a lot of people say there is a steep learning curve during internship, and you know what? they’re absolutely right. there is a huge learning curve… about narcotics. after about a half a week of working, it seems like i’m on a narcotics internship instead of a surgical one. seems like i write for narcotics more than morning labs. oxycodone, percocet, morphine, dilaudid, roxicet, fentanyl… is there any narcotic i haven’t prescribed yet? i understand people are in pain, and that sucks. but at the same time, i hate them and i wish i could just load them up on pain killers so they would go to sleep and just shut the fuck up. and having had night call, i had a pleasure of taking phone calls from drug seekers about their “lost prescriptions”.
internship just sucks ass. in an ideal world, i would write an order for a chest xray. it would actually be done, and i would be notified when it was available to see, and the attending radiologist would go over it with me when i wanted. but i work in the real world, and working in the real world is infinitely more painful.
1. make box to order chest xray
2. order chest xray
3. shade half a box to signify having ordered the chest xray
4. wait 2 hrs
5. go to chart to see if order was faxed to radiology
6. wait 1 hr
7. call radiology to see if they got the order
8. wait 30 minutes
9. call radiology to ask when they will take the xray
10. get tired of waiting, write chest xray STAT (costing hundreds of extra dollars for shit people should be doing quickly anyway)
11. xray done
12. wait 1-2 hrs for xray to show up on stentor
13. look at cxr
14. let senior resident know about cxr reading
15. wait 2-4 hrs for final read from attending
16. let senior resident know about final cxr interpretation
17. check off rest of the box indicating cxr was ordered and read
18. write note about xray findings on sign-out sheet
19. write note about xray findings on tomorrow’s progress note
20. write note about xray findings on tomorrow’s rounding list
21. write note about xray findings on the trauma tertiary survey form
the best thing about internship is spending the whole day obsessing over other people doing the work they’re supposed to do, 1) because you don’t trust them 2) because if they don’t do their mcwork it’s your ass on the line 3) patients suffer if people who don’t give a shit don’t do their mcjobs.
the second best thing about internship is documenting the hell out of everything onto four, five, sometimes even more pieces of paper, because hospital computer systems are total shit.
the third best thing about internship is getting paged about someone’s pain, seeing that they are on fentanyl and morphine, and it isn’t “touching them”, and writing for dilaudid. and then having to increase the dilaudid. and then finally giving up and giving them dilaudid PCA even though we’re supposed to “normalize” patients to get them the hell out. and hoping they push the PCA enough times to go to sleep and stop bothering me for the rest of the night. then getting paged about a phone call from someone who was recently discharged and lost their narcotics. then having them ask to talk to the attending because i won’t give them more narcs for them to sell to their friends. then writing for narcs anyway.
there’s some irony in how painful internship already is, and that i’m prescribing all these narcs all the time. but i didn’t major in english and i’m lazy.
thankfully 4th of july was unexpectedly quiet. and there’s free chocolate milk in the resident’s fridge. i do love chocolate milk.
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