Being On Call

I am on call again, and I will remain on call for two hospitals until Monday. Many people who are not nurses or physicians don't really understand what the unrelenting stress of being on call means.

For me, it means remaining in my scrubs for the duration. If I take a shower, it's with my pager and cell phone outside the curtain. I don't go out to eat where I might have to wait for ten minutes to get food. I don't go shopping where I might have to wait in a ten minute line at the register. Any social engagement where getting up and leaving gracefully presents a problem is out of the question. No activities where exiting a grid locked parking lot might be a problem. No church. No funerals. No theater. No school functions for my child. I don't even watch movies on DVD. No wine or spirits. None.

I try to catch up on my sleep when I can, and I keep something to eat pre-prepared and ready on the kitchen counter. Preferably something pre-prepared that I can eat while driving through the night to the hospital. Something like a burrito or a chicken wrap. I keep my car's gas tank full of fuel.

I have to stay within a thirty minute radius of the hospital at all times. When my pager beeps, the clock starts ticking. I have thirty minutes until I should be starting the case. It is not very different than when I was in the Navy, being called to General Quarters again and and again. As I drive towards the hospital, my cell phone hums. I am getting as much information on the patient as possible from the ER staff. I am fielding calls from the doctors and my team, everyone wanting to know what is going on and what needs to be done. I do this because some person desperately needs us.

Call is supposed to be for life threatening emergencies. The truth is, it is frequently abused so physicians can meet (or avoid) the demands of their spouse's social agenda. It is not uncommon for me to be roused out of a deep sleep only to rush to the hospital and start a case that could easily have been done the next morning. I have learned to expect to be called out at any time, with no regards to when I was last called out. There have been times that I have turned into my driveway at 2:00 AM only to have my pager go off again. Keep in mind that while this is going on, I still have scheduled cases that start at 6:30-7:00 AM. Sometimes I just stay at the hospital and sleep on a gurney in a dark room.

I usually do not take five days of call in a row. Doing so brings a person to the brink of total exhaustion and irrationality. The most I usually take in a row is three days, a Friday, Saturday and Sunday. I am doing five this time because other people took call so I could spend Christmas and Thanksgiving with my family. Unfortunately, my scheduled call weekend fell right after New Year's Day, so I get five days in a row.

My pager just went off............