Another case: Abdominal pain

Originally posted by Sacamuelas
Doc T... I think the Team Sergeant should make you Beef Wellington EVERY night. Good GOD...

he has made much more complicated dishes but that remains my favorite... hey , it was mother's day.

doc t.

[ccrn]

hmmmm...

I dont know what to say to that. I dont know all the nuances of residency or internship.

The ICU I work in is based on intensivist model. All I know is when I call them to the bedside in the middle of the night they are there. I have also heard them say they are grateful for the limits on hours. I havent heard any of them complain about crosscover. Many Docs crosscover here not just residents. My statement was subjective based n my own experience rather than any research.

But now that I have heard that side I will have to ask them. Maybe even do some searching on it.

Thanks to whoever cleaned up my post and my apologies for lack of clarity. I seem to have forgotten some vBulletin skills. Can I PM you for advice or will that be covered in another forum?

So the official Dx and tx is?

ccrn

[Sacamuelas]

Originally posted by ccrn
hmmmm...

I dont know what to say to that. I dont know all the nuances of residency or internship.

Well, you can do like me and say "thank you" for enlightening us on the subject from a first hand do'ers perspective verses our assumptions based on knowing a trauma surgeon(s) and experience in the hospital setting. HaHa

Priginally posted by ccrn
Thanks to whoever cleaned up my post and my apologies for lack of clarity. I seem to have forgotten some vBulletin skills. Can I PM you for advice or will that be covered in another forum?

You are most welcome, Sir. Check the cleverly disguised Frequently asked questions (FAQ) link at the very top, right side of your screen. It goes over all the basics,etc of things. Any other questions, you can post in knuckledragger or feel free to Pm me, and I will help if I can.

Originally posted by ccrn
So the official Dx and tx is?

It has been confirmed already in prior posts. If you have any other questions please feel free to chime in or fire away.



Anybody got any more... How about someone posting a S-O-A-P format entry covering all the covered info. I KNOW some of you just love that soap format and I have heard from the peoples medic that it is the MANDATORY format for 18D's.

[Surgicalcric]

Originally posted by Sacamuelas
How about someone posting a S-O-A-P format entry covering all the covered info...

And this is all I have to say about it...

[DoctorDoom]

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[ccrn]

Yes our intensivists are the attendings. They round in the mornings and staff during the day also. Residents are a part of the team and stay over night and take call-

ccrn












Edit:spelling

Originally posted by DoctorDoom



My experience was different. Cross covered at least two services every night, one of which was subspecialty like ortho or urology and had no idea who the patients were until I got called. Had to see every patient to make sure I didn't miss something. It was exceptionally rare to get any sleep on call

okay...now cut down your work hours so instead of covering two services you have to cover four on your call nights... do you think you could see all the patients you are called about if your patient load on call doubled??? covering two services kept you from seeing the call room....where will the time come from to see all the new patients added to your call night coverage census??

In your case I would say the 80 hour work week would be increasingly dangerous as you certainly wouldn't have the time to cover extra patients than the demands previously placed since you already were using all time allotted and not getting any sleep.

is this making sense to anyone?

[Sacamuelas]

Originally posted by Doc T
Is this making sense to anyone?

NOT ME!! It is like a foreign language to me. I can't make myself comprehend anything over 40 hours per week... and that's only having to actually work a small portion of that time. LOL You guys need a union or something!! HAHA Sorry, couldn't help myself ma'am.

Good discussion though... interesting to hear thoughts on this topic. I have argued it many times with loved ones and friends that are MD's, etc. They never covered the benefits side to the long hours/shifts. Bunch of winers I guess.

[DoctorDoom]

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Originally posted by DoctorDoom
Why not reduce my work hours by letting me go home before noon post call? instead of staying until whenever? How about letting me not have to cover the patients on the ortho, urology, and neurosurgery services on call for GS? make the subspecialties get their own PA's instead of heaping on the GS guys just because we were there.

this really doesn' t need to be continued on this board...just keep in mind that going home post call at noon if you are on more than one night a week (say every third night) doesn't decrease hours enough... you have to cut back on call nights also which means more coverage on each night you are on since everyone has to take less call.

take a q 3 day call schedule....
you are there for 12 hours on monday (6am till 6pm..typically resident day)
call tuesday so there for 24 + 6 hours to clean stuff up but home by noon the following day
back on thursday for 12 hours
on call again friday but there saturday until noon since you thought leaving at noon was a good idea.
lets say you even get sunday off since residents now have one day a week off....

grand total of hours worked: 84...too many.

so call needs to be less than twice a week on any week since it throws you over too often which leaves most programs covering more and more rather than less like you would have liked. Again, same number of people but reduced call days and expected days off.

I hate the present system....and do believe that patient care has suffered not improved. We are actually changing the ICU service at my hospital to have the bare minimum of cross coverage and 24 hour coverage by a single resident every day because I feel so strongly about this.

doc t.

[ccrn]

Originally posted by Sacamuelas
LOL You guys need a union or something!!

From what I've read this is already happening to Doctors against their free will in some institutions. I dont know much about it as Ive only read just a little, but from what I have read it has not been well recieved.

As an RN I avoid institutions that are unionized. I dont like the idea of anyone negotiating issues I dont believe in much less supporting PAC's that I dont.

I worked for one that was unionized yet was still an open shop therefore I didnt have to pay dues etc.

As far as call goes I do believe I get it ie if RN's all of a sudden were mandated to work only 20H/week then our pt load would double. Thank God I work in ICU.

Ive seen this type of thing occur in a different way on the floor where they try to hire more ppl (as if they are available) and cut everyones hours. The resultant failure results in floor nurses having to pick up one or two more pt's. If they work opposite an LPN their pt load doubles p/t meds.

But thats a different story.

I think the bottom line is no matter what they do there isnt enough ppl to go around in healthcare period. I firmly believe when I am elderly hospitals as we know them now will not exist as there will not be nurses to staff them. We will die at home assuming there is anyone there to take care of us. No more radical or aggresive interventions as the norm.

'nuf said from me I guess.

I would definetly like to see more field related threads such as this one was, I have much to learn-

ccrn

[DoctorDoom]

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