Sunday, March 27, 2011
The first of a few posts about my last on call; in case, and I can't imagine why this might be so, you're becoming bored of my relentless music Nazi-ism.
Anyway; the following events take place over about 15 hours; I thought about jamming them all into one post, but figured that'd be massive, and might cause forced quit in some readers.
But, the muse is upon m, so I'll write it, and chop it, and preload it.
Part the First. On Hospital Politics.
I am terrible at politics. Terrible. If I was a good politician, I'd be a politician. But I quite want to help my fellow man; so I'm a doctor.
Anyway: for those of you not in the business, there's a lot of politics within even small hospital, an mine's a biggie. I'll be honest with you, I don't really give a shit about it; cheesy as it sounds, all I really care about is doing my job, and making sick people feel better.
I suppose the counterpoint to this is that by being a politician, I can do my job better; but I don't really see it that way. The profession needs politicians, for sure, although those we have appointed have sen us reamed by successive Governments, to the extent that I'm not sure we even count as a profession anymore, so emasculated are we.
So a fat of of good that did. I continue to stand on a single issue platform: what's right for my patient is what I'll do, and you can shove everything else right up your arse.
Vocalising this loudly, sees you marginalised, and less able to influence policy, so it's something of a double edged sword, but there you are.
The point of this rant is this: in the ED, our on-call shifts are rostered from 1pm until 10pm, with additional coverage as needed. We disagree with management on the meaning of that last phrase, but suffice to say, I am almost never off the floor at 10.
My last on call was no different; worse, in fact as we were short handed, and when everyone else goes home at 6, things can go runny very quickly. Rapidly, I had 7 patients needing my 4 bedded resus, and long waits throughout the department.
As I was contemplating taking a break, at about 9, one of our managers (whom I strongly suspect accused me of sloping off on a previous on call: another story) approached me, to tell me that the Duty Exec. was trying to call in the On Call Physician.
As far as I know, this never happens. We all work later these days, in the name of the targets, but I don't think physicians expect to be called in. I'm not sure surgeons do, at least not as much as in Pa Shroom's day, but this is opinion only.
Anyway, he was, so I'm told, declining the offer, unless I wanted him in.
I hate being put in this position. My department was busy, sure. But patients were having to wait longer; all the sick patients were being attended to. So I didn't need him, per se. Of course, extra hands are useful, but a Physician, even an acute one, is NOT an ED Doc, whatever you think.
So, I said I didn't NEED him, but if the Hospital 'escalation' plan called for him to be summoned, that was between him and management.
I'm given to believe he came and was grumpy about it. I never saw him: too busy in resus, but I expect there to be fallout. Questions will have to be answered about why I couldn't cope.
Well, shit happens.
No-one died who shouldn't have done.
Part the next: in which I discuss Bayesian probability with the Medical Registrar