Wednesday, April 04, 2007

The Hours Part 2

I'm on a Q 3 schedule right now and it absolutely killing me. Slowly, painfully. Death by a thousand sleepless nights. Or at least that's how I feel. I'm scheduled to be on call 10 times in the next 28 days. Let's think about that. Thirty hours a shift X 10 shifts and were talking three hundred hours. Now in the real world, the world of forty hour weeks, it would take me 7 and a half weeks to accumulate that many hours. But I'm an intern. My sole purpose is to serve as a cheap source of labor. So that means in 10 shifts, I will work as many hours as it takes a normal person to do in almost 2 months. Does no body else understand the absurdity of this. And during your two months, you will get to go home, get federally mandated lunch breaks, call in sick if you need to. And I will get none of that... not in my ten days.
Old school docs, those who don't support limiting hours will say it's not that bad, you can still get some sleep. I'm working in the trauma ICU. I'm in charge of 16 critically injured patients, by myself, all night long. I don't sleep. I not allowed to actually. This particular ICU was cited recently for not providing interns with a place to sleep at night. So they created one on the 7th floor. Little room that even says SICU intern on the door. Reality check. The ICU is on the third floor and the call room is on the seventh. I'm not allowed to leave the ICU. No matter what. If I leave I'll fail the rotation. So every night at my hospital there is an empty call room with a nice comfy bed and there is a SICU intern who badly needs to lay down. And next time the AMA comes by to evaluate working conditions, my program will point to the SICU call room, and the reps will nod their heads approvingly. But no one will notice the sad, exhausted, depressed intern who will never get to sleep there.

Saturday, March 31, 2007

The Hours

Any intern no matter how smart or stupid can quote the the hours regulation. 80 hours max per week. 24 +6 at a time ( 24 hours straight seeing new and old patients and 6 hours to tidy up loose ends) Any intern up to snuff also knows what a crock of shit it is.
Internship was once termed "the last sweatshop" in America, by the AMA no less, and that it still true today. In no other job do you have no right to quit, have forced uncompensated overtime, are denied lunch breaks, bathroom breaks, or the luxury of sleep. We have no protection from abusive bosses or nurses for that matter as shit runs down hill and at the bottom of every hospital is a pile of interns. Complain and you will be thrown to the wolves. There are no truly anonymous ways to fight back. Whistle blowers have been forced out of their residency programs or denied letters from their program directors to get their liscence. We are forced do to it in the name of patient care, because the patient comes first. Ahead of our families, ahead of our selves.
The hours are by far the most painful aspect of my life. I wake up before the sun comes up, before my daughter wakes up and trudge off to a world that will never be understood by outsiders ( though I appreciate you trying). Once there it is a whirlwind of lab results, progress notes, problem lists and admissions. Everyday you hustle, you sacrifice. Then before you know it, you look up and the sun has set, normal people begin the long trek home but not me. If I'm lucky I remember to call home before my kid falls back asleep, if not then I can't help but grieve for my husband who feels like a married single parent. In the hospital there is no distinction between night and day, like some twisted perversion of Las Vegas ( and by the way, what fuck ups happen at the hospital, stay at the hospital). All night long I admit new patients, follow up labs, answer phone calls about patients I have never seen, and replace electrolytes. The one thing I don't do is sleep. Or just rest. I deny myself a most basic of human needs. Before you now it the sun is rising again. I have to prepare for rounds, track down that x-ray, collect vital signs. It's so exhausting. My knees ache in the way that only someone who has been standing for twenty four plus hours can understand. My sense of balance is off because the most primative part of my brain is screaming to just get horizontal for 10 minutes. Even if I can't get sleep , I just want to be horiziontal, maybe even on a bed. After rounds end I start the difficult task of finding the car. Everyday blends into the next and its not unusual to see several post call interns searching for their cars. Like a Seinfield episode magnified by a hundred. Oh and the light. You're so tired that the sun is blinding, you literally can't see. After 24-30 hours of hospital light your eyes just can't make that adjustment. Some interns bring sunglasses. The drive home can be the scariest and most exhausting 20 minutes of call. I never change lanes because I just don't trust my abilities. It's akin to being a drunk driver (A recent study actually proved that being post call is equivalent to being legally drunk). When I get home my daughter smiles so wide, she does a little dance and claps. I try to stay up late enough to put her down for a nap and we sleep together. A little unconscious mother-daughter bonding. My husband gets her when she wakes up because I'm so tired I don't hear her. Sometimes she screams for me, she holds on to the toddler gate and screams Ma, Ma, Ma. The definition of being exhausted is ignoring your screaming child who just wants to see you after she's been waiting all day and all night.

Now repeat every third day, over and over again. For a year.

So why should you care, just one intern bitching about the hours. Because I fell asleep the other day. I fell asleep while driving. I was less than a two blocks from home, I stopped at a stop light and I had pulled my emergency brake (a learned trick to prevent roll back). I guess I set my head down against the steering wheel, I'm really not quit sure it's all a blur. But I woke up to the sound of a little old lady tapping on my driver's side window. Apparently a line of cars honking hadn't woken me up so this poor woman had to get out of her car to come see if I was okay. I can't believe I fell asleep. I can't believe that I was that tired. But what I really can't get my mind around, is that a half an hour ago, I was treating patients.

Thursday, January 04, 2007

Happy at Last

I promised myself that I would blog next time I'm happy so that I can stop being called the "most depressing blog out there" Thanks for sharing everyone. So why I am happy today. Well I found out that I get to stay at my current program. I was originally set to leave after this year and go to another place but I really didn't want to . My family is established here, I have friends and I love the ER here. My new program was fine with me staying and my current program wanted me to stay so everything seemed fine. But then the NRMP stepped in and said that we didn't have the right to change our minds. So, long story short there has been a fight for the last three months to be allowed to stay. And now I finally can
Then I found out I got nominated for best new medical blog fo r2006. I feel very honored. So thank you so much to everyone who cares. You make me happy.