I experienced my very first switch call this block. And firsts always call for a blog post.
Ah, but what is switch call, the uninitiated may ask? Switch call is almost as bad as in-house call (i.e. being stuck in hospital for 26 hours). Switch call begins at home call (i.e. cozied up with a book and a blanket) and then you spend enough time at the hospital after midnight (i.e. cold and hungry in your rattiest hoodie and scrubs) for it to count as a “switch.” Like in-house, switch call gives you the benefit of a post-call day, yay!
So yes. The switch.
Here’s a rundown of how it goes. (Times changed to protect the patients.)
12:00 noon – Pity party. Code blue that morning means being physically and emotionally drained, and there’s still 20 patients in clinic that need seeing. And charting. And dictating.
17:00 – At work. Ugh. Hungry.
18:00 – First consult. It’s a legitimately sick patient and really needs help. I can help. Feeling useful and satisfied. But still hungry.
19:00 – At home. AGH. SO HUNGRY. And now also hangry.
20:30 – Fed and watered, mood significantly improved. Post-prandial sleepiness begins, but the family needs visiting.
21:00 – First page. Sick patient continues to be sick. Continuing to feel useful. Also have family’s approval to see their gazillion dollars weren’t wasted on educating a total moron.
22:30 – Second page. Need to clarify meds because I was dumb and didn’t order the right route the first time. So much for sub-total moron.
23:30 – Finally to bed. Sweet sleep. Sweet… <yawn> sleepy… sleeeeeeeeep…
0:30 – BEEDLEDEEDEE BEEDLEDEEDEE BEEDLEDEEDEE
0:31 – Holy Jesus, &@&*, effing !$*@ oh pager. Oh okay. Pager. Kay. Wake up. Wakeupwakeupwakeup.
0:32 – Third page. Sick person coming. I need to come in. Yes, you should please page the real doctor, am I qualified for this?
0:33 – Quickly brush teeth. I feel sick. I think… I might… nope. False alarm.
0:34 – Splitting headache. Urp. Urrrrrrr… no, no, I’m okay. Urp – nope, still okay.
0:35 – Pull on scrubs. Where are my shoes? Where do I keep my shoes. In a closet. Where is the closet. What is a closet.
0:36 – Oh my God what if I have to resuscitate somebody. Do I know how to do that? I took that course. I should. Yes. Yes, I do. Maybe. No I totally got it.
0:40 – Drive to hospital. Safely. Slowly.
1:30 – Patient arrives. Does, in fact, require resuscitation. Offer assistance where needed but mostly watch in wonderment and awe. It’s all so fluid and fast.
2:30 – Continue to resuscitate. Awake. Super duper awake. Buggy-eyes awake.
3:30 – Do a procedure for the first time on my own. Very supportive staff all around, lots of pats on the back. What a lovely feeling. “Well if it doesn’t work, you know which resident to blame, hah hah hah hah hah!”
3:45 – Murphy’s Law occurs. Nothing I did wrong, specifically, but it doesn’t just fix itself.
4:00 – Consults 2 and 3. Equally sick people. Once again useful and competent. Self-confidence rollercoaster continues.
5:00 – Dictate. Must… okay, focus. History of presenting… uh… dis- no, illness. Age is… what even is their age… Wow, that person sure is pretty. So nice, too. Such nice hair.
5:01 – No, no, no, focus. (But hungry.) This patient presented… uh, presented with… (So huuuuuungryyyyyy…) God, they’re nice-looking. And so nice. Amazing hair.
5:45 – Drive home. Is this the reeeeeeeeal liiiiiife, is this just fantasyyyyyy…
6:15 – FOOD. YUSS.
6:30 – This is the sole reason I have a dryer now. Warm blankies for bedtime. 🙂
And that’s pretty much it. In-house call certainly isn’t nice, but at least you’re prepared to be up all night. You’re in hospital, you have your little snack-pack and your comfortable hoodie. Nobody can anticipate when switch call happens.
Just another little sneak peek into the weird life I lead.
– Atalanta
Photo courtesy of: Feelart | FreeDigitalPhotos.net
It might be helpful for your dictation to write out a “script” for yourself first, even if it’s just a few brief notes to remind yourself what to say (CC, PMHx, Meds, Allergies, etc.). As a new nurse, I literally used to write out a script for myself when I had to call doctors, so I wouldn’t be riffling through the chart while they were waiting.