Trying to take things less seriously

(pics in this post courtesy of a fwd from my Mom).

Sometimes I feel like I have the worst job in the world. I started in the ICU/CCU (intensive care/coronary care unit) at the VA on Monday, and it's been a rough week. I had a long day Monday, there until 8:30 p.m. (ok b/c L and T weren't back from the beach yet). I ended up missing a continuity delivery b/c I didn't escape fast enough from the VA to drive to UCD (even though my awesome senior res, Zach, allowed me to leave), but then returned to do another admission. I think I got out at a reasonable hour Tues-Thursday but then Friday, got slammed with admissions on our senior's day off and was there until like 9:45 p.m. (definitely breaking one of those RRC rules, b/c I was back at 5:15 a.m. the following morning)! Yesterday night (today was my day off this week-- the only reason I'm able to sit down and write.... I apologize for not calling people back!) I left at 8:30 p.m. Yes, I kid you not! (Amusingly, yesterday, when I tried to d/c a patient around 2:30 p.m. after he decided he wanted to go home rather than wait in the hospital for a BKA [below the knee amputation], the pharmacist (who may have had his Rxs to fill) told me, "You really shouldn't be discharging people this late in the day. I've already been here for 8 hours and was headed home." I was smiling inside but think I even said something along the lines of, "How'd you like to be here for 16 hours in a day?!?!( and then 15 hours the next day??!)".

The VA system is really bad in that we admit every day of the week. It is a day float/night float system so that you don't take o/n call; however, this means that, every morning, you come in with new admissions to your team overnight that you then have to learn and present (along with rounding on all the other patients). This really drives me crazy-- I get so anxious every morning wondering how many new people I will have to learn while scrambling around in the morning. And then, since you didn't admit them youself, I always feel like I don't know them well enough. I don't think there's a "cap" (i.e. max # of pts you can carry) because we are the only ICU/CCU there.

We admit until about 7 p.m.- and then there's always orders, the H and P notes to write, etc (while trying not to get behind on d/c summaries). It's pretty brutal. It's not so bad when you have a service of 3. But with a service of 17-- which I think is what our census swelled to at one point last week-- it's almost unmanageable.

Also how I feel:
The pulm fellow asked me the other day if I was doing okay, because he obviously picked up on the fact that I constantly look (and feel) stressed. I am frustrated because, at this point in the year, I want to think that I am efficient and confident and know how to do most things. But these cards and ICU patients are complicated, sick, and just make me nervous!! Get me back to L and D where I feel like I know what I'm doing (most of the time)!!!

This is kind of how I feel:
I wonder if next year will be better. There is just so much to learn and know and I hate not feeling ontop of things. Hard to believe that only 2 1/2 months remain of intern year! I do have to do some "intern" FP rotations (newborn, peds wards) as a 2nd year but the responsibility and expectations will surely be stepped up. I hope I can handle it!


Here are just some other amusing pics in that e-mail my mom sent:

In honor of my patient yesterday who took somewhere around 66 oxycodone pills and had to be on a narcan drip....

On feeling lost and like I was swallowed whole...On infidelity? ...

Scrubby!!

In honor of May baby XY (coming soon!!!!!!!!!!!)- JB, don't feed him too much Thai food!
On still loving California...

Today was great. I SLEPT, Shomir and I went to church, and I've just been catching up on some things around the house. One more week of CCU/ICU madness before I'm on cards consults (nice schedule! Can't wait!). Happy Sunday!