Sacrificing sleep

One of the big differences between working nights and days is sleep pattern. I don't know what other night shifters did, but I would get out of work at 7 a.m., go home, eat, and go right to bed. This allows me to get up whenever I want, and rarely do I ever set my alarm, nor sacrifice sleep. I just kind of get up when I get up.

Working days is quite the opposite. After I work a day I get out of work at 7 p.m. and when I get home my kids are up to greet me. So I spend the evening playing with them, and then prepare them for bed. So obviously I'm not going to sleep right away. This kind of forces me to have to set the alarm clock, and perhaps get up before I'm ready. Which can make for a long day.

However, at least when I'm allowed to sleep during the night, when the sun is down and it's cooler outside (especially in the summer months), I sleep better. When I worked nights, it was often hard to sleep well during the day. So I'd often be extra tired at night.

Now that I work days I like to get up really early. I'm not the kind of person who likes to let the alarm wake him up, hit snooze 30 times, and then rush to work barely making it there. That's not me at all.

I like to get up at least an hour and a half before I have to go in, have a cup of coffee, eat breakfast, smoke a cigarette or two (just kidding), prepare food for the day, and play on the Internet for a while. It's kind of an easy pace morning, and then I go to work early enough so I have time to sort of ease into it.

Today I got up at 4:00 a.m., which some may consider a bit early since I don't need to be to work until 7 a.m., yet it was nice to be able to spend time doing this, and not have to rush. Yes I'm tired, yet slept pretty well. I sacrificed an hour of sleep, yet to me it was worth it.

How do you guys prepare for your long shifts?

I'm sleep deprived, but not a slacker

A coworker (not in my department) lectured me recently because she thinks my work is being effected by lack of sleep. She came to this conclusion after having a discussion about me with the nursing supervisor on duty a few nigths ago after I was asked to assess a patient.

"The patient was fine when I assessed her, and she was not in need of any respiratory intervention," I said.

My coworker said, "That's what you say, but the supervisor and I decided you weren't at the top of your game because you were overly tired."

"Why did she say that?"

"Because during the next shift the patient coded and died."

"I'm sorry, but when I assessed her she was fine."

And she was. I auscultated her lungs, and noted in my charting no change from previous assessments. The patient was mentally sound, and showed no such mental changes.

"Well, you need to be careful, and you need to get more sleep."

"Yes maam," I said. She proceeded to lecture me another ten minutes or so, and I stood there like a 1st grader in the principal's office after melting a wax crayon on the heater.

The truth is, it doesn't matter how much sleep I get prior to coming to work a night shift, because I suffer from what a lot of night shift workers suffer from: Chronic lack of sleep.

There is another word for it, "Circadium Rythm Sleep Disorder." When you have this problem you either don't get enough sleep (chronically) or you sleep and you don't sleep sound enough for it to make you totally satisfied.

Either that, or you never quite get caught up on your sleep. It's a chronic disease and it is a documented disorder for people who work nights. And I can honestly say it has never effected my work... PERIOD.

In fact, that patient crashed the next day and it was totally unrelated to what happened to her the night in question. Even if I had foresight and could predict when a person would crash, I couldn't have stopped her event from happening six hours after I went home at the end of my shift.

In fact, the patient coded following surgery that day. So, according to the night shift supervisor, I could have prevented this if I had been less tired. Then again, my assessment must not have been too far off, because both the Internist in charge of the patient, and the anesthesiologist, and the surgeon all approved the patient for surgery.

I wonder if those doctors were lectured about being too tired. Yes, I admit to being chronically exausted (which may also have something to do with having three kids, one of whom is nine-months old, at home), but it does not effect my work.

And yes I do "humor" about stupid doctor orders. But when it comes to taking care of my patients, my patients get 100% of my attention and RT experience. And I don't care what that stupid supervisor says.

Yes I'm sleep deprived, but I'm not a slacker. If there was no thing as politics, I probably would have said that to my boss, and sought out that supervisor and said it to her too. But, being the professional, laid-back, polite, humble, person I am: I said nothing. I bit my lip and said nothing.

