Danger Bakery

A fine baked goods establishment yowling for your attention since 2021

Diary of a Noct-purr-nist

1900 Start the night by taking sign out from the Emeowgency medicine resident, who has seven admits for me that the day team asked him to sign out. He has not laid paw or whisker in their room and doesn’t know anything about them, not even their names or room numbers. I go to get coffee. They are either stable or dead at this time, and another 5 minutes will not change this.

1905 One of the patients I was consulted on was unstable but not yet dead, and decided to die in the 5 minutes I took to find coffee. It is now my problem since the EM resident is nowhere to be found and my name has been stamped everywhere on the chart. The IV that EMS put into the patient’s left toe bean 20 hours ago has gone bad somehow. There is no other IV access. No labs have been done. He received cat-triaxone. His chart indicates he is allergic to cat-triaxone but does not list the reaction nor the severity. He does not appear to be in anapawlaxis. There is no chief complaint or ER note in the chart. We code the patient, put in every line I can think of and a foley. I intubate the patient so he cannot complain of anything in the hopes that no one will call me about this patient for the rest of the night. I have no idea what is wrong with him. I write a note saying so but with more words. The nurses are grateful that they can now send him to the Intensive Cat Unit and get him off of their paws.

1945 Rapid response call for a patient who has had a headache since 10 am and no one did anything about it, but now the night nurses took over and they’re panicking. There is nothing wrong. I order 1000 of a-cat-aminophen, a CAT scan of the head and tell the nurses to lose my number. I will not remember to read the CAT scan later, so I hope this does not turn out to be a stroke.

2000 Stat claw-diology consult on my human who has still not fed me my evening meal. There is no way he can have a functioning heart and see me starving like this. They told me to he-paw-rinize him, repeat an ECG (electro-cattio-gram) and tro-paw-nins and they will see him in the morning to consider a left heart CATh. They instruct me not to call them, no matter how high the tro-paw-nin gets.

2005 I have been fed. This is later than I’d like. I write a PSR (purrsonal safety report) about this.

2010 I take a nap on the computer tower, because it is warm.

2100 Patient asking for something to help them sleep. Order 10 mg of mewlatonin.

2115-2125 I receive exactly 1 call per minute asking for something to help their patients sleep. They all receive 10 mg of mewlatonin.

2130 The mewlatonin did not help one of my patients. At home, they take 2 mg of cativan at night to sleep. This is not on their med list. Ask the nurse where they receive the cativan from. They take it out of their mom’s mew-dicine cabinet. I ask the nurse to inform the patient that this is a crime and that I will not be ordering any while they are here. The nurse attempts not to laugh as he hangs up the phone. I write a note saying so.

2300 I run frantically up and down the floors with no particular destination in mind. I yowl loudly as I do so. I scare some of the nurses. This delights me.

0115-0145 Several nurses from different patients call in rapid succession begging me for something to help them as their elderly de-mew-ntia patients are biting, hissing and climbing up the walls. Zy-paw-xa 10 mg for everyone.

0155 Some of the stubborn de-mew-ntia patients are still up and screeching. Halopurridol 5 mg.

0200 A nurse who just started last week calling to see if I want to put in a stat consult to Purrmonology because her patient has a mysterious rumbling sound coming out of him when he breathes. She has not tried anything. She does not know what makes it worse or better. She has not taken vital signs. I ask her to try a treatment of al-mew-terol and take vital signs.

0201 She does not know how to order al-mew-terol. I order it.

0202 She cannot find the order. I ask her to ask another nurse to find it for her. She seems uncertain if this is going to work.

0215 The al-mew-terol has not helped. The rumbling continues. Worsened by tummy rubs and treats, alleviated by fear or discomfort. She still has not checked vital signs and is not sure where the machine is. I ask her to take some vitals, as I’m sure she will not and I will not hear from her for the rest of the evening. He probably has a little bit of COPD (Constantly Overjoyed Purring Disorder), but that’s a day shift problem. I write a note saying so.

0215 I take a nap on top of the computer tower, because it is even warmer now.

0330 Nurse notifies me that I have not selected a tube treat flavor preference for my new admit. This is an embarrassing oversight and I thank her for letting me know. I pick tuna.

0345 I run frantically up and down the floors with no particular destination in mind. I yowl loudly as I do so. Some of the nurses join me.

0400 Nurse calling because our patient with a long history of Oxycatone addiction is asking for stronger pain medications. I thank him for letting me know. He asks if I have any further orders. I tell him no and hang up.

0401 Notified of slightly low paw-tassium level on room 302. Repletion ordered.

0402 Notified of slightly low paw-tassium level on room 303. Repletion ordered.

0403 Notified of a normal paw-tassium level on room 304. Repletion ordered per nurse request.

0405 Get on the PA system and ask the nurses to all just give 50 meq oral paw-tassium and leave me the hell alone.

0406 Notified of a critically high paw-tassium level on room 305.

0407 The entire nephrology unit is screeching in unison on the phone.

0408 Redact my PA announcement to exclude the nephrology unit from the universal paw-tassium repletion ordinance.

0410 Notified I did not order a diet for a patient who is undergoing surgery in 2 hours. I left it this way. The nurse is in tears.

0430 I take a nap, but this time on top of the filing cabinet, so no one can find me.

0529 One minute before my admission cut off, the EM resident comes crashing through the door with an admission. She does not know any vitals, has no lab results and has not finished coding the patient. She thanks me for taking the signout and leaves before I can ask further questions.

0550 I have finished coding and stabilizing the patient. The patient has everything failure, status post several ampawtations and does a lot of drugs. I have no idea what is wrong so I put in a consult for every single specialty we have. I write a note saying so, but with more words.

0645 I have finished my work and have only 15 minutes before I’m free to go home. I settle in to take a nap.

0646 The patient that I coded at the beginning of the shift is critically unstable, and no one from day shift has arrived early to take care of it. I take a big stretch (paws out, beans wide) and sigh.

0701 The day team arrives while I’m still in the room. The patient is still unstable despite me putting him in Reverse Trendelen-purr-g and giving him a 1 L bolus of Cat-tated ringers. I leave to go home.

0710 The nurse with the rumbling patient has found the vitals machine and calls me to read them out to me. They are all normal. I thank her for the information and ask her to call the day shift Paws-pitalist if she needs further assistance.

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