Let me rephrase. The worst part of being at the absolute bottom of the totem pole is getting a whole bunch of crap crapped on you, and having to sit there, smile, and take the abuse.
Especially when you totally don't deserve it, because you didn't do anything wrong.
Yeah. If you couldn't tell, today was not a good day at the hospital.
I have a patient who gets her blood drawn every morning at 4am. Yes, she gets woken up every morning at 4am for her blood to be drawn so that by the time the medical team gets to the hospital, results will be waiting. That way, we can figure out our plan of attack for the day.
For the past two weeks, those results have always been there. And my patient is a very smart lady, so every morning when I go see her, I bring in her daily results, and we sit there and add another data point to her growing graph.
Today, there were no results at 6:30am. There were still no results at 7:03am when my intern walked in the door, no results at 7:29am when I left for morning report, no results at 8:35am when I came back from morning report, and no results at 9:15am when we were standing outside her door as I updated the team on her condition before we went in to examine her.
ME
Good morning Ms. Prince!
PATIENT
Hey there Michelle - is my bloodwork in yet?
ME
No, it doesn't seem like it..but don't you worry - I'll be in and let you know what they are as soon as they pop up on my chart!
PATIENT
Okay...just as long as I don't need that biopsy.
ME
Nope, I think you're good for now...but we'll wait for those results to make a definite plan.
At 11:30am, when rounds finally ended, some of her other lab work started to trickle in. A sputum culture had grown out some stuff, antibodies for a couple of bugs were negative, and some cancer markers had come back negative. But her bloodwork was still missing. So I worked on my notes and waited for stuff to come back. Except it never did. And at noon, I had to go to class.
And at 2:45pm, right before class ended, my pager started buzzing.
Patient's husband found blood tubes in room - apparently never sent to lab. Btw, family very angry with care team. - Nurse
Oh shit.
So there was lots of yelling over that. Even though I had absolutely nothing to do with blood draws and making sure those things got to the lab. Apparently I should be checking under beds and in bedpans for vials of blood. Who knew?
Then, later that evening, because the aforementioned patient had fired her Infectious Disease team, I had to call and arrange for the other ID team to come see her.
ME
Hi, I'm calling regarding a consult for Ms. Prince.
MEAN RESIDENT
This better not be about treatment, because you know you can look that stuff up right? Don't waste my time.
ME
Oh no sir --
MEAN RESIDENT
Sigh. What's the one liner on her?
ME
She's a 55 year old female with a past medical history of leukemia presenting with fever of unknown origin.
MEAN RESIDENT
She had leukemia?
ME
Diagnosed in 2000.
MEAN RESIDENT
IF SHE HAD LEUKEMIA, YOU CONTACT THE OTHER TEAM, NOT ME.
ME
Oh, see, the thing is, she fired --
MEAN RESIDENT
[dial tone]
Fabulous. So then I went back to my team room to finish up my notes, and my intern - as he was leaving - remarked slyly about how the recycling bin was getting awfully high and that it ought to be taken out...by a med student.
So knowing my cue, I got up to go empty it out.
Only, the new interns had thrown their lunch and gum and other sticky things into the bin.
So I stood there, throwing away the papers coated in cottage cheese into the trash, and feeding the others into the Shred-N-Recycle bin.
SOMEONE IN CHARGE OF SOMETHING
Are those patient files?
ME
Yeah.
SOMEONE IN CHARGE OF SOMETHING
Why are you throwing those into the trash? They need to be shredded. Privacy rules, you know.
ME
Yeah, but they have food on them and I didn't want to mess up the shredder.
SOMEONE IN CHARGE OF SOMETHING
So you'd rather have patient information be leaked?
ME
Well no...I'm sorry, I'll put them in the shredder bin.
SOMEONE IN CHARGE OF SOMETHING
Ah, finally a smart idea! Maybe your first!
Then I stand there trying to rip just the piece of the paper with gum on it off, and feed the rest into the shredder. And he finally walks away.
SOMEONE ELSE WHO THINKS THEY'RE ALL THAT
WHAT are you doing?!?! There's FOOD on that!
ME
I know I know...but I'm trying to rip off just that section...
SOMEONE ELSE WHO THINKS THEY'RE ALL THAT
You're going to ruin the machine. Sigh. Please. Stop. Just step away please.
There was no winning this battle. I ended up shredding it myself with a pair of scissors and I scattered them among 3 trash bins. Hopefully that was enough to appease the higher-ups.
Ugh.
Like I said, it wasn't a good day at the hospital.
The thing is, I had been loving it up until today. I get lectured at every day, but it's typically about stuff that I can be doing to improve patient care. Constructive criticism. Slow down when you're talking. They still have a PIC line in? Uh...that's high risk for bacteremia. You probably shouldn't give a patient a whole bucket of ice chips if they're NPO.
But today? Today's lectures were unnecessary. I didn't need to be lectured at as though I were a five year old - [sing-song voice] So then, after blood work is drawn, what do you do? Yes, you put the label on it...good girl.
Especially when I don't even do that stuff.
I keep waiting for someone to pinch me and tell me that today was just a big bad dream.
