nihlists with good imaginations?

well, it's been some time since my last rant. 7 days to be exact. which is the same number of days i have left in the ccu. actually, it's 5 days: i have 1 more off day, plus one day "off" during which i will be taking an exam rather than going to work. so that makes it 5 days; 2 of those are post-call days where i go home by noon, and since i am usually so tired/delirious i almost enjoy the morning, that really becomes more like 3 days. but there are 2 call days, which can be horrible and never-ending, which brings me back to 5 days. i can handle 5 days. especially since it is now t-minus 14 days until i have 2 weeks of vacation!

i was on call last night. it sucked. not only was i sick, but 2 patients came after midnight, meaning i got basically no sleep. i thought that was bad, but then on rounds this morning the attending was not thrilled with the manner in which 2 patients were managed and insinuated that i was not such a competent doctor after all. not so much fun.

that didn't bother me too much, since it is quite easy to come in ex post facto and deride overnight decision making, but i did spend the few free moments i had this morning re-thinking some of the choices i made. the end result was that i spaced-out and lost my train of thought many times when discussing other patients, leading to paroxysms of gibberish coming from my mouth, which only further this attending's low opinion of my abilities.

so i did what anyone is my position would do: i took out my frustration on someone beneath me; in this case, it was a nurse and then a patient. the nurse was someone who paged me 3 times in a row to ask me about orders for a patient that wasn't even a ccu patient, so i knew absolutely zero about her. i was very pleasant the first 2 times, but at number 3...

the patient i yelled at was a 50 year old woman who was supposed to be discharged today and then return this thursday for an outpatient surgical procedure. she told me that she would need to stay until then because she would have no ride back to the hospital on thursday. i told her that she didn't need to be an inpatient for 4 more days, that bad things can happen in the hospital, etc., but she was unbending. i asked why she thought she couldn't get a ride and she said her husband worked early in the morning. what about friends? no one would do it, she informed me. i was livid. i asked if she really had no friends who would drive her to the hospital for a life-saving procedure? nope. how about a cab? she told me she lived too far away and that it would cost too much and that it would be easier for her to stay. this is when i told her that she needed to take some responsibility for her health and well-being and just because something was "easier" for her doesn't make it the right choice. i told her that there were people who were actually sick who needed her bed and the hospital was not a hotel.

i was so angry that i left while she was talking, telling her i would be back to discuss it later. these type of people make me hate-filled that i can't even type more about it. what is so irritating is that everything i said is true: a person shouldn't stay in the hospital if it is not necessary--some very bad things can happen. second, there are people who are acutely ill who do need her bed. third, the wasted health care dollars spent dealing with patients like her is astronomical and wasteful, particularly in this resource-poor environment. aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaahhhh!

i will update you on her discharge status tomorrow.