Year in Review: My Gratitude

7/1/13 At 8am I left Jersey Shore hospital after working my last shift as an intern. *happy dance* It's a great feeling to know I'm not the littlest monkey on the totem pole anymore. Though, if the intern is out then I'll be reverted back to my younger days and be forced to hold the damn pager (No other sound will ever instill as much irritation, panic, sadness, and anger as that ring... we even have nightmares on call where we think it went off and didn't answer it). Actually, every resident will still cover the pager if needed, but as long as you're not the intern, you can pass it off to a junior person as soon as possible (so much so, that you can throw it at the junior the minute you see them down the hall.... I mean, it's a curse. Why would you hold on to it?). And what does it all mean? It means I won't have to do these annoying months of alternating between day shifts and night float on a weekly basis, but instead will actually take real "call" and be at the hospital for 24 hours (which means I get a post call day, and get to sleep and be productive in my personal life). I'll get to operate more. I'll get some more days off a month. And as scary as it sounds (which is really scary), I'll be the most senior resident at the outside hospitals during the night when on call... but more on this later. Things are better for a second year (for most people), and that's exciting. Intern year was not the worst.... I had a great time, overall. I've formed some great friendships, made some great memories, and have done/seen some pretty cool shit. I mean, do you get to put in chest tubes to help re-inflate someone's collapsed lung? Amputate some toes? Use sweet instruments to take out an appendix or gallbladder? Or a wedge of a lung? Or delicately suture an artery to a vein? Probably not. So, yeah, as much as the long work hours, co-resident tension, ER frustration, and the more than ocassional grumpy, unappreciative patient annoy me, surgical residents do some awesome shit to save lives, and you can be jealous while you sit at a desk excelling. But, our social lives are sub-par, so there's a decent trade off, but we make the most of it. And, I'll still drink you under the table. But for what it's worth, I've decided to reflect on my past year, and before doing so, I wanted to start off by showing my appreciation and gratitude to those that have made this year what it is. However, this isn't to thank friends and family. (But, very quickly, I love my family and my friends. I thank them for always showing support. I also really thank everyone who keep inviting me out and understand that chances are I won't be able to make it, but they don't forget about me. So for that, I am very grateful. It's very easy to become a hermit in a job where you are working 80 hours a week, 6 days a week, day or night, and when you get home, all you want to do is sleep.) No, this is to thank the rest of the supporing players, and they are mostly at work. NURSES I would not do your job. NOPE. I'm not sure you need 3-4 days off a week, but I suppose it's well-deserved... at least to the good nurses. (By good nurses, I mean the ones who aren't lazy and work hard. I'm not a fan of a nurse who questions a proper order to replete a patient's potassium through an IV because "that'll take all day." I'm here all day, so are you, and the patient isn't going anywhere, so hang up the damn bags) I don't know if the ladies and gents currently in the profession would agree, but I think it's glamorized to the outside world. You have beautiful nurses who assist sexy doctors in treating good-looking patients... and then they start haveing sex with each other on the patient's bed... oh no, wait, that's porn. No, wait, it's not. But, I think it's true. You don't see the truth of what it is to be a nurse until you are hands deep in someone's shit trying to clean them up for the 3rd time on your shift. Their day is full of charting everything that happens, following orders from doctors (and sometimes, astutely, catching errors and potentially saving lives), cleaning up patients, holding their hand, talking with them and trying to answer their questions and comfort them and at increasingly frustratingly times, get a damn doctor to see them. They are the ones taking care care of patients. I would say we manage their care, but I'm definitely not the one giving medications (orally, intravenously, or rectally) or doing most of the aforementioned. I will most certainly talk to patients and try to comfort them or make them laugh, and of course put in orders and operate, but for the other 20 hours of the day, the nurses are the front line. When I first started, exactly a year ago, I would mentally piss my scrubs everytime the pager went off. I was responsible to call back and respond to the nurse. I had to make a medical decision, no matter how small. A great piece of advice when starting off was, "Just ask what the nurse would do." And by golly, I did. Of course, this is only appropriate in certain situations. But, the nurses have been around for years and they've seen a lot of this before and know what's usually done. And, especially for that first month, thank God they do. Can you imagine having to deal with interns as a nurse each year? Here you are working at a hospital for at least 10-15 years, and in comes some sexy, cocky yet self-deprecating, nerdy surgeon straight out of medical school who hesistates at whether to put in a foley or straight cath a patient, and you have to call HIM for orders and answers? Right there I'd want to kill myself. Is that patience? Understanding? I don't even know. And that's another thing. Nurses can't do much without an order from doctors. I guess in an era of malpractice and lawsuits, everyone has to cover their asses. Honestly, I would feel so constrained not being able to take care of things without an order. Can you put an order for tylenol for a headache? Can you put an order to flush the foley? Can you put an order saying it's okay for the the patient to shower! Of course the patient can fucking shower, I don't want to smell him at 4 am in the morning when I'm rounding! (It's a him, because girls only smell like roses... and they don't fart or poop. So much the superior race.) Yet for everything they have to deal with, most nurses love their job and their patients, I think. And I'm sure they have the best stories at parties. If you're going to be a nurse, you have to be truly altruistic. You have to deal with a lot as much as we may complain about their attitudes, and work habits, and what have you, patient care wouldn't be provided. There'd just be orders in a computer... (they're in the computer?!) So for all that, I thank you. PLUS, some of you are attractive... or funny. Or both! I thank you for that, too. NURSE TECHS You help out the nurses and that is invaluable. Thank you. PHARMACISTS An invaluable resource. Many times, especially when starting out did they help me with medications and doses and antibiotics. And I love it when they teach why an order should be changed and then volunteer to fix it (I mean, I'm already busy putting in an Okay to Shower order). The pharmacists at RWJ are great and extremely helpful, and I love them for gladly adjusting and re-ordering TPN for my patients. It's a slap to the face when I'm at the outside hospitals and they are not as helpful or generous. So for that, I thank you. ORDERLIES Thank you for wheeling my patients where they need to go. Surgeons need pictures, and pictures are taken down in the basement at radiology. Patients need to get there. Thanks, Wheelman. Your stretcher-handling skills, I will write home about. JANITORIAL ENGINEERS A hospital has to be clean. Everyone plays their part in making it run. And, for the 89 year old man who still cleans our call rooms, you are an inspiration. Thank you, gramps. CAFETERIA PEOPLE Thank you to the people who don't charge me a nickel for a cup of water. Shit adds up. OPERATOR How do you know the know the numbers to any office/department I ask for so quickly!? How do you know everything!??! Thank you and your witchcraft. PATIENTS Thank you for letting me stick a knife or needle in you. Most fun.