Wednesday, February 18, 2004

phone triage

Nothing beats a slice of cold pizza for breakfast. Nothing except eating that slice of pizza at 8:30 in the morning because you missed Chief of Service Rounds this morning secondary to an alarm clock misfire, and are now able to enjoy an unprescedented site: sunshine through my window. Honestly, probably the worst thing about intern year (or residency in general, I guess) is never getting to see the sun. Dark when you leave for work, dark when you get home. Sure, there are windows in the hospital, big ones even, but they're all in the patient's rooms. And who ever goes in there? (Ha. I kid. I kid because I love. Love KIDS, that is.)

Yesterday night I was on phone triage for my clinic. What this means is that any calls from anxious parents in the middle of the night would get forwarded from the clinic answering service to my home phone. I was on pins and needles all night, clutching my pager in one hand and phone in the other, waiting for these horrible calls. "My kid is having seizures!" "My kid is turning blue!" "My kid just impaled her sister with an ice pick!" Well, actually, I guess those would be easy ones--I could just tell them to call an ambulance and see them in the hospital in the morning. But it's the subtle ones that I was worried about. How should I decide if a kid's vomiting and dehydration sounded bad enough to send them to the hospital, versus telling them to stay home and follow up in clinic tomorrow? How could I tell the bad kids from the OK-for-tonight kids if I couldn't see them? What if I told them that their kid would be fine until morning and they weren't? I mean, I know people in Washington Heights seem to have a low threshold for bringing their kids to the ER ("Papercut? Call an ambulance!") but watch me get that one parent who actually listened to me to have the kid stay home, and then watch me be wrong.

Anyway, I didn't get any calls at all last night. So either my pager was broken, no kids were sick, or all the sick kids went into the ER straight away without bothering to call. I hope for the latter two scenarios.

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