You look tired.

The past two weeks were quite busy. Apparently it showed in my face since a pediatric patient told me I looked tired during our encounter. Gotta love children’s honesty.

Svikki MD

March Week 1

The first week of March, I spent most of my time in the hospital. I had a quiet call on Tuesday. We cleared house pretty well throughout the week as many of my swing bed patients were either discharged to nursing homes or were able to go home. Wednesday, I gave a virtual lecture about fatigue to the South Dakota Academy of Physicians Assistants via Zoom. Thursday, I had another STEM mentoring meeting… also via Zoom. Due to some shortages of staff in the clinic, I helped out Thursday and Friday afternoon. The other Family Medicine doc was headed off for a week-long vacation and signed out an acute care patient to me on Friday. This bought me the second weekend in a row of coming in to see patients.

March Week 2

This past week was even busier. Since we had cleared the house the week before, we were due to increase our census again. A few of those swing bed admissions didn’t arrive from Rapid City until about 4 or 5 PM, which kept me there late to see them and get all the orders placed. On Wednesday, they were short providers in the clinic and I headed over to help out with walk-ins. On Thursday, one of the clinic providers had to go home due to their child being sick. I discharged a patient and saw two of my inpatients and then headed over to the clinic at 9 AM to see walk-ins for the rest of the day.

As so many times before, there was a walk-in at 4:45 PM for a skiing accident from the nearby mountain. They reported the accident had happened within the hour….it is odd how these accidents keep happening right at the closing time of the mountain at 4 PM. This late walk-in again necessitated a nurse to stay late with me and the radiology tech to stay late for imagining. I was pretty sure the bone wasn’t broken when I saw the image but I always wait for the official radiology read to be sure. It wasn’t broken. I let the nurse leave to get to an appointment she was running late to and ace wrapped the injury myself and got the family out of the office by 6 PM.

I drove home to have dinner and spent the rest of the evening finishing up charts from that day (I hate carrying unfinished charts over to the next day).

A Holiday Weekend that didn’t need to happen IMHO

Friday is really when the madness started. This past weekend was St. Patty’s Day weekend in Deadwood. It is essentially a huge drinking festival all weekend. Although I was told it was a bit scaled back from the normal due to Covid, the radio ads for the pub crawl and party announcements made me think it still wasn’t going to be low-key. I was on call all weekend and I feared I would be called in because the ED would be overrun by drunken people. Luckily, they doubled up on ED providers for the weekend. I started the day with discharging a patient and then had two swing bed admits lined up to arrive.

After the first had arrived, the ED called regarding an intoxicated patient that needed admission. Simultaneously, I was trying to field several prescription requests that were pouring in Friday afternoon. I was the only doctor in the hospital and clinic that day and I was on call, so I got all of the patient messages and prescription requests. Many of them were for controlled substances….which aren’t quick click-of-the-button refills. I make sure the refill is appropriate, check drug monitoring programs, calling pharmacies, and having to decide the minimum amount I can prescribe them so that their primary care doctor can continue the refills if they deem them appropriate. That all takes some time.

In the midst of all of that, I received a text from the office asking if I could come to see patients because two of the three mid-level providers that were working that day had to go home. They were either sick themselves or had a sick child. That left only one mid-level in the office. I was able to find an hour to pop over and help out before the clinic closed. Afterward, I still had my second swing bed admission to take care of. The acute care admission bought me my third weekend in a row of rounding.

Saturday

Throughout Friday night, I received several calls from the ED to go over patients. Saturday morning, the calls from the hospital started regarding the intoxicated patient. The treatment plan wasn’t working properly. I was on the phone 4 or 5 times before I quickly hopped into the shower before heading to the hospital. A call came in the middle of shampooing my hair. I thought it was the hospital nurse again and it would be a quick call. However, it was the call center and a patient’s daughter wanted to speak to the on-call provider. So I hopped out of the shower, shampoo in my hair and dripping wet to go grab something to write down some information. For the next 10 minutes, I was dripping all over the floor while taking care of the call. I quickly finished my shower afterward and headed to the hospital.

For the next 5 hours, I worked on adequately managing the patient going through withdrawal. I was able to take care of a few other tasks with other patients in that time as well before finally going home. I was exhausted and took a nap. My first nap in a really long time.

Sunday

Last night was also interrupted a couple of times with calls. Needless to say, I didn’t feel particularly refreshed this morning. Luckily, I had implemented a functional plan for the withdrawal patient and didn’t receive any calls related to them. I spent a few hours this morning in the hospital and then returned home for another power nap. Since then, it’s been pretty quiet.

Indecisive weather

The weather has been sort of wild these past two weeks as well. During the first weekend, it was 68 degrees Fahrenheit! I went on a beautiful hike at Look Out Mountain in Spearfish. Over the past week, the temperatures have dropped again and as I type this, a winter storm is moving in and it’s snowing out with multiple inches expected to fall.

One thing I love:  Working with great nurses. It’s been busy and I’ve worked with some great nurses to get through it. Experienced nurses are such a valuable resource for physicians, especially new grads. We also laugh a lot together which makes the work environment so pleasant here.

One thing I ate: Coconut Miso Ramen from Purple Carrot… nothing like slurping down delicious Ramen in between seeing patients to keep you going!

One thing I’m grateful for: the vaccine rollout going as well as it is and President Biden’s announcement that all adults will be eligible to receive the vaccine by May 1st,… Hallelujah!

mfg

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