Wednesday, November 22, 2006
24-hour call, again.
My head hurts.
I just got paged by a local pharmacist wanting to know how much Robitussin with codeine to give to my pregnant patient. I wrote "1 bottle". You would think this would translate to whatever standard cough syrup-sized bottle is on the shelf. You would think wrong.
This guy tells me, "We carry this stuff in bulk, I can give her as much as you want."
I'm thinking: that's great dude, give my pregnant patient everything you've got, give her so much cough syrup with a narcotic in it that she can't carry it out the door. Let's see what happens. Perhaps she can score some sweet cash on the street for that stuff. Instead, I say: "How much did I say she could have?"
"You wrote for 1 teaspoon every 4 hours." (1 teaspoon = 5 mL)
"Good, let's give her enough to last her just a few days."
"Um, so how much should I give her? We carry it in bulk. I've got TONS of this stuff."
"Just give her a small supply, she's going to see her real doctor soon."
"Ok, how about 500 mL?"
Seriously? Seriously? Did you really just say that to me? This is a controlled substance, and my DEA number is technically not even real. "Um, let's go with SIXTY."
"Ok, we can do 60. Just so you know, I have this stuff in bulk."
"Great, thanks. You might want to save some of that stuff for someone else." Click.
And yes, I am being a little stingy with the supply on this one. My attending approved the dose, but I still don't like giving it, and the patient said she really didn't want to take it anyway.
My head hurts.
Just prior to that I got a call from the nurses' station. Apparently, one of them is vacationing in Chicago with her mom, and wanted to know if her mom's antibiotic eye drops could be causing the rash on her face.
1. It's 10 pm. I have been here since 6:30 am.
2. I'm an intern.
3. I'm an intern on the "Obstetrics Service".
4. I don't even know this nurse.
So what do I do? I get out of bed(!), walk down there, punch the drug into my PDA and say, "Nope, don't think so. She probably doesn't need to go to the ER unless she can't breathe or her mouth/throat starts swelling up. Glad her eye looks better. Happy Thanksgiving."
My head hurts.
I currently have an "induction of labor" cooking. Only instead of putting in a cervical-ripening agent that lasts for 12-hours, my attending went with the one that lasts for 4. This means that I have to check the patient and place another tab at 11 pm, 3 am, and 7 am. Perhaps he hates me? I don't know, I think perhaps he just didn't think about it as he also ordered her a sleeping pill. How is she supposed to sleep for 8 hours if I'm supposed to check her cervix several times overnight? Then, in the morning, after she's had a crappy night's sleep we'll start the pitocin drip, which will make her uterus start contracting and she'll really feel awful. Great technique, eh?
Just a few more minutes, and hopefully we can get her next dose going and I can grab a few hours of sleep.