Saturday, September 19, 2009

Stupid pages on call

So, I was on call last night.  I was taking care of, oh, I don't know, maybe 20-30 patients.  Some of these people I had never even met, but it was my job to take care of any urgent problems that arose overnight.  In the morning, their primary doctors (other interns on my team) would return and resume responsibility of their care for the day.

During the course of the night, I was paged or called ~30-40 times.  Sometimes I was paged more frequently than I was physically able to dial the phone to return the pages.  (Keep in mind that I had other responsibilities at the same time, like admitting the new patients from the ER.)  Most of these pages were legitimate patient care concerns, usually from the floor nurses.  But then, around 6 am, I had the following conversation when I returned yet another page:

male voice: "Hello?"
me: "Hello, this is [my name], returning a page."
male voice: "The platelets are 5!"
me: "Can you give me a patient name, please?"
male voice: "Oh.  I don't know, just a minute."

[WTF?  Did he think I was a mind reader?  Yes, a platelet count of 5 is impressively low (for the non-medical folks, normal values are in the hundreds), but I will still need to associate this lab value with a particular patient in order to do anything about it.]

I wait while he looks up the patient name.  Until this moment, I have not taken a break for several hours.  Waiting for this dufus counts as a break.

male voice: "[patient last name]"

I recognize the name as a patient I cared for last week at a different hospital.  (And am not surprised at her platelet count.  Sounds like par for the course, for her.)

me: "Wait a second!  Are you at [other hospital]?"
male voice: "yes"
me: "I'm not working there this month.  Please call the doctor who is currently caring for this patient."
male voice: "Oh.  Are you [other doctor's name]?"
me: "No.  I'm [my name, again]."
male voice: "Oh.  Are you at [other hospital]?"
me: "No."
male voice: "huh.  okay."  (Hangs up.)

This was presumably a lab tech, and it's standard protocol to page the doctor for critical lab results so they can be acted on sooner rather than later.

However, they usually know who they're calling about.

I really don't know how he got my pager number last night.  I removed myself from the electronic charts of all my patients when I switched hospitals for the month.  If I had had forgotten to do so for that particular patient, I'm sure I would have been paged about her much more in the past week.

Ah, the mysteries of random on-call pages.

He did give me a nice little break, I suppose, and that's something to be happy about.