Shouldn't have been, but t'was one of those nights

Just to give you an idea of how my night went last night I'm going to post here my tweets from this morning.

1. Finally a night with no patients on the floors, but unfortunately Dr. letsordertxsoneverone is working in the ER
2. Since when does croup get treated as asthma. I'll have to do some research on this. She orders Q30 Xopenex for stridor? Huh?
3. now the croupy kid is going home with a nebulizer. Talk about wasted healthcare resources.
4. I don't think Dr. Q1 has a clue what she's doing. This is getting to be a joke. And they want me to take my job seriously.
5. I almost lost my cool when that last order was written. I did if you count rolling eyes at Dr. Q1 as loosing coolness.
6. They have to beg to get Dr.s to come here to this small town. That explains why we have to put up with reject Dr.s who have no clue

To call the Dr. or not to call, that is the dilemma

Here's something you will come across from time to time if you work nights. Of course as all RTs may have noticed by now, there often seems to be no rhyme or reason to "some" doctor orders, nor consistency to how a doctor will respond to a request to change the order.

Consider the following example:

The patient is a 75 YO non-COPD post operative patient with a registered SpO2 of 88% at 3-o-clock in the morning. Mind you, I did say three a.m. The patient is in no respiratory distress, and has no respiratory history. Otherwise, his vitals are normal. The order is for 2lpm. What do you do?

1. Call the doctor and wake him up
2. Increase the oxygen to 3lpm and have the RN call the doctor in the morning
3. Ignore the spo2 and pretend you didn't see it as the patients SpO2 probably always drops while he is sleeping
4. Since the SpO2 has an accuracy of plus/minus two, assume actual reading is 90%

Okay, what's your guess?

Day #1: This night the RT decides to use his common decides "b" is the best solution. The patient is stable and no harm done. If the patient's SpO2 was at a critical level, then a call to the doctor would be warranted, but not in this case.

The next day when the RT arrived at work he was lectured by said doctor who said, "Why do I write orders if you're not going to follow them?"

Day #2: Different patient but same information; different doctor, but this doctor is the spouse of the doctor in the scenario above. What does he do now?

Using the same choices above, since the RT now knows option #2 is not good, he decides to go with option #1 and wake up the doctor. The doctor says, "Why the hell are you waking me up at 3 in the morning to tell me this?"

"Um," says the RT, "Because yesterday, same scenario, your husband told me that I have to call before I increase oxygen to get an order."

"Oh," she says, "Well, then increase it to 3lpm and leave it at that."

"Well, then can we..."

Click. The doctor was no longer available.

"...get an order for protocol just in case... oh, what the heck.

So, what is the best thing to do in a scenario like this? Well, based on my experience, you're damned if you do and damned if you don't, so you might as well wake the doctor up and let her lecture you about how idiotic you are.

Thus, RN Cave Rule #72:

If you think you better call the doctor you better call him. If you think the doctor might yell at your and tell you you are an idiot because he doesn't want to be irritated in the middle of the night, call him anyway.

Here we are working on our holliday off

HAPPY 4TH OF JULY EVERYONE!!!

Today might perhaps be my last opportunity to complain about the holliday work schedule, because Jane Sage has informed me that she will retire sometime between November 1010 and March 1010.

So, chances are, for better or for worse, I will be going to days and then I will be able to have every other holliday off like everyone else.

It's funny that today is supposed to be my holliday off and here I am at work, and it's been busy tonight. My heart just isn't in it. I am having trouble being joyful as I plop that neb into the mouths of people who are not short of breath. It's hard not to grumble every time my pager goes off.

I figured tonight would be a good night being a holliday and all, but that hasn't been the case at all as my pager has gone off every 15 minutes all night. In fact, it just went off agian. This time it says: "Come down to ER and play in 2-3 minutes." Hmm, who know what this will be.

Dog gone it, now it's beeping again... "Come to ER please!" I guess they're getting impatient. Be back...

Turned out to be a false alarm. That's good.

So, here I am working on my holiday on. I don't know how they do the night shift Holiday schedule where you work, but here at Shoreline the Holiday is the night before the Holiday, and the 4th of July is not considered the Holiday.

