I've been on night float for the last five days. I'm probably giving myself acute kidney injury, because I now refuse to go to the bathroom. Because the moment I sit down on the toilet, my pager will go off. Every time. Every single time. And then I have to fumble to throw my pants back on and rush over to my adjoining call room to turn off my pager before I wake up the other 4 residents sleeping in the neighboring rooms. I finally got smart and just started taking my pager with me, but yesterday, I almost dropped my pager into the toilet, because it freaked me out when it started ringing mid-pee. Gross, but true.
Most of the time, the pages are pretty legitimate. A patient needs to be admitted, another patient had a sudden drop in her potassium level, someone needs benadryl to sleep, and so on and so forth.
Yesterday, I got paged about one of the rocks on our service. He had a stroke and he's currently waiting for a spot at our rehab hospital. And at two o'clock in the morning, his nurse paged me urgently to tell me that my patient had a sudden change in his exam.
I freaked out.
Sudden change in exam usually means progression of stroke, or worse yet, a brand new one. As I pulled up his most recent labs and imaging, I asked the nurse what had changed.
NURSE
He spilled water all over himself!
ME
What? How?
NURSE
I put the cup in his hand and he spilled it!
ME
That might be because his stroke affects his left side. He has 0/5 strength in his left arm and hand.
NURSE
Oh. But doctor! He also very unsteady on his feet.
ME
...
NURSE
When we did walking trial just now, he almost fall over. Very dangerous.
ME
Yes. That's why he's on strict bed rest. He has no strength on his left side at all.
NURSE
Well, he also very sleepy.
I didn't tell her that he's probably sleepy because normal people sleep in the middle of the night instead of participating in walking trials. Instead, I went and saw the patient, assessed that he was exactly the same as he has been, and then I went back to my call room.
And just as I took off my glasses to get some sleep, my pager went off yet again.
