PICU Bedtime

This actually belongs under the heading of "More Things You Can't Make Up."

The child in bed 18 in the pediatric section of the ICU has been in for almost 2 months. He is a 7 year old who has an undiagnosed, but improving neuromuscular condition which has left him with paralysis. He's had a stormy ICU course. But as I said, he's improving. And part of the goal is to start normalizing his routine, to the point where he's getting back to a normal eating schedule, and trying to get him on a normal wake/sleep schedule.

So, last night, when I did my 8pm round, he was asleep. With the lights on. So I searched for the switch to turn off the lights in his room. And I couldn't find the bloody switch.

"Excuse me," I said to the nurse taking care of him, who looked slightly annoyed I'd interrupted him from reading the paper, "where's the light switch?"
"Why."
"Because he's asleep, and I'd like to turn out the lights."
"Sorry doctor, the order is written to turn out the lights at 10pm. I'll do it then."

I can't make this shit up!

After a few days of being utterly annoyed by the nursing staff, I had decided I would take the lead from Fatima, one of my co-residents tonight, and just smile and go about my job. But this was a serious test to my smile capability. It dawned on me that I am, in fact, the doctor taking care of him, and I could be passive-aggressive by cancelling the order that is written for lights out at 10pm, and write a new order for 8pm. But I was so flabbergasted at the lack of normal comprehension by the nurse that "turning the lights out" was a pretty flexible order, that he couldn't see the ridiculousness of his reply. But, again, it confirmed my thoughts that the majority of the nurses here work on a "tick-box" mentality. I have a task to do. I do it. Tick. Done. Back to my newspaper.

So I thought, what would Fatima do?

So I dropped my ego, laughed to myself thinking that I would have to tell this story to the attending in the morning, and just moved on to the next kid. And when I, on rounds, recounted the story, it garnered the humorous response that I hoped it would, and I knew that my colleagues on rounds felt the same way.

"Please change the order, to turn off lights when patient is asleep at night."