Friday, July 07, 2006

Rules for paging a doctor

Now, I like my job. I do. But sometimes I just gotta blow off a little steam. And since it's July and all of the new interns are hitting the floors, I thought I would publish a fun and interesting guide to the fine art of paging.

Once upon a time, pagers were more than just accessories to low-budget drug dealers. Pagers (and those oh-so-secure little chains back to the belt loop) adorned the waistband of many respectable professionals. MDs were one of the groups that I'm sure fell into the early adopter category when pagers came out. What better way to free the doc from having to pay attention to all those annoying overhead pages? Now we could focus exclusively on the phone conversation at hand and only listen for horid little chirps from the mysterious black box on our waists.

Now the evil cell phone has replaced the pager for everyday people, and the Blackberry takes pagers to the next level. But alas, doctors haven't kept with the program. Early fears of cellular interference with medical equipment kept cells out of the hospital... which is okay 'cause a lot of phones won't get reception in the bowels of the wards anyway. So we're still shackled to the pager.

The problem is those paging the doc on call still haven't freaking figured out the basics of proper paging. In order to solve this woefully neglected need, below you'll find some guidelines for the art of paging. As with my rules for baseball viewing (see October of 2005), the most important rule with be first, with less important rules following.

Without further ado...

Rules for paging of doctors, version 1.0

1) If you page me, stick the fuck around to answer the phone. Do not walk away. Do not start another conversation on another line. Do not leave the phone to go to the bathroom. If you do not answer, I won't call twice. You will have to page me again, and I will protest if you say, "But doctawife I paged twice and you never called me back!" Yeah, actually I did. Your ass just wasn't around to answer the phone and you might find my foot so far up said ass that you can taste the breakfast taco I spilled on my clog this morning. You have been warned.

2) Page me with a complete call back number. If you miss the first digit of the five number extension, I ain't calling back. My ass is rolling back over to sleep (if I'm in-house) or back to whatever I was doing before you paged.

3) Speak clearly. If you have an accent, use the simplest words you possibly can to get the message across. I'm not a racist, but at three a.m. I am a bitch. Unless you can make English words like 'shock' or 'sick' or 'hypotension' understood go back to the ESL classes, do not pass Go and do not collect $200 and do not come back to work until I can understand you. I may be getting paid to listen to you, but you're being paid enough to be comprehensible. Capiche?

4) If I don't answer after 5-10 minutes, page me again. I might not have gotten an understandable message the first time. Sometimes, even I understand that the system can break rule #2, not the person trying to reach me.

5) If you page me, and I answer, then say I will be by to see the patient, don't page me 10 minutes later with the same question. I assure you, the answer hasn't changed unless the patient has changed. If the patient hasn't changed, then paging me just delays my arrival at the bedside. And that's counterproductive, ain't it?

6) Repeatedly paging an person who never ever answers probably means that the person isn't available to get pages. Try someone else or a supervisor. Example - increasingly ill patient worries nurse. Nurse pages resident. Resident went home post-call five hours ago and turned pager off (which is perfectly appropriate, by the way.) Nurse continues to page resident for three freaking hours with no response (duh) but nurse never tries to page any other doctor. Patient codes (ie gets really really really sick and tries to die - not good). Lesson - if paging a doc every 10 minutes isn't getting a response try someone else! 'Cause if the doc should be answering his pager and isn't the idiot deserves to be in trouble. If the page operator/nurse/clerk who made the call schedule has the doc's number wrong then at least someone will know what's going on. And usually that someone at least has some kinda clue who to call or what to do while waiting for the right person.

7) On a similar note, be nice... until it's time to not be nice. Non-urgent stuff shouldn't ever be flung at me at three am after paging me five million times for other equally non-urgent shit. But if someone is really Sick, feel free to kamikaze page me to your heart's content. Simple, really.

So there you go. Follow these seven rules and everyone's life will be better. Disobey them at your own risk.


Anonymous said...

I am assuming you went straight from medical school to being an attending...

Me said...

No, she worked her ass off for three years in her residency.

doctawife said...

No, actually, most of these rule come from two years ago when I was an intern. As a fellow/senior resident, only violations of rule #1 still truly pisses me off.

But whatever, if you don't like the idea of treating everyone in the hospital with respect, I can't help. Folks who think that docs, just 'cause they are docs, will function just fine on 1 hour sleep in a 30 hour period are crazy. Everyone in the hospital needs to help keep patiets safe. And sometimes, that includes keeping patients away from doctors.