While all my friends are enjoying a picnic, and... oh, about a half hour from now the fireworks, here I am.

I don't really want to work days, but it sure would be nice to have the holidays off. And it's not even about me, because my kids would sure love their dad home for the holidays.

That aside, HAVE A GREAT 4TH OF JULY! And I'm going to go out now and get all my 10:00 treatments done as fast as I can so I can watch the fireworks from a window in the critical care. Chow.

It's finally slow again.

The hospital industry might just be the most unpredictable of any industry in the world. Of course I'm saying this as a person who works in the hospital industry and hasn't done much of anything else.

Yet, so far this year, Shoreline Medical has gone from extremely slow, to swamped, to slow again. And I can tell you something with utter honesty: when you go from being swamped to all of a sudden being slow, you appreciate every moment of slowness. That's a fact I won't back away from.

Normally my work doesn't effect my home life, but we had a three month rush that was so bad here I had no energy to do anything at home. If there were dishes sitting out I might just leave them out and let the wife gripe at me because I'm sitting around doing nothing but watching TV.

And, with children at home, that's saying a lot. When you have kids, and your wife is watching those kids for five straight days while you work long hours at night and sleep all day, she becomes weary eyed and very eager for an adult conversation and some help around the house.

Yet, after five days of hell at work, the last thing I want to do is anything more than the minimum when I'm on my days off. It's hard. It's the hardest part of this job as an RT. I would hate to work at a larger hospital that is THAT busy all the time. To come home every day with achy feet and weary head would make for a long life.

The last two days, however, were so slow I basically sat around and talked all night, or read books, or surfed the net, or blogged, or cleaned out my locker. It was nice. And, trust me, I appreciated every minute of sitting around. Not for one second was I bored.

I think one of the reason I appreciate it so much is you know -- in a heartbeat -- the good times could end. In a way, the way I felt the past two nights was not unlike a marathon runner in the moments following the race -- relief, joy.

So, for the first time in 12 years, I get to take a scheduled night off tonight. Even while I slept until 5:00 p.m. as I would if I were to work, I think I'm going to go to bed at a regular time tonight, which is right now: 10:16 p.m.

Have a great night

You know it's time to go home when....

....you just finished hooking up a patient to the EKG machine and, as you go to type in the patient's information, you realize you are in the wrong room with the wrong patient.

Oops. No harm done.

That's about how crazy it's been around here lately.

'Nuf said.

3 types of lethal arryhthmias

Dear RT Cave readers:

I promise I will write something useful soon. It has been extremely "swamped" where I work each of the past six days. We have one vent right now, but we have had up to two on many of the past several days.

And, if I am not mistaken, I have had at least one BiPAP ongoing all 6 of those days, and have set-up at least one BiPAP each of those nights. And add to this ten regular patients on bronchodilator treatments (perhaps three of which actually need them).

And then you have to add constant calls to the ER. And, of course, you have to note that I am the humble night shift RT here at Shoreline medical, so that means I did this all by myself.

Oh, and you also have to add to that some one in in my department has been a god awful something that rhymes with twitch and starts with a b minus the tw. You can figure that one out. I swear you can have a million more important things to do, and
this person still finds something to nag about.

Whoops, I'm not supposed to complain anymore. Oh, and I forgot that we (I)had an RT student last night too for the first four hours of my shift. And since I love to teach, this kind of added another responsibility to my long list of things to do.

We RTs here at Shoreline like to share our RT humor with our students. Albeit they often aren't sure if we are joking or not. Last night the day shift RT (The sagacious Jane Sage) educated them on the three basic types of lethal arrhythmia's you should be able to recognize on a rhythm strip or EKG.

These Lethal Arrhythmia's are:

1. Too fast

2. Too slow

3. Oh shit

Have a great weekend. And, oh, as soon as my energy level returns to, say, the 50% level, I will write something useful on this blog. So bare with me.

Sincerely:

Rick.

What % of night shifters do not drink coffee???

I read a post in Time magazine about coffee. It was a long article, so about half way through I nearly quit. The part of the article I read talked up coffee to the point I was thinking I should start drinking it.

