12 AM to 6 AM Thread

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QofQuimica

Seriously, dude, I think you're overreacting....
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Along the lines of the Friday night thread, we need a thread for those of us who are up till the wee hours on any day of the week. (I seem to recall there being a similar thread in PA.) So, here we go. If you're up between midnight and 6AM your time, and you feel like chatting with some other nontrad night owls, you've come to the right thread.

I'm once again in the ICU overnight, just me and a PA. (My intern has the night off.) So far I have pronounced a patient dead, filled out the death packet, and sedated/restrained an agitated patient who tried to punch one of the nurses. I'm now waiting for an admitted patient to come up from the ER. I have no idea why it takes so long for the ER to send patients to us; I got signout from the ER resident hours ago. But there you have it.

What are the rest of you doing up in the middle of the night?

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Along the lines of the Friday night thread, we need a thread for those of us who are up till the wee hours on any day of the week. (I seem to recall there being a similar thread in PA.) So, here we go. If you're up between midnight and 6AM your time, and you feel like chatting with some other nontrad night owls, you've come to the right thread.

I'm once again in the ICU overnight, just me and a PA. (My intern has the night off.) So far I have pronounced a patient dead, filled out the death packet, and sedated/restrained an agitated patient who tried to punch one of the nurses. I'm now waiting for an admitted patient to come up from the ER. I have no idea why it takes so long for the ER to send patients to us; I got signout from the ER resident hours ago. But there you have it.

What are the rest of you doing up in the middle of the night?


Hi Q of Q. I have wondered about this very often in the ICU too; but it's either feast or famine. You wait long periods of time to receive the pt from the ED, or they just toss the pt(s) on you with barely any warning. Admittedly though, the latter seems more true in pediatric ICUs. But I am further amazed when I see pts w/ hgb's of 3 or 4 taking forever to come to us, yet they hadn't received any pRBCs or blood products in the ED in that time. ???? Of course this is not so everywhere, and I realize traumas get priority, but I have been sad to see l.o.l's w/ hgbs that low infarcting when they get to us. I do think a number of places have gotten better with this kind of thing. It's just one of those things that bug me.

Hope the rest of your night goes well. Whatever you do, superstitious or not, be careful about using the "q" word too. Soon as it's spoken, you know what breaks loose. :)
 
Thankfully I'm in a bed at the moment, but I've been up catching up on work (last week with Pifzer, before I switch over to Ariad) and watching the U20 Women's World Cup (soccer). Ghana is playing the US. I have an insane week... lots of work and am experimenting with taking three labs (physics I and II labs and o-chem I lab). Lots and lots of lab reports to work on this week!

What are the rest of you doing up in the middle of the night?
 
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Along the lines of the Friday night thread, we need a thread for those of us who are up till the wee hours on any day of the week. (I seem to recall there being a similar thread in PA.) So, here we go. If you're up between midnight and 6AM your time, and you feel like chatting with some other nontrad night owls, you've come to the right thread.

I'm once again in the ICU overnight, just me and a PA. (My intern has the night off.) So far I have pronounced a patient dead, filled out the death packet, and sedated/restrained an agitated patient who tried to punch one of the nurses. I'm now waiting for an admitted patient to come up from the ER. I have no idea why it takes so long for the ER to send patients to us; I got signout from the ER resident hours ago. But there you have it.

What are the rest of you doing up in the middle of the night?
Sounds like an exciting night for you as well!

I was studying until about 2 a.m. and fell asleep on the couch only to be awaken at 3 a.m. by my sick 15 month old who needed another dose of tylenol and cough syrup. Of course she didn't want either, so we tried calming down with some milk and Ni Hao Kia Lan. It didn't happen. After a bit of work, she's back sleeping and the first dose of cough syrup has been cleaned up off her, me, and the carpet.

Now the kitchen and living room are clean and I've got 3 hours before heading out to work. To study or to sleep...
 
