Monday, July 31, 2006

Round and Round

Much to my dismay I'm out of the ER now. I only get two months in the ED my first year and it's halfway over. I'm on medicine right now, and I hate medicine. Everyone picks their specialty for different reasons but most of us in the ED say the same thing about medicine: we can't stand rounding.
Rounding is the art of doing and saying absolutely nothing for hours on end while standing up and pretending to be interested. Each patients every past and present medical complaint must be examined and discussed ad nauseum. They could be here for pneumonia or DKA but we still have to talk about that time when they were twelve and they got an ear infection. Why? What the hell does that have to do with why their here now. And do I really have to miss breakfast because Mr. Smith's INR is not exactly two and a half. Is 2.4 really that unacceptable. Ever little lab abnormality must be worked up to the fullest. Maybe he has hypercalcemia because he had too many TUMS for dinner. Maybe it's a lab error. But I really don't think we need to talk about it for ten minutes and start a work up for multiple myeloma. Even completly normal people are allowed to have abnormal labs from time to time. If someone invented a machine that could give out a minute by minute Chem-7 the internist would strangle themselves with their stethoscopes. This of course would make rounding infinitly more interesting.
It's not like we only round once a day either. No the entire process has to be repeated in the afternoon. The same patients, with their same problems, get the exact same discussion not just once but twice. That's a real good use of my time. "What? We only spent a half an hour this morning discussing whether Mr Johnson should be on the renal diet for his kidneys or the cardiac diet for his heart. Let's do it again please, pretty please, with sugar on top. Let's not go home at a reasonable hour and spend time with our actually families or better yet get some sleep. This is critical life and death stuff".
Thank God it's only for a month.

1 comment:

Allie said...

I'm on my IM rotation too. Rounds are the worst part of total boredom.