Current PGY-3 on a tough stretch of call and feeling very burnt out. Please withhold the unnecessary comments about being tough or how bad it used to be. I’ve been Q3 for most/all of residency. I think there was a lot of merit to taking call early on to get my bearings about how to manage patients. However, after the ED calling to “give a heads up” on the 4th CES rule out of the night, I can’t help but wonder if this could be done better. It seems so unnecessary for me to wake up for every one of these calls to see a patient with no imaging and then write a note, just to try to go back to sleep while waiting on said imaging.
I am interested in going into academics but am struggling doing research with how busy we are and all I want to do is sleep.
Residents at programs with mid level support, do you enjoy it? Is it helpful? Do you feel like you’re missing anything in your training?
It never stops. When you’re the boss, you’ll just have multiple EDs calling about Meemaw falling on Coumadin, especially if they want to transfer to your facility and especially if they can get you half asleep so they can say whatever they want about what you said. Most facilities make you take that call, too, instead of a resident or NP.
Having an NP doesn’t get at the root of the problem: it is costless for ED docs or mid levels to call a bullshit consult or to call too early. The patient has to pay the consult bill, your elective patient at 7 gets a tired surgeon, and you don’t get to sleep. The EM provider goes home at the end of the shift and has no idea what happened outside of they covered their ass. You want to fight back? Get into leadership and set a quality goal for them that disincentivizes that behavior. You won’t have time though since you’re a busy, tired surgeon that’ll be paid on production, so…good luck with that.
Suck it up. There are many people wishing they were in neurosurgery or a neurosurgery resident. Be thankful for your opportunity.
My hospital has protocols for minor spine fractures such as mild compressions fractures, tp, and so fractures. There is also a minor tbi protocol for trace traumatic hemorrhages for patients that are not on anticoagulation. This significantly reduces pages about these nonsurgical patients. And when you do get a consult, you can defer to the protocol that says a surgical consult is not warranted. If your program doesn't have protocols like these, it would be a good opportunity for a QI project.
Be careful of some programs that are run by midlevels. Just a few malignant midlevels are enough to sabotage your training.