Then, for some reason, I decided to read the rest of the post. I'm glad I did, because it brought me back down to reason. Sure, coffee is a natural drug that has many benefits. It does make you feel good. It improves your alertness and mood. It has even been proven to decrease depression and anxiety.

However, once you drink it for a while (get addicted I might as well say), it takes 1-2 cups of coffee just to get up to the happiness of a person who doesn't drink coffee. And then you have to have 2 more to get the happiness (or wakefulness) you used to get with one cup.

So, I decided, I might as well continue not drinking it.

That in mind, I wonder what percentage of night shift workers drink coffee? I'm quite certain I'm in the minority as a non-coffee drinker.

Perhaps a poll is in order. Still, I bet I'm in the minority as one of the few night shif workers who do not drink coffee.

Here is how and why I work nights

I received quite a response from my last blog post from people wondering how I manage my sleep schedule when I work nights. When I have a day off, do I stay up all night? Are you tired all the time?

Basically, I like to tell people that there are ten things I love about working nights and 1 thing I hate about working nights. You have to decide what's more important, the 10 good things or the one bad.

The ten good are bsically all the opposites of the list I made in my last post, "Reasons I do not want to work days." The good are as follows

1. no bosses
2. no doctors and few new doctor orders
3. you can do what you want in your down time
4. you don't have to work around meals
5. you can park wherever you want
6. you don't have to work around ancillary services like X-ray and physical therapy
7. patients are usually sleeping
8. all the snobby nurses work days
9. Charts and computers are easily accessable
10. We have fun on nights

The one thing I hate about working nights:

1. Lack of sleep or being tired all the time

To me, the 10 good things are more important to the one bad.

I guess what it comes down to is that there are things that I place as more important to me than getting a good nights sleep. For one thing, since I work at a small town hospital, there are times when it is not real busy. During these down times, during the day, there is no place to hide. I hate that.

I walk over to the nurses station and I can't even get to a chart or a computer because there are so many people there. Then you go to do your treatments, and the patients are eating. So, now you have nothing to do. So, do you go back to the department and hang out with the administrators and the RT bosses.

I have no problem hanging out with these folks, it's just that once the initial conversation is over, what do I do? I most certainly don't want to sit there and read a book, or play on the Internet when all the bosses are around. It's not that I think they would care that I do that stuff, it just wouldn't seem right to be playing when the bosses are working so hard. I think this has something to do with my work ethic more than anything.

So, I wander the hospital looking for things to do. On nights, I never have that problem. On nights when it's slow, I can play on the Internet or read a book. I can socialize if I want to, or I can hide out in the waiting room and watch TV. During the day, you wouldn't dare hang out in the waiting rooms.

To me, what I do during my down time is much more important than how much sleep I get. I would rather be tired when I work than spend my whole morning trying to decide what I'm going to do to entertain myself.

That in mind, how do I sleep? Well, that's easy when I work. If I work, I go home at 7:30 a.m. and by 8:30 I am in bed. I usually sleep until I get up. Never do I set an alarm to wake me up, I just sleep until I naturally get up. And that in itself is an advantage to working nights.

When you work days, you get home from work and you stay up until about 10 or 11. Then you go to bed and set the alarm so you HAVE to get up by at least 6:00. When you work days you can't sleep until you naturally get up. I hate that. In that sense, working nights is much better.

In fact, I actually feel that I sleep better when I work nights than when I work days.

So, how do I manage sleep on days off? On my first day off, I go home at 7:30 and hopefully I'm in bed by 8:30 or 9:00, depending on whether I have to get the kids to school or not. Then I sleep until I get up, which on my days off is usually any time between 12:30 and 3. I usually don't sleep as long as when I work, because I like to be tired when it's time for bed at night.

Then, I go to bed when my wife does, which is usually around 11:00 and I hope I sleep. Usually I find myself getting up at 2 or 4 in the morning the first few nights. Usually, it takes 3-4 days to adjust. But I don't care. Remember I made the decision I'd rather be a little tired all the time than have to hide when I'm working. I'd rather be a little tired and be allowed to do what I want during down times.

