ARCHIVES - 1996 to FOREVER

Yesterday was a lot longer day that I'd thought it was gonna be; I got to bed about 03:00 finally.

I got called in shortly after I posted last nights' entry, wound up doing three patients. The one that I was called in for had to wait for labs to get back. The prevailing attitude right now is that if the labs are ordered, even when no risk factors are evident, you wait for the creatinine, the marker for kidney function.

Unfortunately, the radiologists haven't come up with a solid line. For some, anything over what the lab has established as normal means that we don't do the exam. For others, the value can be as high as 2.0 and they'll still do it. The lab normals top out at 1.2 for females and 1.3 for males.

So, we have a sizable grey area. Today we had a patient with a 1.4, and I was thinking that the rad wouldn't go for it and recommended that the physician be consulted and consider doing a VQ lung scan. Then I talked to the rad about 30 minutes later, and he said O that's OK. And the same guy a month ago told me a 1.3 wouldn't work.

We have a group of rads, maybe 20, and keeping track of what all of them want is a nightmare, but they won't come to a consensus, so what the hell are we supposed to do? Well, what we have to do is consult with whoever's assigned to us every damned time. Which would be OK if they were always available... but they're not.

Anyway, I made it through the day, and even a little bit further. Right before I was supposed to leave we had a slightly mentally deficient young man that we had to do a contrast exam on. We'd done him before, and it took three of us to get the IV in. Today there were two of us, and I was the one who snuck up on him with the IV. Worked out OK, but it was a mental struggle.

And I am dead beat. Not *a* deadbeat, not yet anyways.

I did oversleep this morning, and got in a full four hours, heh.

That, my friends, is not nearly enough to keep my mind straight, and that's probably obvious.

Gonna be an early bedtime for me tonight, yes it is.