When Crabs Attack

Have you ever been so tired that you wanted to throw yourself on the floor and have a temper tantrum? Have you ever been so sleepy that you doze off mid-sentence? Have you ever been so zapped of energy that your 80 year old stroke patient can get out of a chair faster than you can? Welcome to Suckiest Call Night 2010.

I have been told before that I am one of those people with a “happy gene”. I am a glass half-full kind of girl and generally opt to see the positive side of everything. MICU call last night, however, was too much for even this eternal optimist to handle.

It’s one thing to pull an all-nighter doing what you love. OB call? Not a problem! I am running to deliveries, c-sections, seeing patients in Triage. The variety keeps me awake, stimulated, and always on my toes. MICU call (read: glorified secretarial work) is another story. Last night consisted of sitting in front of a computer admitting one patient after another. I sat up all night writing H&Ps, entering admission orders, following up on labs, studies, and vital signs. These are not the kind of activities that keep me awake after 24 hours.

At 4:00am this morning, while admitting our fourth patient of the night, I was struggling. Sitting at my computer with a hospital chart laid out before me, I fought with every ounce of reserve I had to create an assessment and plan of care for my patient. It was a losing battle. The sentences on his note trailed off li..ke.. th….is….. It took me triple time to enter his orders. From the time I read his home medication on his chart to the time I looked up to my computer to re-order it on our computer, I had already fallen asleep. A quick second later, I’d wake up and forget what I was just about to order. I tried everything to stay awake. I tried stretching. I tried brushing my teeth. I tried eating. I even gave in and had some coffee. Somehow I pulled through the Suckiest Call without killing anyone. But I couldn’t help wondering what the impact of my resident fatigue was on the patients I was treating.

Around 5:30am this morning, I got my second wind. Great for getting me through the last 7 hours of work, right? The caveat, however, was that last night’s sleep deprivation had turned this usually cheerful, happy-go-lucky resident into cantankerous little bitch. I didn’t even recognize myself. I heard myself snap at the pharmacist on the phone. I grumbled under my breath about our half-hearted medical student. I felt my blood rising as my senior resident butted into a conversation I was having about a patient. I struggled not to roll my eyes when my attending embarked on his usual 20 minute long “teaching point” during rounds. I was tired, cranky, and in no mood for either inefficiency or intellectual masturbation. At this point, I was even annoying myself with my bad attitude.

By the time I leave the hospital, I had been up for approximately 30 hours straight. My eyeballs felt coated in sandpaper. My head was heavy and my facial muscles lacked the strength to smile. The only thing I could think of is my warm cozy bed. I was asleep before my head hit the pillow.

P.S. Just to end on a positive note, there was one great thing about last night. I discovered TEDS! These sexy little stockings (insert sarcasm), most commonly used in bedridden patients to prevent blood clots, are a dream come true to every on-call resident. They feel like a 24 hour long calf massage. Ahhh...