In
our residency, we have a system where our clinic patients can page us
after hours with problems they are having (not to mention the nursing home pages, floor pages, and pages from the ER for admissions). Now one would think that
people would use this system as an 'emergency line,' so to speak. Well, one would be wrong
on that fact. Some people page with legitimate problems....some are
even serious, yet silly in the sense that people should be going to the
ER immediately (ie. a kid who fell, hit his head, is bleeding, and has
an 'indented head.') We get pages about questions that are ridiculous,
and not emergencies. Some are even enough to make me say "you're paging me at 3 in the morning for what now?!"
As the person on nightfloat currently getting some of these pages, plus some of the ridiculous pages that I get from nursing staff, pharmacies, etc through the night. I'd
like to share some of the moments I (and one of my colleagues) have had
over the past little while....
-not-for-long-
**note....italics are what I am thinking, not what I am saying...**
Re: Testicle Swelling....2am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Pt - "Yeah, I'm calling because my left testicle is swollen!"
Me - "Oh my! Is it painful at all?"
Pt - "A little maybe.....not really."
Me - "Okay. When did you notice this coming on?"
Pt - "About 2 weeks ago."
Me - "And it's gotten worse tonight?"
Pt - "No....it's been the same for 2 weeks."
Me - And you decided to wake page me at 2am because.....wondering what's wrong with your testicle at 2am is keeping you awake and you didn't want to be the only one?!?!
Re: Patient's PCP....5am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."Nurse - "Hi Dr. T. I was just calling to let you know...on the chart of patient X, it says that the PCP was Dr. Stephen Whats-his-name, but it's actually Dr. Philip Whats-his-name (note...Whats-his-name being the SAME last name).
Me - Thank you for notifying me on this amazingly important thing regarding this patient....I agree that this could not wait until morning when the day team rounds.
Re: Medication Question....4:30am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Pt - "Hi there. I just had a question about one of the medications I'm on....What's Lisinopril for?"
Me - Not for your lack of common sense....would you like some Ambien?
Re: Clinic Patient in the ER....3:50am call
Re: Allergic Reaction...11pm call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
ER Doc - "Yeah hi. I have this patient in the ED who sees you guys in clinic. She came in complaining of some abdominal pain, and I just wanted to let you know that we will be sending her home to follow up with you in clinic."
Me - "Did you need me to come down there to see her or something?"
ER Doc - "Nope. Just wanted to let you know."
Me - Really? REALLY?!?! You do know that the CC function on dictations will notify us of what you just woke me up for, don't you??!!
Re: Allergic Reaction...11pm call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Pt's mother - "Hi.
I'm calling because my daughter had an allergic reaction this morning
around 8. She ate something new, and got a rash on her neck."
Me - "Okay, have you given her anything for it?"
Pt's mother -
"Yeah, I was seen in the clinic, and they gave me some Benadryl. They
said she would be okay, but now I'm about to go to sleep and I wanted to
make sure she wasn't going to die while I was sleeping."
Me
- They said she'd be fine...I haven't seen your daughter....how on
earth can I say with 100% certainty that she won't be fine without
examining her?
Re: Depression....12am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Pt - "I think I'm depressed."
Me - "I'm sorry to hear that....how long have you been feeling this way?"
Pt - "Months! I think I need something for it."
Me - "I understand. Have you seen anyone for this?"
Pt - "No....I always forget to talk to my doctor about it."
Me - "Okay....I'll be sure to send them a message. Is it any worse tonight?"
Pt - "No."
Me - "I have to ask - are you feeling at all like hurting yourself?"
Pt - "Oh no....nothing like that."
Me - "So you aren't feeling suicidal?"
Pt - "No. I just think that I should be on a medication for this, and I just remembered, so I figured I'd call."
Me - We do not have medications for ridiculousness.
Re: Patient's IV Orders....1:40am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."Nurse - "Hi it's Nurse Ridiculous-question from the burn unit. I just had your patient Miss has-a-fever come up from the ED, and I saw that you had ordered IV fluids to be running at 75cc per hour. I just wanted to make sure that you wanted them running at that rate."
Me - No, I wanted them running at some other completely other rate....I was testing your skills in telepathy, and guess what.... YOU WON!!!! Stupidest call of the evening award, 2012.
Re: Orders....3am call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Nurse - "Hi,
it's so-and-so from such-and-such nursing home. I wanted to notify you
about a critical lab that we got on a resident of ours, and I need some
orders. He has a potassium of 1.6."
Me - "Okay. When was this drawn."
Nurse - "This morning."
Me - "Like this morning, or yesterday morning?!"
Nurse - "Well, I guess it would be yesterday morning."
Me - Glad to know our elderly are so well taken care of.... Idiots...
Not received by me, but by Dr. M
Pt - "Can I travel when I'm 7.5 months pregnant?"
Dr. M - "Our records say that you're only 12 weeks right now."
Pt - "I know, but we're talking about moving..."
And my ultimate favorite...Re: Pink Eye...9pm call
Me - "Hi, this is Dr. T from Family Practice....I was paged to this number."
Pt -"Yes, thank you for calling." (very flustered and anxious sounding woman) "I'm calling because the inside of my right eyelid is pink."
Me - What color do you think it's supposed to be..."Okay, are you having any pain?"
Pt - "No, no pain."
Me - "Okay, any discharge or watering?"
Pt - "No, nothing like that."
Me - "Any itchiness or redness of the white part of the eye?"
Pt - "No. Everything else seems pretty normal."
Me - "Any runny nose, congestion, sneezing or anything?"
Pt - "No. Just a pink eyelid."
Me - "Okay....well, what color is the inside of your left eyelid?"
Pt - "Hold on a second.....it's pink too!!"
Me - "Well, I think everything sounds pretty stable. If you think you need to, you could take a tylenol and..."
Pt - "Do I need to be quarentined?!?!"
Me - No....but you may need a psychiatrist.... "No, I think you should be okay to follow up with your doctor on that at your appointment that is scheduled for tomorrow morning."
Moral of the story is
HAVE SOME FRICKEN COMMON SENSE!!!!
Just cause you have the right to page 24 hours a day, does not mean you SHOULD
page 24 hours a day. Yes, I am most likely awake, yes I am working, and
yes, it is my job to answer these pages, but do you really think I have
nothing better to do with my time than answer silly questions you have
in the middle of the night?? On Hubbs' recommendation, I am going to
start these clinic phone calls with
"Hi, this is Dr. T from Family Practice....you paged the emergency line - what is your emergency?"
No comments:
Post a Comment