Hi Q of Q. I have wondered about this very often in the ICU too; but it's either feast or famine. You wait long periods of time to receive the pt from the ED, or they just toss the pt(s) on you with barely any warning. Admittedly though, the latter seems more true in pediatric ICUs. But I am further amazed when I see pts w/ hgb's of 3 or 4 taking forever to come to us, yet they hadn't received any pRBCs or blood products in the ED in that time. ???? Of course this is not so everywhere, and I realize traumas get priority, but I have been sad to see l.o.l's w/ hgbs that low infarcting when they get to us. I do think a number of places have gotten better with this kind of thing. It's just one of those things that bug me.

Hope the rest of your night goes well. Whatever you do, superstitious or not, be careful about using the "q" word too. Soon as it's spoken, you know what breaks loose. :)
The ER here is good about giving blood to the GI bleeders. The big problem I've been having is getting crappy signouts from off-service interns working in the ER. It's not their fault though; our ER is a sink-or-swim kind of work environment, and the only reason they're muddling through trying to give me signout on an undifferentiated critically ill patient is because the attending told them to call. What I've started doing is looking through the ER chart, telling the intern what I already know, and asking them if there's anything else to fill in. It saves both of us time and stress. :hungover:
 
Up a dark:30. To make surgery pre-rounds by 530. Dude.....
 
I normally browse through once or twice a night (work 10pm-6am). I should be studying right now but I'm slacking because classes don't start until next Monday...maybe tomorrow night. :rolleyes:
 
Two more hours until my overnight shift is over. The quiet hours give me too much time to think, so I peruse the internet for fun house listings. Sooooooo sleepy tonight.
 
Got our butts handed to us tonight. I feel like I've been hit by a Mack truck. Fortunately, no one died even though a couple of them tried to. :hungover:



Yea! You lived to fight another day. :)
 
I don't even have an excuse...if left to my own devices I naturally switch to a 6AM-2PM sleep schedule. No idea why. Apparently I even stayed up super late as a baby!
 
Just logged in for a minute and there's 41 people on the nontraditional thread atm. Last couple of nights had half or lower than half that number. :thumbup:
 
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Up right now due to a miserable case of Acid Reflux, normally up this time of night when I'm on the ambulance. Classes started yesterday, can't seem to make myself try to study. I've got to be up in 4 hours for an 830 Physics lab.
 
Up right now due to a miserable case of Acid Reflux, normally up this time of night when I'm on the ambulance. Classes started yesterday, can't seem to make myself try to study. I've got to be up in 4 hours for an 830 Physics lab.

I keep telling myself I should be getting a head start on ochem2 studying but keep putting it off because we haven't started yet. Hopefully you can get some sleep before the lab.
 
Turns out, my day shift for my real job here in Kandahar, Afghanistan is the middle of the night back home. Only took three medivac flights today, so tonight should be slow for my volunteer time in the ICU. Getting the chance to volunteer at a combat hospital I now realize is a great opportunity that folks home don't get...I'm constatly surprised at what the nursing staff will let me see and do here.
 
Turns out, my day shift for my real job here in Kandahar, Afghanistan is the middle of the night back home. Only took three medivac flights today, so tonight should be slow for my volunteer time in the ICU. Getting the chance to volunteer at a combat hospital I now realize is a great opportunity that folks home don't get...I'm constatly surprised at what the nursing staff will let me see and do here.

Thanks for what you're doing over there. :highfive: I wish I had been in the medical career field when I was in the military.
 
Thanks for what you're doing over there. :highfive: I wish I had been in the medical career field when I was in the military.

Thanks for the words. I'm just a volunteer with a real (military) job. It's the kids I see with less than two legs that deserve the real praise.
 
I finish work at 11:30 PM so I'm usually up until at least 1-2AM CST. Usually doing something SDN related. I just got a new phone (Samsung Galaxy S3) and have been playing with that constantly.
 
