything ought to go in the body. If you're a general surgeon, you can take people apart and put them back together with no bits left over. I've gotten speech of a few of them that's beyond "mmmmrrrppphhhh" as I wake them up, but not many.

Endocrinology:

Your average endocrinologist has a second brain somewhere in his body, in which he stores minute bits of important information that came from some obscure study in Backobeyondistan five years ago. They will speak to you as equals, even if their conversation about a complex patient eventually sounds to you like "Grobble grobblescrink mmmmREEEE! ppphhhhbt!"

Psychiatry:

Well-dressed, with a fondness for expensive shoes and dangling pendants (men and women respectively). Pleasant but strange. Psych nurses are nice as well, but strange. You *have* to be a little odd to work psych and be good at it.

The best illustration of a typical non-psych-nurse and psych-nurse exchange I can come up with is this:

Me: (trying to reach a med on a high shelf) "Sometimes I wish I were taller, dammit!"

Psych nurse: "Oh...do you have body image issues?"

Next week: The Nurse's Guide to Nursing Students

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