Ending the Interns' Year

You would think that by now, the interns pretty much have their shit together. It's obvious who wants to be a doctor and who wants an office job aka no patient contact.

But yet there is one intern who should never put his hands on a scalpel because a toothache would end up in a lobotomy. Calling him is always, ALWAYS, a last resort. For patients and nursing staff alike.

Nurse A requests tessalon pearls for a sore throat and cough. An EKG, Chest XRay, and six sets of vital signs later, this intern declares the patient has a cough and orders carafate. The nurse suggests phenergan with codeine, Robitussin or, um, tessalon pearls maybe, which were all shot down by the intern. Carafate only. I guess we could let the patient cough till they gag, then they'll need some carafate. Great thinking.

Nurse B requests an order for PRBC's per the attending's written orders to transfuse if HH is less than 9/29. An EKG, 2 NS boluses, a laxative order (on an acute GI bleed, genius), and a cardiology consult later this intern says no. Nurse B says you're f-ing crazy and calls the attending at home and Nurse B gets her PRBC order stat. But not after the intern throws in a few post transfusion lab orders such as calcium and mag and a full renal profile. I'm shocked he didn't transfer her to the ICU.

Nurse C requests an O2 order on a patient who is a little snowed from some morphine and is in a nice, relaxed sleep. Cardiac enzymes, Chest CT, Abdominal ultrasound, and a thorough interrogation regarding his brief smoking history 25 years ago, the patient gets 2 liters nasal cannula, only because Nurse C called the surgical intern instead. The patient's sats recovered when the morphine wore off.

And last but not least, a patient asks for some colace d/t recent narcotic use. Nurse D notifies the intern which turns into, you guessed it, a million tests. The order is written as mag citrate and the patient is kept in the hospital 2 days longer because he's shitting his brains out. Attending rounds in the AM and asks, why didn't you ask for a stool softener instead?

Sometimes, I think our patients are better off coughing, anemic, dyspneic but euphoric, and full of shit than they are under this intern's care. Is June here yet???