Dysequilibrium

vivianimbriotis | Sept. 30, 2023, 7:10 p.m.

The clock hits four thirty p.m., so you click your pager on.

You have to get bloods from Mrs Moore, so you walk towards the cannulation trolley. Needle, syringe. Band-aid, alcohol wipe. There are no tourniquets left in the cannulation trolley. You walk into the storeroom - surely there's one there.

Your pager goes off. You snag the only tourniquet (check, needle and syringe, check, bandaid and wipe, check) and then drop back into the office, grab a landline phone, and look down at the pager - "11256". You obediently type the number into the landline, which beeps tones back at you - "one one two FIVE six".

"Hey," you intone, "this is the after hours doctor returning a page."

"Oh hi, this is one of the nurses on the mental health unit - one of our patients has a high blood sugar up to twenty-one, just wondering how much insulin we should give?"

You ask a couple of probing questions. You realize that behind you, a good-looking swarthy bloke in scrubs is watching you, waiting for an opportunity to talk to you.

"Okay, just give eight units now and do some blood sugars at two and four hours, thanks." You place the receiver down gently and turn. "Hey, can I help?"

"Yes actually! I was just wondering if you'd done those bloods for bed six?"

"Who is that?"

"Bed six? It's a lady, uh, Mrs Moore."

"Oh yes I was just--"

Your pager goes off.

"One moment," you say. "One FIVE FIVE oh FIVE," the landline intones.

"Hey, this is the after hours doctor returning a page."

"Hi thanks for calling back, I was hoping we could get a cannula in bed twelve, he really needs his antibiotics."

"Sorry where are you calling from? And who is bed twelve?" Several other questions to this effect later, you add "I just need to do some urgent bloods, then I'll get around to Mr Dayle."

Receiver goes down, you realize Tall Dark and Scrubs has departed. No worries.

You introduce yourself to Mrs Moore, who looks very cranky. "I don't want any more blood tests!" she proclaims. Fair enough, honestly. She is turning into one big bruise. You try to explain why she needs the tests but no one has sufficiently explained it to you. Eventually she acquiesces. You feel pretty bad about the whole interaction. You put the tourniquet around her arm.

Your pager goes off. Code blue - medical emergency. "Sorry," you say to Mrs Moore, "I'll be back in a moment". You release the tourniquet and take off down the hall, running to another ward.

"False alarm!" cries the in-charge nurse. "Someone got curious in the shower and pressed the red button!" Okay, you think. No worries. Time to finally do some bloods. On your way back --

Your pager goes off. It's okay, you think, you need to get something done tonight. You press on and get the bloods from Mrs Moore. It takes two attempts and now she has two new bruises. She thanks you anyway.

Your pager goes off. You decide to answer the newest page first. "FIVE two four one THREE."

"Hey, this is the after hours doctor returning a page."

"Oh there is, um, there is a patient who, their family is very upset. And they, want to, I just think they need to speak to, a doctor or they might leave." Gently, you coax out a story. You're not sure that you understand, and feel very under-qualified to talk to the family. You tell them you'll be there when you can but you have to do a cannula first.

Your pager goes off.

You now have two pages to answer. You hang up the phone and answer the old page first. "THREE two two two four."

"Hey, this is the after hours doctor returning a page."

"Oh I'm not sure who paged you, sorry -- I'll go and have a look."

"I'm actually pretty busy--" They have already gone. You wait.

And wait.

Your pager goes off.

"Hi sorry I'm not sure who paged you."

"Okay get them to repage if you find out, thanks-bye." You should have returned the page faster.

You still have two pages to answer now - you take the oldest first this time.

"Hey, this is the after hours doctor returning a page."

"Hey this is the pathology laboratory. Did you send samples from a Mrs Moore?"

"Yes I did."

"Her last name is misspelled on one of the samples, so we have destroyed them. The samples will have to be recollected. Have a good night."

Receiver down. You think about Mrs Moore's bruised arms. You answer your other page - "six six FIVE FIVE one."

"Hi I talked to you before about a patient's blood sugar - we gave him that insulin but now he's a bit groggy so we repeated the blood glucose and it was three point one."

You panic and tell them to push fifty millilitres of fifty percent glucose IV until the nurse calmly tells you they have already given the poor bloke some apple juice and he's fine now. Your eyes feel gritty and you thank them and tell them to keep monitoring (as if they needed you to tell them that).

Defeated, you return to Mrs Moore's bed and try and explain why the pathology lab has not processed her bloods. You end up taking another sample of bloods from a vein in her foot. It is obviously very painful. She still thanks you.

Your pager goes off. You walk back to the landline to answer it and run into Tall Dark and Scrubs. "Hey, did you hear that you need to recollect those samples from Mrs Moore?" You hold out the new blood tubes by way of response. You sit down next to the landline. "One FIVE FIVE oh FIVE," and then, "Hey, this is the after hours doctor returning a page."

"Hey just calling back about that cannula, it REALLY needs to be done soon." You realise you actually can go do it now and walk via the cannula trolley to his room.

You introduce yourself to Mr Dayle and explain you're replacing his cannula. Your pager goes off. You realize there is no tourniquet. You remember taking the last torniquet from the storeroom earlier. You silence your pager and try and figure out from where to get another one.

Your pager goes off.