Monday, October 03, 2005
Week 2
I had call saturday, 10/1/05. It was a very long day. I got there at 0700, as is my usual custom. However, I am not used to being in the hospital all day long, all night long until the next morning.
The good thing was that we weren't that busy. We got 2 admissions, a transfer from the unit, and a consult or two. Not too bad. However, things move very slowly here. Maybe it's just me not being used to the system, but all the admissions took about twice as long as they should have - an admission for chest pain took 2 hours because as myself and the intern finished talking to the patient, the upper level came in and wanted to pretty much repeat everything we had already done. It didn't help that the patient was, how do I say, less than cooperative...
Let me share: This was a 48 year old homeless fellow that looked 80. He was picked up at a bar after complaining of chest pain. He had a history of a quadruple bypass surgery about one month ago at the other local hospital here in Bethlehem. He had been admitted here at St. Luke's 2 weeks ago with the same complaint (Chest pain and EtOH intoxication) and left against medical advice (AMA) 2 days into the admission. So, now he's back after being seen at that same other hospital 2 days ago and earlier tonight. The fun part of the story is that when he got to the ED, his blood alcohol level was 198. However, about 3 hours into his visit, he was caught with a mostly-empty bottle of vodka in his room and his blood alcohol level was 218.. pretty impressive, huh? He was also very belligerent, yelling profanities and telling us all to "stop wasting my fucking time!!" as he asked to go out and smoke.
Fortunately, we were able to convince him to stay (mainly by letting him go to sleep) and we admitted him with the full knowledge that after he 'slept it off' he would most likely sign out AMA again. Unfortunately, that is the way of the world - we have to admit them because should we not we would be at fault, but we can't make them take responsibility for their health. So someone like this guy gets to take advantage of the system for a warm bed and a night sleep with a couple of meals any time he feels because he says he has chest pain.
Our system needs an overhaul to prevent stuff like this happening. Ah, well. Such is life. Without people like this, medicine would be boring, right? ¶ 5:18:00 PM
The good thing was that we weren't that busy. We got 2 admissions, a transfer from the unit, and a consult or two. Not too bad. However, things move very slowly here. Maybe it's just me not being used to the system, but all the admissions took about twice as long as they should have - an admission for chest pain took 2 hours because as myself and the intern finished talking to the patient, the upper level came in and wanted to pretty much repeat everything we had already done. It didn't help that the patient was, how do I say, less than cooperative...
Let me share: This was a 48 year old homeless fellow that looked 80. He was picked up at a bar after complaining of chest pain. He had a history of a quadruple bypass surgery about one month ago at the other local hospital here in Bethlehem. He had been admitted here at St. Luke's 2 weeks ago with the same complaint (Chest pain and EtOH intoxication) and left against medical advice (AMA) 2 days into the admission. So, now he's back after being seen at that same other hospital 2 days ago and earlier tonight. The fun part of the story is that when he got to the ED, his blood alcohol level was 198. However, about 3 hours into his visit, he was caught with a mostly-empty bottle of vodka in his room and his blood alcohol level was 218.. pretty impressive, huh? He was also very belligerent, yelling profanities and telling us all to "stop wasting my fucking time!!" as he asked to go out and smoke.
Fortunately, we were able to convince him to stay (mainly by letting him go to sleep) and we admitted him with the full knowledge that after he 'slept it off' he would most likely sign out AMA again. Unfortunately, that is the way of the world - we have to admit them because should we not we would be at fault, but we can't make them take responsibility for their health. So someone like this guy gets to take advantage of the system for a warm bed and a night sleep with a couple of meals any time he feels because he says he has chest pain.
Our system needs an overhaul to prevent stuff like this happening. Ah, well. Such is life. Without people like this, medicine would be boring, right? ¶ 5:18:00 PM
