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Ack, not enough hours in the day! I need a prescription for synthetic sleep!

October 22, 2009

I have been working too much and not sleeping enough. Specialist residents have it far harder than I, so I shouldn’t complain, but I’m going to anyway. Just a little, since I’m too tired to think of anything else to write, and I haven’t posted in a few days.

The ER is a fun but demanding environment, and now I’ve definitely bollocks’d up my Circadian rhythm; I inadvertently tested my body’s ability to “phase advance” and attend an early morning Rounds and then completed a day shift, after having worked last night. This is certainly not the most I’ve worked, nor the most tired I’ve been. But it is not the most comfortable way to persist.

I’m glad I did it because the talk (about a Palliative care twinning project in Nepal) was well worth it. That, and I had a great shift in the ER, getting to do a thoracentesis for the first time (following my last night’s first-time Heimlich valve chest tube insertion). Fluid and air in potential spaces, watch out! I’ve got a needle and I (kind of ) know how to use it!Β  I also recently was part of a code, in which I got to tube someone and finally learned how to do a Subclavian Line (whoopie!) after reviewing some software about Subclavian Line insertion and feeling rather an idiot for not having learned one clinically.

Lucky me, I’m on house call all weekend, and will be doing ER shifts Friday and Saturday during the days. It’s going to be quite rough, but somehow it always works out.

So, I would sleep more, but between some genius’ idea of a location for on-call sleep rooms (right at the entrance to the OR, a high-traffic area at most hours, with several *beep-latch click* security door access panels directly on the opposite side of the thin walls) and the vibrating (stuff falling off the shelves, windows rattling) construction during the daytime at my apartment, I’ve had a HARD time this month.

Incidentally, our Resident Physician union is currently offering a survey in which one of the questions asks about a hard-cap on weekly hours. Does more sleep make for better doctors? (NY Times article). I don’t know about that because sometimes there are learning opportunities that far outweigh sleep, but a lot of the time sleep is sacrificed for less important reasons. But right now? It’s totally nap time.

Oh. And I should probably eat.

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9 Comments leave one →
  1. October 22, 2009 6:55 pm

    O.O

    I can tell you right now I’m not cut out for a career in the medical career. When I was first reading this, I was speechlessly horrified. I mean, how can someone be happy/excited about doing something rather technical and nasty sounding to another person?

    Then I realized…well you kinda have to. You’re saving lives.

    But at the same time… O.O

    • October 22, 2009 7:05 pm

      Haha yeah we do mean things sometimes, but the risk/harm is always outweighed by the benefits. That’s the basic math of modern medicine: do something if it will help more than harm the patient. Balance risk with benefit, yadda yadda.

      I stuck a needle in a person and drained Litres of fluid from a place where it wasn’t supposed to be; ask her whether he felt better before or after. There was so much fluid pooled below her lung that breathing was compromised. After? All better! Yes, a little bit of pain, discomfort, and coughing because of the tube I stuck in his chest… but much better for it.

      Learning procedures is a pseudo-glamorous part of medicine. They are important to learn, most of us LOVE using our hands to help, and gaining proficiency with a technique means it will work better and faster and have fewer complications down the road. The more you do, the better you are. It’s very nice to have a break from talking to healthy people worried about having H1N1 all day long, and to sit down and do something that gives a person near instantaneous relief. Surgeons get to do it often, but for the rest of us, even one little procedure can be so satisfying!

  2. October 22, 2009 8:59 pm

    Stop your bellyaching and get back to work

  3. October 23, 2009 10:27 pm

    The experience of killing a patient because you are too fatigued and overwhelmed to work efficiently is an essential part of every resident’s training.

    Why if we cut work hours to 80 per week a typical resident might only be overwhelmed enough to kill one or two patients in residency! Think of all the learning opportunities that would be lost.

  4. bix permalink
    October 24, 2009 10:13 am

    If you were an android, you could simply unplug and dream of electric sheep.

  5. October 24, 2009 1:21 pm

    a good daytime work out, a rainy night, a mug of hot tea with honey, a fireplace, and an old book – that would be my recipe for your pill – oh wait, you’re imprisoned in the hospital. It gets better, promise. Unless you have kids πŸ™‚

    • October 24, 2009 10:02 pm

      rainy nights we have plenty of
      books, too many
      tea ahhhh I have forgotten how lovely
      workout during the day? well, if our hospital had a gym…

      no kids yet, so I really shouldn’t complain!

  6. Simon-Pierre permalink
    October 27, 2009 6:56 pm

    From the article in the NY Times;
    “And in a culture of handovers and shifts, where individuals are interchangeable, we might have to accept that each of us, doctor and patient, and our individual contributions to the doctor-patient relationship, would no longer be as unique as we might otherwise have once liked to believe.”

    This is accurately describing the future practice of our generation.
    We are all anesthetists.

    SP, also sleep deprived and maybe slightly grumpy about it πŸ˜‰

    • October 28, 2009 3:49 pm

      haha I hope there is still some valuable contribution that I offer to the doc-patient relationship, because my knowledge base is certainly not the most advanced! Wouldn’t know why I’m in medicine, otherwise.

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