The reasons I love residents.....(medical residents that is.) En noche pasado, (last night to my no espanol hablando brothres and sisters), a man had the nerve to go from a simple chest pain to developing a new left bundle block with reciprocal changes as we were going down the road. For those of you scoring at home, he was working on a heart attack and doing a fine job at it. But that aint the story, I called the receiving facility to ask for a CARDIAC ALERT based on the above, the voice on the other end asked me again where his elevation was, I repeated the new onset LBBB with symptoms and reciprocal changes, she advised me to go to triage. I knew where I stood, but I had a back plan, find the resident... And here is why I love residents.... 1) They are poor and hungry. Therefore they know the codes to all of the nutrition and snack rooms. They also know where to get the real cokes, not mini shastas as well as where one can find the non soggy sandwiches. Very useful. 2) They are smart enough to be doctors. And thats good, they are also smart enough to know that a 20 year critical care nurse is smart enough to save their ass and keep them from killing someone. That is essential since a botched residency means a career as a well read, articulate member of the Geek Squad at the Apple store or a lateral entry program into teaching. Both noble professions, but hard to repay 250000 in loans with either of those. 3) Knowing the PGY is useful for two reasons, it gets the nurse what they want for either a: If you confront a PGY -1 with a complex case, thye will say in a terrified voice, Whoa man! im just a first year! Let me go get the attending. If you confront the caliper armed, pocket pdr carrying PGY 3 with a complex case, they will say, I am a PGY 3 thank you! as they look down their nose at you, BUT, BUT they will see this case as a chance to impress the attending, and will want to run to present it to be the cool kid in class and get published...EIther way ,I win. I get an attending to the bedside much faster which is better for the patient. And thats what it is all about.. 4) They have made the CHOICE to become doctors in this current world of healthcare. Dont get me started. But this brave new world is less about the patient and their overall well being and more about, cost effective care, market share, metrics, satisfaction scores, lengths of stay and reporting of required data in order to maintain the good graces of JCAHO (a private star chamber that often pulls measures for quality out of their ass or based on one or two studies) then holds organizations accountable to them or imposes big penalties or jeopardizing the JCAHO banner which could jeopardize payments from the government and private insurance. Dont even get me started on CMS (medicare Medicaid czars), they re essentially the single payor system that is administrated by the federal government, there is no room to argue or any wiggle room. Before you advocate for the single payor system, take a long hard look at them. Anyway, to wrap this up, the nurse essentially ignored what isaid and it was worse in triage, so I gave the 12 lead to a pgy -1 (I saw her name tag.) She saw what I did and took it to the attending, then she told me where the good snacks were in the unit as well as provided the code for door entry. Everybody was a winner.....G night Children. I do so hope I made you laugh just a little reading this cause I sure did living and writing it:-)
Posted on: Wed, 10 Sep 2014 16:02:33 +0000
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