Thursday, July 09, 2009

Welcome, new residents!

He came out of the isolation room in full isolation gear, strode to the nurses' station, removed one glove, and began to return a page.

"Hey," I said, "Take off that gown and glove and wash your hands before you use the telephone."

"I don't have time for that" he said. "Besides, I took off this glove." He waved an ungloved hand at me.

"Dude. You're not Michael Jackson. Get that gown off, go wash your hands, and don't come out of an isolation room with gear on again" I said, feeling a little growly.

"They let me do this on the cardiac floor!" was his parting shot.

"You gotta be a grown-up over here!" was mine.

*** *** *** *** ***

The neurosurgery residents aren't bad at all. Neither are most of the other residents. All of 'em have been on our unit before, because of the weird residency program we have. It doesn't matter what service you're with; you're going to round with psychiatry, neurology, neurosurgery, or internal med at some point, and that means you'll end up with us.

The two exceptions to that are urology, for some strange reason, and cardiology. And, given that the head of the urology department was a nurse before he was an MD, we don't have too many problems with those residents and things like respect and infection control and signing orders in a timely fashion.

Cardiology, though? Makes me want to tear my hair out.

They're nice people. Really. They're not the arrogant assholes portrayed on popular TV shows. There's not a prima donna in the bunch. They're very hardworking (almost as hardworking as the junior residents on neurosurgery), polite, knowlegeable, thoughtful folks. But they've been spoiled by the nurses on the cardiac unit, who don't care what you do as long as you keep the patient alive.

I, personally, care a whole lot what you do. I'm not going to go through every chart you've touched to make sure you didn't rack an order; I have better things to do, and besides, that's on your watch. And it doesn't make much sense to me to keep one patient in isolation alive if you're going to transfer bits of that isolated bug to other patients and the nurses' station. By the same token, I know a little about drug interactions, but it would probably be a fine idea to consult the pharmacy if you have questions. And, for God's sake, don't attack me because a patient's on a particular antibiotic for which you have a personal antipathy. (Not coincidentally, that was the same resident who didn't take off his isolation gown. Hmmm.)

*** *** *** *** ***

Other than that one service, whom we thankfully don't see much of, things have gone smoothly. We have two new residents in surgery and two in neurology. The surgical residents look, as they all do, about twelve years old. One walks with his arms straight down by his side, peering short-sightedly through granny glasses, with his shoulders a little hunched. I want to feed him sandwiches and pinch his cheeks. The other has such an unfortunate surname that a nickname is superrogatory. That'll save us some time, at least.

The neurology residents may take some getting used to. The senior this time around is a brilliant woman--one of the smartest, most well-rounded people I've ever met--and a total bear to work with. Like a lot of geniuses, she's impatient with us normal folks and doesn't bother to try to hide it. The junior will be a whole lot more pleasant to work with once he gets over his shyness. Speak to him and he jumps. With the patients, though, he's great--he's careful, friendly, explains stuff in English, and never seems to be in a hurry. He's also trilingual in Spanish, Arabic, and English, which will be a huge help. He speaks a smattering of French, Farsi, German, and Russian as well. He's promised to teach me how to cuss in Farsi, which'll be my sixth obscene-word language.

So. All things considered, it's been a better week than I could've hoped for. Nobody's gotten horribly sick, my dehydrated patient with CHF didn't fill her lungs with fluid, and the number of racked orders hasn't been so large that we've had to mount a full-on offensive.

*** *** *** *** ***

In non-work-related news, it's one hundred and bloody four degrees here just now. The projected high for today is 106 to 107. The only things moving are the cicaidas' vocal apparatus. Max is sacked out on the kitchen floor, just in front of the air vent. For those of you without a good idea of what 104 feels like, I offer this: I just went outside and hung up a load of wash on the line. It was scrubs and jackets. After I finished hanging up the last pair of scrub pants, I went back to the first ones I'd hung up and took them down. They were bone-dry.

The kittens, apparently unaffected by the general heat-related malaise, have destroyed a makeup box, my CD player, two shelves full of books, a hot-pan-holder, a box of drill bits, and two stuffed animals (those last are theirs to destroy) in the last three days. I'm going to have to bolt the bookshelves that my grandfather built to the walls, as Notamus is such a fatass he's going to bring them down one of these days.

Friend Elizabeth has a 1949 stove to get rid of. Does anybody want it? It lacks a thermostat for the oven, but is otherwise in good shape. It weighs about three hundred pounds and is currently in Manhattan, Kansas. Anybody in the area from Wichita to KC who might want a vintage stove and oven, please let me know. We'll work something out.


LivingDeadNurse said...

liked how u told it like it was to the glove way to go

GingerJar said...

We're still dealing with the swine flu epidemic here. Seems like we get a sudden respiratory distress...vented w/fever and the who freaking triology of crap...and we (of course after the fact) put the pt in watch the doc's so carelessly just waltz in because they've "already been exposed"...well have we...but we don't want to take any unnecessary chances.

I had to run into the temporary iso tent apparatus (looks like an airlock in a sci-fi movie, made out of what looks like pvc and white tarp with gigantic zipers and lots of velcro fasteners) to get into the room stop a guy from yanking his tube out when the Diprovan dose wasn't adequate. I wasn't too happy about it, but I saved the tube. I'm one of those...wash, suit up, do what ya got to do, unsuit, wash up, come out of the airlock and use the alcohol sanitizer, I even cover my hair with a disposable bonnet. What the hell is wrong with doctor's? Do they think their MD degree insulates them from germs or what?

girl_in_greenwood said...

You have a friend in Manhattan, Kansas? That is deeply astonishing! That's my hometown. Now I live in Seattle, though, so I'm not in the market for the antique stove.