Weekends at Bellevue Read Online Free PDF Page A

people who got tired of waiting for the social worker and just left without picking up their belongings, or if they were never actually deemed safe to be discharged but have somehow managed to escape.)
    After I have figured out how many patients are in the CPEP and where they’re likely to end up, I see how the staffing looks. Do I have any medical students rotating through here tonight? How many residents are here, and are they first-years or second-, slackers or stars? Most important is which attending—which doctor in charge—hasbeen working the shift that immediately precedes mine. This will establish whether I have a mess to clean up or whether things have been left in pretty good shape. Sign-out is the changing of the guard between the attendings. It will occur whenever the departing doctor has the time to sit down and run the list, discussing every patient in the area. Often, there are many loose ends to tie up before that can happen.
    A busy Saturday night for me is twenty-five or more patients in the CPEP, or more than five on triage. If there are a lot of triages, I won’t wait for sign-out. I will just “glove up and dig in,” as they say in medicine. (This saying is medical jargon for manually dis-impacting a constipated patient, but it has morphed into meaning “suck it up and get to work.”) I will grab a chart and see any patient who has already been triaged by a nurse and looks like he could be a quick T & R, which only involves writing up the interview and a discharge order, considerably less paperwork than the other dispo plans, since there are no legal forms or admission orders to fill out.
    When it is less busy, the first order of business is, “When’s dinner and where are we ordering from?” This was especially true during the months at Bellevue when I happened to be pregnant and took “eating for two” very seriously.
    The nights tend to progress smoothly. The on-call resident and medical students see the triages, and then present the cases to me. I help them decide who stays and who goes, and I check over all the paperwork to make sure the admissions get packaged for transfer to the upstairs wards. By one a.m., I usually turn in, letting the resident run the show in my absence. I am available for phone calls and consultations, both by the second-year resident in the CPEP and the third-year who is doing consultations upstairs in the rest of the hospital. The attendings in the medical ER often call me as well, to let me know they’re sending someone over to CPEP. I usually sleep about five hours or so, though it is interrupted by multiple phone calls, and occasionally I need to go across the hall to deal with some problem or fill out restraint orders that require an attending’s signature.
    I don’t usually eat like a lumberjack, but on Sunday mornings I make an exception. It’s the middle of my Bellevue weekend, and I like to treat myself. Short stack, two eggs over easy on the side, sausage split. I’ve developed little traditions as the years have gone by, and the men behind the counter at the Bellevue coffee shop, with their easy grins andmischievous eyes, have kept up with my preferences. Their pancakes are legendary among the ambulance drivers and police officers, and their prices are so low even the panhandlers can sit down to a good meal.
    I bring my breakfast back to the CPEP and give sign-out to the Sunday morning attending and the moonlighting residents hired to work the weekend day shift. By ten, I am out the door for my eight hours off before I drive back into work Sunday night and do it all over again.

Hello Goodbye
    M y oatmeal with sliced banana and my lousy Bellevue coffee are lined up in front of me on the counter of the nurses’ station. I spend a few minutes opening and sprinkling the sugar packets into the two matching paper cups, one filled with brown liquid, the other with brown solid, waiting for the other doctors, psychology interns, and social workers to