Wednesday, April 1, 2009

at 2am he forgets what he learned in med school

I hate calling this surgeon after midnight; he seems to forget he ever went to med school. Night one pt. in CICU for afib post-op. Pt. has hypo-active BS, pt. reports no BM since pre-op(lobectomy) Now post-op day 3. I began tx with what I had; no results. In am Req. for more aggressive bowel regimen. Left a note for physician on the chart to address issue notifying him of lack of progress and abd changes each day. By my fourth night of doing SSEs, dulculax, fleets, miralax, mag citrate and so forth without results she vomits 100ml anti-emetic given; vomits again (200 ml) at 2 am. Now I know what I need to do and am required to notify him that I want to insert an NGT to LIS, change her amiodarone and lopressor to IV and make her NPO. When I call him he states "I know who she is, whats going on?" I have reminded him that she has not had a BM and it is now post-op day 7, and that she has vomitted twice therefore...and I state my request. His response is "Why is she nauseated and throwing up?" I again remind him that she has not had a BM in over 8 days. He asks if I gave her meds to make her nauseated and seems stumped as to why she is throwing up. I wish I had the nerve I would have stated "Because, Dr. ... she is FOS!! (In my fantasy I don't use the acronym). Do MD's appreciate the fact that we don't like calling them at 2am any more than they like being called?

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