Don't mess with the Universe. We were destined for a long night.
The let me come in an hour late from my afternoon break. As I have mentioned before the entire team works most of the day, and then at night there are 2 juniors and the senior on-call. One of the juniors gets 4 or 5 hours off during the day and then is awake all night, the other junior is there all day with the expectation to be able to sleep for 4 or 5 hours at night. And the senior on overnight gets a bit of a break during the day as well.
So, the day was slow yesterday. Not many admissions. They called me and told me to come in an hour later than normal, and when I get there things were still very, very slow. Slow enough, in fact that we let one of the other junior residents go home (technically, we still have one extra junior because I am there, making 5 of us instead of the usual 4).
I swear, that person had been gone no more than 20 minutes, and then there were 5 kids waiting for admission. The night quickly decompensated.
I swear, that person had been gone no more than 20 minutes, and then there were 5 kids waiting for admission. The night quickly decompensated.
I'm wrecked, having run errands post-call this afternoon, I've been up since yesterday morning. (I did lay down for 30 minutes at 5am).
My Admissions:
#1) A 3 year old with symptomatic anemia, with a hemoglobin of 3. (Should be well above 12 or so). Reason unknown. His color was so pale that when I walked past him at about 3 am I almost freaked out thinking he was dead! I actually shook awake.
#2) 2 year old who was being observed in the observation unit, but had recurrent seizures, so wasn't simple febrile seizure, and then proceeded to go into status seizure.
#3) A 13 year old boy with pretty impressive blood in the urine
#4) a 4 week old with a cold (yes, even in mighty Bara there are some bogus admissions)
#5) A 3 year old boy with meningococcal meningitis. Our 3rd of the month!
We had 22 admissions. But we also had to intubate 2 other kids. It was a little bit crazy.
The breakthrough, though, was more personal for 2 reasons.
First, I've expressed some frustration privately to some about the dynamics of my being back to a junior status. Well, last night was finally the night were I was treated as a peer by the senior, and in fact when one of the nurses said something about the interns working last night, the senior quickly corrected her and told her I was a senior. But more importantly, with the sick kids, when I made suggestion about management of some of the kids, those suggestions were done. And also, things were so hectic that the senior last night didn't write notes on any of the patients I saw.
I had asked to change teams for next month, and found out that this wasn't going to happen. I think had I pressed, I would have been able to change teams, but there has been a shift the past few days and I think it'll be ok to stay in Ward 18.
Second breakthrough. The Grand Slam!
At some ungodly hour (about 3am), I obtained the pediatric grand slam. With only the assistance of a nurse, I got urine, blood, spinal fluid specimens and an IV in the 4 week old child (yes, the one I admitted for a cold). We won't even discuss why this kid got a sepsis work up. It was a proud moment. A proud moment with a lot of fortunate luck (for the child).
Anyway, keeping this on the brief side, I need to sleep.
