The Problem with V.I.P. Patients

I came across the following article about VIP patients in teaching hospitals, and I must say that I agree with Seligman-

http://www.atrium-magazine.com/2011/05/bad-education/#more-4406

As a medical student, I often got the impression that it was the norm to "cater" to VIPs while "dealing" with the other patients.  We must remind ourselves that all patients are VIPs deserving of our best efforts. (Yes, even the ones who test our patience... relentlessly at times).

TGI

As Summer Ends, Intern Year Gets Real...

I am now in the third month of my intern year.  The first month was a very relaxing elective block, the perfect segue from being a seemingly anonymous medical student to carrying out the duties and responsibilities of medical doctor (a title which can be both gratifying and dreadful in these early stages of my career).  My second month-long block was night-float coverage, with every fourth day off for some much needed R&R.  The idea of taking responsibility for over 100 patients every night was scary enough, and being reminded that, above all else, I must "keep the patient alive!" did nothing to ease the anxiety...

Overall, I learned a tremendous amount in a short period of time during my night float rotation.  I interfaced with a variety of patients, families, nurses, and other healthcare professionals.  I had to deal with many difficult situations: pronouncing death and delivering bad news; tending to the malingering drug-seeker threatening to leave AMA, and to the nervous patient in need of gentle words of reassurance (and perhaps an anxiolytic); reacting to the decompensating patient fighting to survive, and negotiating with the overly-aggressive nurse fighting my decisions.

During what often felt like complete chaos; I had to accurately triage patient issues, manage and organize my time and notes, think critically, communicate effectively both verbally and through written documentation, and remain calm and composed (and awake!).  To call it multi-tasking would be an understatement.  It is during night float that one also truly appreciates the art of good, clear sign-out and anticipatory guidance.  The experience was not all stress and chaos, however; as many nights were punctuated with the occasional online movie, texting with loved ones, ordering take-out, connecting with fellow co-interns, and receiving encouraging guidance from senior residents.

Having only completed a fraction of my intern year at this point, I've just begun the ascent up the dauntingly steep learning curve inherent to medical education.  I certainly feel more confident in my medical decision-making abilities, and I look forward to applying lessons learned during my time as NF intern toward future rotations.

All of that being said, the following cartoon from Doctor Fizzy with Atrium-Magazine.com really sums up the night float experience quite nicely :-)

http://www.atrium-magazine.com/