Thursday, January 14, 2010

the waiting game

I hate this game. In every sense. I am impatient and I hate the feeling of helplessness (hello, Type A here, thus I like to be in control of situations). I hated that I had to sit and wait for hours to find out if I passed the nclex. I hate that after you put yourself out there and ask a boy out, you just have to sit and wait for his answer (but thats another story :-p).

But really, I HATE the waiting game when it comes to work. I understand that some situations are minor enough that waiting, seeing, and monitoring is appropriate - like if someone's staples look a little red and inflamed. Could just be irritation, so cont to monitor and if the redness/swelling increases, ok we'll take some action. That is legit and I understand that. But typically if a situation warrants reporting off to the doctor, some kind of action needs to be taken. For example this conversation took place during my last night shift at around 3am:

"My patient is complaining of shortness of breath. His O2 Sats are good: 99% on RA, but I put on O2 for comfort and he says he still feels like he just cant catch his breath and feels tightness in his upper abdomen" (I am 95% sure this patient has a fluid collection in his abdomen which would explain the tightness, and all the fluid pushing up on his diaphragm would explain the difficulty breathing, but I still need to tell the doctor so that maybe we can order a couple tests to confirm. Plus, whenever a patient complains of SOB, it is never ever good.)
"Ok, we can order chest x-ray and maybe an ABG in the morning. Just watch him for now. His Sats are fine, right?"
"Yeah... but he's on 3L of O2 and still feels short of breath"
"Yeah, ok, we'll order some tests in the morning."

WTF. Why? Why do you have to put off ordering these tests till the morning? Why the hell would you put it off for 3.5 hours till the rest of the team gets here when you know that as soon as they take one look at him, they'll order exactly what you just suggested? You're the freakin senior resident! Just order the damn tests. I dont know if its b/c they're not used to how sick our patients are or what, but the waiting game never ends well with our patients. It is not a good game to play with these people. How is it that they dont understand that? Ugh. Frustration.

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