Its been awhile... I know. Lets just jump right in.
Today I had that moment where I asked myself.. Have I lost myself? Sitting next to an excited, enthusiastic medical student I realized in that moment where my spirit used to be and where I am currently headed without rapid, solid intervention.
Tonight I started my shift with dread, darn near tears. I just couldn't understand why I was being forced to walk away from my cozy home through the snow to the hospital and this after doing absolutely nothing all day. Walking to the hospital I kept wondering.. I hope no one comes in super sick.. I'm praying for sore throats.... runny noses... even a dog bite.. diagnosis that take relatively no thinking and I could treat in my sleep. And don't let them be old I prayed.. smh. With each decade I must use more areas of my brain..
I know this is bad...
I sign up for my first patient... And wait a minute.. She was just in the ED less than 12 hours ago. She must be cold with nowhere to go. I walk in... She has her suitcases.. and her flight of ideas are bounding off the walls and the frustrations of everyone in the room. "I need my meds, Can I get some tea, do I get a sandwich.."
What do I do...
Fine. Its cold. We let her stay overnight I say..
First the primary nurse says.. "Are we really letting her stay?"
Then another nurse comes to me to say, "did you read about this lady..? She was just here."
Then the primary nurse from yesterday with more frustration and anger then I expected says.. "I explicitly told her what to come back for.. She is crazy and needs a psych eval. I don't even think she left the waiting room when i discharged her. Why does she have her bags?"
Just having read my little devotion... I had just enough patience to make it through her frustrated speech.
I walk around the unit thinking the situation has passed. The attending said she is saying so its done.. right? Wrong.
Then there is the huddle of nurses... All glaring in my direction. I stop and say "What?" (WRONG move..)
To say the least everyone was heated with me for letting this homeless woman stay in the ED overnight. I would have been the hero and favorite resident of the night for putting this poor woman in the cold overnight. As I walk away from the huddle of frustrated nurses... I am disappointed in so many things.
Disappointed that they did not realize their frustrations were displaced. I'm not the enemy. I'm just the one tasked with telling them.. because we have no resources for this lady, yes I'm sorry you are left with more work for the night. Disappointed that after going to medical school to "help people".. On a Saturday night in West Philly I have nothing more to offer this poor woman than a sandwich and a warm room until 6am. Letting her stay until 6am didn't take any critical thinking on my part.. No complex problem skills were needed. No assertiveness was needed.. She would require no more thinking of myself for the rest of the night.
The former not burnt out self before residency would have given the nurses a passionate speech back and demanded to the attending that we come up with a more thought out solution.
I simply let the moment pass... trying to conserve as much of my energy as I could for the 10 hours left in the shift.
.
Would things be better if I worked less and had more energy for these moments.. or is it the system? We have multi million dollar research buildings for cells and rats to run around in. But no where for me to send this lady to sleep...
I left this shift wondering where my sense of self and hopefulness about medicine had disappeared too..
I think 2014 will be dedicated to finding the sense of hope in medicine that led me to choose this profession.
These are just the thoughts in my head at 1am on a Saturday night..
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