No sleep = severe crankiness

I have been blessed to recognize, since early on in my life, that sleep is a very big priority for me. I try to get at least 7 hours of good sleep a night. 8 hours is the very best, allowing me to perform at my maximum intellectual level. So what happens when I am on call and the resident sends me to bed at 4:30am and I have to get up at 6am for morning rounds??? Lets just say I am not very pretty (in any sense of that word).

Example: during morning rounds the Chief resident pointed to me and asked me a question. It took me a whole 10 seconds (of complete silence and everyone staring at me) to realize first, that he was pointing to me. I said "are you directing the question to me?" and he said "Yes". And then, after pausing for another 5 seconds, I said "What was the question you asked?" He then gave up and pointed to another student which I was entirely happy about. The funny thing about this whole conversation.....the Chief was also on call with me last night and was fully aware that my sleep was non-existent (as was his), so why he even thought of pointing to me in the first place was something I contemplated for almost 10 minutes after this whole exchange (which of course led me to miss the presentation of the patients in rooms 225A, 225B, 226A, and 226B). So, to start a list of sleep deprived issues...so far I have decrease in responsiveness, confusion, pre-occupation on things that are not relevant at that specific time....oh, and lateness, considering rounds started at 6am, and I arrived at 6:24. Although I could also classify that as an inappropriate behavior and non-caring attitude considering the fact that while I was in the call room staring at my watch thinking to myself that I'm late, I was also saying "I don't really give a shit, I was on call last night!!!" Of course if you truly know me, you realize that none of the above really even come close to describing me, which leads me to the conclusion that without sleep, I am a totally different person. So the moral of my story....sleep is very important for me!!

Last night we had alot of surgeries.....a small bowel obstruction, an abdominal bleed on a patient who had surgery to remove the gall bladder 3 days ago, and an appendectomy. I got to scrub in on the last case which started at 2:15am. The funny part....putting the foley catheter in. I asked the nurse if I could do it...she said yes, but insisted on "watching me". So, I put my sterile gloves on, cleansed the area and proceeded to place the catheter. The nurse then says "Are you sure you aren't in the vagina?" In my mind the answer to that was "If you knew me, you wouldn't have to ask me THAT question!!!" but what came out of my mouth instead was "I am positive I am in the urethra." Sure enough, urine was seen in the catheter tube (damn I know my anatomy :)

I also got to place some stitches in the patient. I used a subcuticular stitch: the stitch is placed just below skin level ( in the dermis) and is continued throughout the lesion. When finished, tension can be placed on the ends to bring the skin edges together. No visible suture marks are seen. I am still working on my surgeon's knot for tying purposes so I didn't have a chance to do that. But I'm confident I will have it down by next call!!

Well, that is it for tonight. I have breast clinic all day tomorrow and then Head and neck on friday. I hope everyone has a great night!