I was in one or two situations on clinical rotations where I thought that help was needed but literally did not know the best way to get it. One was in the ER: my patient was unstable (tachypnea, and hemodynamically unstable), I was there for a consult, and I didn't even know who the ER docs were. All I could do was stick my head out the curtain and tell the nearest person.
The second situation resulted in my patient going into cardiac arrest and becoming a vegetable. This patient was sent to the general medicine floor from the ER. He may very well have been stable in the ER, but they gave him a bolus of fluid that sent him from stable into extreme respiratory distress. I was sent to do the H&P on the patient by myself and at least had the wherewithall to see that I wasn't adequately trained to handle the situation. I went and got the person above me, the intern. God help us but he was too incompetent to deal with it too, and I think the time lag between the patient getting sent to the floor then finally getting sent to the ICU where he needed to be intubated was too long... he ended up going into cardiac arrest during transport.
Why god why don't they teach med students how to respond to critical situations like that? We should know who to call if there's a serious situation like that. Going up the hierarchy like we're supposed to results in terrible delays in medical treatment.
Sorry for the tangent, but this is probably one of the worst stories from my training. If this had been a patient of higher socioeconomic status, I believe the hospital would have been sued. "Luckily" for them, he was a poor African American male whose family lacked the education to even know they'd been wronged.