Technically it's only 11:18 p.m. my time but oh well. I'm on call til 5 a.m. I'm putzing around on the computer of course paying bills, filling out my FAFSA waaaaaay late. Looking at houses for sale in the city where I go to graduate school while thinking that instead of wasting time looking at houses there I should work on getting my current house ready to sell since that's obviously got to happen before I can go anywhere else :p
 
Rocked itty, bitty newborns to sleep tonight so they could make it through their hearing tests and go home tomorrow. It was a nice contrast to last night, when they called a code blue on one of my ICU patients, and the night before, when a patient died just as I got on and I did the post-mortem care. Medicine is so exciting. And I'm so tired.
 
Really thought tonight was going to be a good night to relax :xf: .. but the fall babies keep wanting to come in early.. crashed a 29 weeker that was breach and now the rainstorms are bringing in more patients. Working as much overtime as I can before classes start in late September (my school is on the quarter system)..
 
Sleep schedule is a bit messed up from working nights etc. so I'm awake at 6 a.m. watching the Hunger games and eating popcorn, and debating getting an ipad.
 
Sleep schedule is a bit messed up from working nights etc. so I'm awake at 6 a.m. watching the Hunger games and eating popcorn, and debating getting an ipad.
So, did you get the ipad?

I'm on nights again for the next two weeks. The good news is that this is my last week in the ICU. I'm so fried and ready to escape this place. We had a bunch of patients die this week, but even without that, it's emotionally and physically exhausting to work here. My next rotation is 60 hours per week, which is going to feel like a freaking vacation. :laugh:

Also, no offense to your fellow lab folks, but I'm sick of their constant interruptions calling with "critical values" for dying patients. I know they have to do it, so I do my best not to be nasty when they call, but it's incredibly disruptive. I've taken to trying to guess which patient and lab value they're calling about, and some of them have a better sense of humor about me trying to guess than others do. :hungover:
 
Still debating the ipad. Wound up falling asleep before the movie too. I just accepted my financial aid awarding and am trying to get over the sickening feeling of looking at my tuition bill. They just hiked us about 100/credit. I'm debating going home for a year to work at the hospital where I did my internship because I would have cheap room and board and they offered my a sign-on bonus to stay before and are even more desperate for staff now..... but I don't want to lose my current state residency.
 
Also, no offense to your fellow lab folks, but I'm sick of their constant interruptions calling with "critical values" for dying patients. I know they have to do it, so I do my best not to be nasty when they call, but it's incredibly disruptive. I've taken to trying to guess which patient and lab value they're calling about, and some of them have a better sense of humor about me trying to guess than others do. :hungover:

Ah, none taken. I think people who work in hospital have to have a sense of humor or shouldn't be there.
 
So, did you get the ipad?

I'm on nights again for the next two weeks. The good news is that this is my last week in the ICU. I'm so fried and ready to escape this place. We had a bunch of patients die this week, but even without that, it's emotionally and physically exhausting to work here. My next rotation is 60 hours per week, which is going to feel like a freaking vacation. :laugh:

Also, no offense to your fellow lab folks, but I'm sick of their constant interruptions calling with "critical values" for dying patients. I know they have to do it, so I do my best not to be nasty when they call, but it's incredibly disruptive. I've taken to trying to guess which patient and lab value they're calling about, and some of them have a better sense of humor about me trying to guess than others do. :hungover:

If you ever get someone calling in with an elevated blood urea nitrogen, yell out:
"oooo, the hot dog in my bun!" in a sexy black lady voice.

... then play it off as if you meant to say it, and change the subject quickly.
 
When I was working in the blood bank I had an anesthesiology resident come up running up and say, "Oh my god there was a bus crash! It was a bunch of guys on their way to a hemophiliac convention.......

.....

..... Just kidding " :smuggrin:
 
When I was working in the blood bank I had an anesthesiology resident come up running up and say, "Oh my god there was a bus crash! It was a bunch of guys on their way to a hemophiliac convention.......

.....

..... Just kidding " :smuggrin:

You should have said on the DL, "hey buddy, I heard that you can get me some fentanyl"
 
You should have said on the DL, "hey buddy, I heard that you can get me some fentanyl"

LOL, speaking of fentanyl..... there's obviously an extremely tight chain of command on that one, everyone who touches or hands off the stuff in the syringe for the OR has to sign a ledger taking responsibility for it. In the bloodbank the pass thru window to the OR is used for passing pharmacy stuff out as well as blood products, but pharmacy is on another floor so they just drop stuff off or pick stuff up and leave again. So one night this anesthesiologist comes by and drops off a full 100 ml syringe of something and says we aren't going to use this. Pharmacy is going to pick it up and credit it.