The catch here is that you want to make sure you don't have some crazy schedule where you work one on one off one on one off two on three off three on two off one on one off. Those kind of schedule don't work well for night shift workers. Ideally, you want to work a bunch of days on and have a bunch of days off.

The reason I say this, is that 1st day off is pretty much a recovery day. You are exhausted that day so you can sleep during the night so you can sleep normal the rest of your days off. So, if you only have one night off, it's pretty much a wasted day off. This is something that the person doing the scheduling must understand, so he or she can have empathy for the nocturnal workers.

If, on the other hand, that scheduler has never worked nights, or has no empathy, then you might get stuck with a crappy schedule. I, on the other hand, have an awesome schedule. I work a bunch of days in a row, but never more than five in a row (because working too many days in a row stinks too). Then my days off come in bunches.

I don't know about other night shifters, but usually it takes me about three days to get back to a normal day schedule. So if the last night I work is Friday night, by Tuesday I feel normal enough to get some work done around the house. Before that time, I'm lazy. I sit around playing Madden 2009 with my son. I play on the Internet. Overall, I'm not social at all. In fact, I suppose I'm rather boring on first three days off.

Now, before I worked at Shoreline I used to work at a larger hospital in the big city, and during the night there were also down times. It's funny, but during this down time we would pull chairs together and take naps.

My point is, no matter where you work, working nights is far more enjoyable than working days -- in my humble opinion.

Reasons I do not want to work days

Every once in a while I get this crazy idea that I'd like to some day go to days. So once a year I work a day to remind myself why I work nights.

So, that in mind, the last time I worked a day I created this list.

Reasons I hate working days:

1. You have to go to bed early.
2. You have to get up early.
3. There's nowhere to park.
4. When you get your work done, there's nowhere to hide.
5. You have to work around breakfast.
6. You have to work around lunch.
7. You have to work around dinner.
8. You have to work around physical therapy.
9. You have to work around x-ray
10. You have to work around baths.
11. You can never access a chart.
12. You have to deal with all the doctor's orders.
13. Everybody's awake and want their treatments.
14. Patient roulette. That is, you have to deal with patients being shuffled room to room.
15. There's always some nurse who should have retired years ago.
16. The annoying, egotystical RNs who used to work nights with you are now working days.

The Dragons of the RT Cave

I feel bad for you that you have to come back to this place, because it's terribly busy.

Despite that omen from one of my co-workers, it has not been busy at all this weekend. In fact it's been wonderful. And, considering I was prepared for a miserable night, I'm enjoying it that much more.

I don't know if I ever mentioned this before, but the Dragons of the RT Cave wake up early to guard the cave. I usually grab my stuff and run when it starts to stir, and pray it doesn't use it's telekinetic powers to find where I'm hiding.

I have no clue why it wakes so early, but when it does I can smell it. Personally, believe it or not, I like our dragons. They're tough, but they hold down the fort rather well. Still, one of the perks of working night shift is you don't have to deal with dragons, as I write in one of my banner slogans, "the dragons are sleeping at night, if you know what I mean."

And keep in mind that not all dragons are bad. We actually have pretty tame dragons here at Shoreline, and they do a pretty good job of keeping us proles in line, and making sure we have all the best technology to work with. Still, a dragon is a dragon.

From Monday through Friday, however, our dragon hops is sniffing the grounds as early as 2 a.m.. So that means I have to pack up my bags and head to better Pasteur's. Well, I suppose I shouldn't say better Pasteur's as our dragon is quite friendly. It's just that a dragon is a dragon no matter how small, and dragons can get mad and rip your head off, or burn you good.

I used to hide out because it tried to eat my head off every time I got close to it, or so I thought anyway. Every time I forgot to dot an i or cross a t it was right there breathing it's fire hot breath over my head -- breathing fire. While some night shift RTs still fear it, not me anymore. Still, it's good to be wary.

Since those days of long ago, the RT dragon and I have helped each other out enough times now that we are on good terms. Still, having been away from the patient floors as long as it has, it's developed that business mentality -- forgot how it is on the floor per se. And, you guessed it, everything has a monetary bottom line. It has grown it's scales. Now it's a full grown dragon.

