on page, part 2

August 24, 2010

take it down a level
i’m on call this week. as i mentioned yesterday, i’m trying to bring my call stress level down a few notches. because truthfully? there is no reason for the repetitive cortisol surges every time my pager goes off (clearly, my adrenals work fine, as opposed to what seems like 99% of the babies in the NICU). i can do a better job, be a nicer person, AND have a more positive experience when i don’t rush, overly stress out, or let myself become overwhelmed.

let’s start by taking a step back and admitting that i am not yet taking my pager’s ring in stride. honestly, i think it might be a bit of a pavlovian thing left over from residency. because back then (yeah, WAAAAAAY back then — as in 2 months ago!) i carried a pager that did sometimes require running into an emergency situation and perhaps warranted a bit of adrenaline.

but now?


yeah, most of the tme, i get super urgent pages like the above about follow-up appointments and DDAVP dosing. i mean, come on — it’s not like “QUICK! help me interpret these thyroid studies, STAT!“.

sometimes i get alert lab values which freak me out a little, but if i really stop and think about it, lab results aren’t instant, and the kid behind the number has been okay for the hours of processing time, so ACK!! OH NOO!! responses to ugly sodium numbers (even if they are termed ‘panic’ values by the lab) don’t make much sense, either. a calm and thoughtful approach is better for the patient, the caller, and for me.

by far, the most panicky calls (and therefore panic-inducing — unfortunately, freakouts can be contagious) are the ones from parents, usually describing a scenario that is concerning for adrenal crisis or DKA. but really, if they have time to make a phone call through our switchboard (this can take a while, apparently), then i have time to breathe and reassure and think through their scenario before choosing between option A (continue to watch the child at home and follow up) and option B (tell them to high-tail it to the ED).

so today, when the pager goes off (and ohhh it will), i am going to take a minute and breathe/visualize a seascape/sneak some ativan (KIDDING), whatever it takes to try to alter my previous conditioned response. hopefully i will someday be able to glide through my work days — pager beeps included — with a calm and positive energy.

if you are in the medical field, what is your response to your pager like? and if not — is there an equivalent stimulus (blackberry beep, email heading, phone call from the boss) that makes your hair stand on end and your adrenals cry for mercy? i could certainly use your tips + coping strategies!

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8.23.10

workout: 35 minutes elliptical + full-body weights circuit

making it easier: i’ve decided that mondays are going to be official pizza nights in our household. we have a conference that lasts until 6 and the day tends to be a busy one overall, so why not make things just a little bit easier?


luckily, there are a number of frozen pizzas that i like (and don’t feel horrible about from a nutrition perspective). pictured above is 2 slices from the american flatbread pie — this is actually quite no-frills pizza that tastes like the neighborhood pizza joint to me, with plenty of cheese and a bit of oregano.

boards/reading: i spent ~2 hours after work dictating and handling calls, so genetics is getting pushed back a night. it will be okay.

10 Comments

  • Reply Meredith (Pursuing Balance) March 10, 2019 at 7:25 pm

    I have a pager for my dietetic internship, but no one has paged me yet! Mine definitely isn&#39t as fancy as yours appears to be — it just shows a phone number and that&#39s it.

  • Reply Julie March 10, 2019 at 7:25 pm

    I&#39m into my 2nd straight week of pager call including last weekend, so 12 days in a row. One of my tricks for when patients (or in your case parents) call at odd times or with strange complaints are that most of the time they are calling because they are scared and I try to reassure them, even if it does not require a lot of medical action. Think about if you were a parent with a sick kid and had no medical training and didn&#39t understand what was happening. Also, don&#39t you think it&#39s funny that nobody carries pagers anymore but on call doctors and even then many use cell phones. I hate lugging that thing around.

  • Reply Sarah Hart-Unger March 10, 2019 at 7:25 pm

    meredith: hopefully that thing will stay silent 🙂

    julie: actually – i think it would be worse if i could be called directly! i&#39ll pick a page over a cell phone call any day. with a page, you can take time to regroup, look up something (if there&#39s info on the page), etc — and in fact i&#39m going to try to take advantage of that little lag time.

    if i could only turn the ring sound to a zenlike meditation gong sound . . .

  • Reply sarah March 10, 2019 at 7:25 pm

    This is such an "Oh, duh," moment, but I spent the weekend with friends, one of whom is a first-year neurology intern. I have to say, I had NO IDEA how much you all work. It was a complete awakening, and it truly blew me away. You must really love doctoring to go through all that. Suddenly your need for organization is becoming a lot clearer! Anyway, as Andrew marched off to his 15-hour workday on Saturday, I thought of your blog.

  • Reply Chelsea March 10, 2019 at 7:25 pm

    Definitely not stress inducing, but when an article comes back from getting prepped for publication my boss insists we go through the page proofs THAT DAY. Which means going word by work, redoing all the analyses I haven&#39t run in weeks, checking every single digit and graph footer, etc because this is the last chance we have to catch any error before it&#39s set out for the world to see. Ick.

  • Reply Anonymous March 10, 2019 at 7:25 pm

    Sarah,

    On of my tips for dealing with adrenalin rush experiences is to remind myself that the physiological sequelae of panic/fear are very similar to the experiences of excitement. So….wonder if you restructure your thoughts to say that you are excited to get the page–exhilerated to face a challenge, use your skills, apply all of the knowledge you have learned. I&#39ve worked hard on this and while not perfect, it has helped me.

  • Reply Claire March 10, 2019 at 7:25 pm

    DEFINITELY prefer a pager over a direct line to me. Pager provides a barrier, small though it is! I tend to kind of ball up on the inside as I tentatively hit that button to find out who is paging me, hoping that it&#39s "just the floor" or "that kid I already know is coming" instead of a new admit! 🙂 The really annoying ones are "just wanted to make sure that you really want me to give the Tylenol that&#39s already ordered" or even better the attending who wants me to come write discharge orders as she stands there watching me do it…yes, you are an attending and can write you own orders WITHOUT a scribe! The same attending did this to me TWICE!

  • Reply Astrid March 10, 2019 at 7:25 pm

    I am not in the medical field, but have this intense dread of phone calls in general. I always think it is bad news, and if I don&#39t know the number, I just won&#39t answer. But you can&#39t really not answer your pages!! I bet your job is pretty intense at times. Thanks so much for the comment!

  • Reply Susan March 10, 2019 at 7:25 pm

    The patient call system at the hospital ALWAYS get me. Our new systems goes, "ding, PATIENT CALL." And repeats that until someone answers it. I was in the grocery store yesterday and thought I heard it. The calls annoy me if I&#39m in the middle of something or if I was JUST in the room. My patience level with them definitely changes with the situation. Many times it&#39s an "ugh what do they want??" feeling. Probably bad, but it&#39s true.

    The WORST sound ever isn&#39t the patient call system, but the BED ALERTS. We use them on people who are fall risks who get out of bed on their own and might fall, which generally means I go running down the hallway to make sure they don&#39t fall when the alarm goes off. It&#39s the worst because you basically have to drop what you&#39re doing (especially annoying when you&#39re in with other patients) to go into that person&#39s room. CRINGE HATE. Just saying.

  • Reply Steph March 10, 2019 at 7:25 pm

    I&#39m an OR nurse who does night and 24 hour weekend call and I cringe and swear eveytime my phone rings because I know it means I have to come into work. Even though I love my job and know that the surgeries we&#39re doing are emergencies I always feel resentful, especially when it is 3am and I was sleeping. I know I shouldn&#39t feel this way because this is my job and I picked it knowing about call but I&#39m not sure I will ever stop feeling this way.

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