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20 April 2009

Ortho Flying ScutMonkey

For those who would like to know what a surgical rotation is really like, I would recommend The Underwear Drawer. Medical student turned cartoonist depicts the life of a medical student in a humerous fashion with a series of cartoons. Having been there, I can totally understand.

I started the first day of my rotation on the Orthopedic Surgery service at ECMC kinda like a medical student. I didn't know any of the patients, and I was pretty much following the Ortho residents around as we rushed from room to room. We took about 2 minutes per patient, and rounded on everyone on our list within about 30 minutes. I then spent the next 20 minutes helping to cast a patient with a broken ankle.

By the time we were done, I was wishing for some Advil and wondering if I would have time this rotation to start lifting weights at the gym. Seriously, this was a big guy, and I think his leg weighed 50 pounds. Because of the pain, he wasn't able to support the weight of his own leg, so I had to do the majority of the work.

Then we rushed downstairs to "run the board" which consisted of looking at films with the attendings from the previous evenings' consults. Then everyone took off for the O.R. Now, as many of you know, I spent 3 years as a surgical resident. I did an internship. My partner on the Ortho service is the Ortho intern. He carries "the Bomb."

"The Bomb" is the Ortho service pager. Anyone trying to get a hold of Ortho calls this pager. It goes off all the time. And, 75% of the calls are for patient scutwork. Scut is all the little tasks that go along with patient care - writing for medications, ordering tests, following up on tests, ordering labs, following up on labs, ordering xyz, following up on xyz, etc. If a patient has pain, they call "the Bomb." If a patient can't poop, they call "the Bomb."

As an E.D. resident, I carry the tradition set forth by my predecessors, that we DO NOT carry "the Bomb." However, from time to time, it becomes necessary to do so. I carried it this morning while the intern scrubbed in on a case with the promise that he would take it back when he was done. About 15 minutes into carrying it, I wanted to chuck it against the wall.

I was all too happy to give the pager back when the intern got out of surgery. We had a light early afternoon, and then I got called, by one of my colleagues, into the emergency department for a consult. I didn't leave for the rest of my shift as injury after injury started coming into the E.D. I got to do a tendon repair on someone's hand who got it smashed under a piece of machinery. The intern then splinted the patient's hand due to a bone fracture. Several other consults came in, but those got signed out to the oncoming night team.

Now it's time to go to sleep... 0430 comes much too soon... until tomorrow....


a corgi said...

(thanks for your kind comment Veronica on my journal; that was very sweet of you)

Orthopedics I think must see the most patients in a day second perhaps to Pediatrics. I remember years ago when I worked in offices, the office manager at the time in the cardiology practice we both worked for, used to work in Orthopedics. She said the first few days really had her so confused with over bookings, squeezing patients in, long waits, lots of paperwork, x-rays, etc. She learned to like working there but it did take a bit to get used to. Seems like the same could be true for this rotation of yours:)


Julie said...

Ortho is always busy. Seems I always wait at least 40 minutes past my appointments, on a good day.

We always tell the new cardiology residents, if you don't want us to call you in the middle of the night, don't admit a patient for pain control and not order pain meds, don't put a patient on a nitro drip and not order tylenol for the headache, always order something for the bowels because you can bet at 2300 the patient will become fixated on their lack of a BM and drive the nurses nuts thus insuring a call after the 900 time he or she has called out. I do feel sorry for the one who carries the bomb though. At least no one calls me when I'm sleeping. You all deserve medals.

Lori said...

This was such an interesting entry. I'm glad you didn't have to carry the "bomb" for very long. It sounds like this rotation is going to be very busy and stressful.