What a Week...

Here's how my week on cardiothoracic surgery has played out so far:

Mon - arrived at 4:45am. Saw 2 pts, wrote notes, rounded with team at 6:45. Scrubbed into a CABG x 4 (quadruple coronary artery bypass graft) at 7:30. The chief resident becomes ill and has to scrub out. Haven't seen her since Monday. That leaves the 2nd year resident, the 4th year med stud, and me. Snuck away at 3:00p and went home. (The chief states that she would like the 4th year and I to alternate scrubbing on cases)

Tues - arrived at 4:45am. Saw 4 pts, wrote notes, rounded at 6:45. Hung around and waited on CABG X2 to start. A heart transplant bumped it. Heart transplant finishes at 2:00. I was told not to scrub in, but to observe. The 2nd year resident informs us that he would like one of us to scrub, and the other to observe every case. Nice... Left hospital at 8:45pm.

Wed - arrived at 4:45am. Saw 4 pts, wrote notes, rounded at 6:45. Hurriedly changed clothes and went to M&M conference at 7. Go observe a mitral valve replacement from 9-2:30. I didn't get to go to the book club discussion :( because at 3:00 the resident informs me that even though I don't go on call until 7:00pm, I'm "stuck there." Yet he provides no instructions as to what he wants me to do. So I went and got "stuck" in the on-call room and attempted to rest up before call. 7p - call starts. Nothing happens. I study. Nothing happens. I sleep from 11p-1:30am, and THEN the page comes in. *18 y/o fell off his horse. Why was he riding his horse at night? (*info has been changed because I'm afraid of the HIPAA monster.)At 2:15 or so, my fellow M3 on call and I decide to fulfill some of our technical skills we have to do before we graduate. These include things like inserting Foley catheters, starting IVs, venipuncture, arterial puncture, insertion of NG tubes, etc... I'd already done tons of Foleys, but really needed to stick some people. They had the perfect patient for us. He needed arterial blood gases drawn, was comatose and heavily sedated. Awesome. I really didn't want to stick someone's artery that was aware that it was my 1st time and awake. I watched my M3 counterpart stick the artery with incredible ease. Then my turn came. I had to stick twice, along with some rearranging of the needle once inside the skin. Not very encouraging. Then it came time of the venipuncture. Here's how it went down on the very quiet SICU.

Female nurse #1: Well, we don't have any pts that need venipuncture, but *John here has great veins.

Female nurse #2: Oh yeah, they're like ropes. I'll go get some needles. (M3 counterpart and I laugh, thinking they're obviously joking)

Female nurse #1 then reappears, with John in tow. "Here he is!"

Me: You're not serious, are you? Really?

Nurses: Oh yeah, it's fine. He lets people practice on him all the time.

Then my partner and I proceeded to stick this guy 4 or 5 times while sitting at the nurses station with a group of nurses around us in order to each get in an IV and venipuncture. The entire time he was giving us instruction. It was bizarre. Can you imagine telling someone where to stick you? To push DEEPER into your flesh with a needle? He ended up leaving one of the IVs in because he was dehydrated and planned on taking in some fluids.

Then it was 4:00am before we knew it. 2 more trauma pages came in. Old lady with dementia who fell and then young guy who got in a fight. Typical stuff. Overall it was most definitely the lightest call night I've had so far and actually pretty enjoyable.

Then 5:15am rolls around. Time to see my now 5 patients and get notes written on them before 6:45. We go round and the M4 states that she's forgotten to see one of the pts. I have to be in class at 7:00 and she tells me to go do it. NICE... Whatever though. Went and checked on him. Went to class. Decided to stay lost for a while and take a breakfast break. We had another CABG today, but I peeked in and saw 2 attendings, a resident, and an M4 scrubbed in. I refuse to observe another one, especially post-call. I'm about to make like a banana and split! 6 more days of Cardiothoracic surgery!!!