Well an hour later it's still sitting on the ledge of the window so I call pharmacy and tell them it's still there. They said what is it? I pick it up and go "oh crap it's fentanyl" The pharmacy tech was up there in less than 10 minutes just freaking out, "they just left it there!!??!!!?" "yup" That would have been a good way to pay my tuition this semester huh? :rolleyes:
 
Full moon...
A jumper, self-diagnozed "foot-bone" cancer and a polite gent asking for "8 vicodin".
 
Full moon, part two...had to deal with literally the craziest person I've ever seen. :eek: Note I am on OB-GYN inpatient - aka NOT psych.
All rotations are psych rotations. I've read that up to 75% of ICU patients become delirious. I think that's a gross underestimate.

(Picture that one of my patients is currently screaming nonsensically while another had to be restrained because she decided it would be a good idea to pull out her central line - which fortunately was well-sutured into place - and go for a walk. In haldol we believe.)

And incidentally, the one time I came close to being clocked by a patient, it was on my med school surgery rotation. The patient was post op and delirious and thought I was preventing her from seeing her husband. Fortunately I had quick enough reflexes and she missed, because she was way bigger than I am.
 
At work... anxiously watching the clock until freedom comes at 630. Meanwhile, my Ochem homework glares angrily in my direction.
 
All rotations are psych rotations. I've read that up to 75% of ICU patients become delirious. I think that's a gross underestimate.

"We do not have to visit a madhouse to find disordered minds; our planet is the insane asylum of the universe." Johann von Goethe

I agree with that statement every time I make the mistake of reading comments after news articles :(
 
Sitting on post on the side of the highway, waiting for the other ambulance to come back from the trauma center 30 miles away. Praying that "Dr. Ships-em-out" might actually keep a pt. in the 1 bed ED at the local hospital where our station is so we don't have to make the 5 hour round trip to the closest academic medical center. Trying to force myself to read the Kaplan MCAT stuff on the iPad.
 
On academic medicine night float for the month. My poor newly minted second year is getting creamed on her no doc admitting night and I think is a little freaked out. She is so good... But is now leaping to diagnoses rather than keeping an open mind and ordering appropriate tests to narrow the differential focus. Fortunately she is easily talked through the process.

I remember when I was a second year, nervous about admitting myself, handling all the night stuff alone as the 'senior resident'. It was a great learning experience. Now I'm the third year having the second years run their admits by me, calling with questions about floor calls, etc, and it is again good to see how much I have learned, how the thought process changes and evolves.

Tomorrow I need to do my online modules. My goal is to get them all done for the year this month so I don't have to worry about them anymore.
 
Sitting on post on the side of the highway, waiting for the other ambulance to come back from the trauma center 30 miles away. Praying that "Dr. Ships-em-out" might actually keep a pt. in the 1 bed ED at the local hospital where our station is so we don't have to make the 5 hour round trip to the closest academic medical center. Trying to force myself to read the Kaplan MCAT stuff on the iPad.
Sending you a PM
 
On academic medicine night float for the month. My poor newly minted second year is getting creamed on her no doc admitting night and I think is a little freaked out. She is so good... But is now leaping to diagnoses rather than keeping an open mind and ordering appropriate tests to narrow the differential focus. Fortunately she is easily talked through the process.

I remember when I was a second year, nervous about admitting myself, handling all the night stuff alone as the 'senior resident'. It was a great learning experience. Now I'm the third year having the second years run their admits by me, calling with questions about floor calls, etc, and it is again good to see how much I have learned, how the thought process changes and evolves.

Tomorrow I need to do my online modules. My goal is to get them all done for the year this month so I don't have to worry about them anymore.
Being a new senior is definitely scary. The knowledge that you are now the most experienced person in the unit makes you go :eek:

I was helping an intern today and going, good god, was I really that slow and cumbersome a year ago? I know that I must have been, but at the same time, it's kind of hard to believe. And the specifics of the inefficiencies drive me crazy. I mean, I've got a perfectionist streak myself, but I had to almost physically force one of my interns to sign her notes so that she (and I) could go home. She kept wanting to add just one more thing....
 
All rotations are psych rotations. I've read that up to 75% of ICU patients become delirious. I think that's a gross underestimate.

(Picture that one of my patients is currently screaming nonsensically while another had to be restrained because she decided it would be a good idea to pull out her central line - which fortunately was well-sutured into place - and go for a walk. In haldol we believe.)

And incidentally, the one time I came close to being clocked by a patient, it was on my med school surgery rotation. The patient was post op and delirious and thought I was preventing her from seeing her husband. Fortunately I had quick enough reflexes and she missed, because she was way bigger than I am.
In the past week, I've been clocked by a 90ish gent who thought I was his captor (no dementia but hospital-induced psychosis) and his roommate kicked me hard in the gut and told me he was going to kill me. This was on a med-surg floor. Neither one of them had orders for restraints and despite other medical complications and advanced age, they were both intent on throwing themselves through me and out of their bed or chair. The roommate had already had two falls. There were supposed to be two attendants in the room. I was sitting between their beds when the nursing supervisor checked in - they both chose that moment to jump out of opposite sides of the bed. I jumped for the closest one and she dashed across to the other. I asked her, "Next time, which one do you want me to catch?"
 
Day bleeds to night and back into day.

Life is The Blond Man and I the little boy.
 

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i fully appreciate the wonderment of how much I have progressed. The first intern I taught about central lines... oh my. Well over an hour for one line. And art lines - again, well over one hour. Heck, over 10 minutes of her feeling the artery just poised to strike but not having the confidence to do so. Another that kept contaminating her field and getting angry at me for making her stop and clean it all up before I would let her attempt the line. And let's not forget teaching that odd lift motion for intubations. One poor intern put in a central line and made a bloody mess that filled one of his shoes because he put a fold in the drape that just sent everything right down to his foot but he didn't want to say anything.

It does bring up some considerable respect for the seniors that taught me watching me, encouraging me, being patient with me.
 
No central lines for me yet, just 1/2 inch copper lines. I stayed up until just after midnight installing a bathtub in the house I'm remodeling. I stupidly chose to use copper pipes instead of CPVC, so the plumbing took forever and required a propane torch, never much fun to use in an uninsured house. I've been working intern's hours on my remodel project, trying to get everything in good condition so I can sell it and leave Fairbanks before it gets too cold.
 
One poor intern put in a central line and made a bloody mess that filled one of his shoes because he put a fold in the drape that just sent everything right down to his foot
Haha, I did that once. Spent the rest of my shift wearing ill-fitting OR scrubs and walking around in hospital socks, to the great amusement of the nurses and techs. Though a couple of them cleaned my shoes and soaked them in bleach for me while I kept working, which was awesome of them.

It does bring up some considerable respect for the seniors that taught me watching me, encouraging me, being patient with me.
Definitely.
 
another night shift. I have a med student on tonight who seems to be the kiss of death for any calls. Hope he sticks around all week. I could use the sleep. I am, however, using this time to get my computer learning modules done for the year. I'm up to April and that will be the last one. I'll certainly check it off my list this week. Yay!!!

In the meantime, the call beds are horrible for my back. :(
 
I'm finishing up an installation of my wife's new 1TB hard drive, listening to dubstep, and quietly panicking because she just told me she's begun losing her vision in her eye in the evenings, which means another MS attack, the second one this year.

I'm trying to figure out if we should call her neurologist for a round of steroids and wondering if I should lobby for a change of drugs, though her compliance is sort of meh on the Copaxone, so it's hard to tell if it's working or not.

Also ordering MCAT books and debating whether said books are useless because wife will need me to start working ASAP so we have enough money for when her vision goes totally.
 
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