I don't make many mistakes anymore, but occasionally I still get a note, or, if I happen to be working when it finds out I did something incorrectly, a telepathic call at. Mainly the goofus mistakes are minor things, but a mistake is a mistake no matter how small.

Recently I left a blood gas syringe by the ABG machine.Could the dragons let this one little slip pass without letting me know about it. No. The lab dragon sent a fireball with a message to the RT cave dragon, who snarled and waited for me to be working so it could call me at four in the morning to let me know about it.

But that was last week. Yesterday I'm sitting in the CCU with Scooter the RN, and my beeper goes off.

Just one morning, I think to myself, just one morning I'd like to go without getting a page from the RT dragon. Not that I don't like it, nor that I can't get along with the dragons, because I do, but it's 4:00 in the morning and I'm tired. Doesn't it get that? This is the time of the morning I just want to do my work or, if I have my work done, just sit around. I don't want to be quizzed.

Like a good boy, and wanting to stay on good terms with it, I picked up the receiver and dialed the extension to the RT cave.

"Hello," the dragon said.

"Yeah, this is Rick," I said into the receiver.

"Hey, Rick. No you didn't do anything wrong. But when you get a minute can you come talk to me."

"Sure, I'll be right there." I hung up the receiver.

"Was that your dragon," Scooter said.

"Yep."

"Well, you said it'd call you right at four. You have it pegged."

I laughed. "Yep, you're right." But I don't wanna go. I just wanna stay here and chill.

But, like a good peon, I left the unit and walked through the hospital to the RT cave. As I walked through med-surg I could swear I could smell that a dragon was here. I could feel it; sense it. It has telekinetic powers after all.

"So how was your night," it said as I approached the entryway to the cave.

"Oh, it wasn't too bad. Actually, it was very slow compared to the last several days I've worked. It was a great break."

"That's too bad," it growled, a puff of smoke billowing from its flared nares. "We need to make money, and we don't make money when you're not doing anything."

I had already been up 24 hours, so I had developed that 2 a.m. loose lipped mentality. I said, "Well, it's one thing being busy, but when we're busy doing a bunch of useless breathing treatments it makes me twice as burned out as if I were actually using my brain."

I followed the dragon around while it unchained the doors. It didn't snap around and throw a fireball at me, so I knew I was still in the good, even though I had more than likely crossed the line with my honesty. I never would have done that a few years ago, but, like I said, I was on good terms with it now.

"I think there are a lot of people here who no longer come to work because they love their jobs. They come here just to get a paycheck. When I used to do your job, I used to do it because I loved my job."

I was NOT going to touch that one. (However, my lack of comment here still haunts me today. This is one of those times where I thought of a good comeback after the conversation was over. I will write about this tomorrow). "I love my job, boss." Am I being political by saying that, or truthful, I think.

"I know you do," it said, "but I think that a lot of you guys are just too complacent lately," she said, "I think it gets slow, and then you guys forget how to work." It stopped and looked at me. "Not just you, but all you guys in general. Those treatments are how we make money. "

"Well, boss," I said, "I don't have a problem working, it's just that if we're going to be doing useless breathing treatment just to make money, I think they should be done during the day when there are two RTs on."

It turned around. I hit a button. Smoke was puffing from its little nares. "It's not just you, but all of you guys have been making a lot of little mistakes lately. Here, I'll show you."

I followed it into the dark cave through a corridor in the back. It was dark and horrifying back there, but I followed her anyway. In a way, being in here reminded me quite often of being in the principals office. I watched as it shuffled through papers on it's desk

"Here, see." it grabbed a stack of paper, flitted through them so I could see all the notes and who they were left for.

"I see that even Dale has made mistakes."

She flitted through the stack again. "Yeah, he's made several."

"Oh, I thought he was perfect."

"None of you guys are perfect."

"Well, it seems that's what you bosses are trying to make us out to be." Of course I won't call them dragons to their faces. That would be a violation of one of the RT cave rules. "Look, boss, we aren't' perfect, we are going to make mistakes."

"Well, you shouldn't."

"At no other hospital I've ever worked at did I ever receive one note, and I know I screwed up many times. I guess the feeling there was, if I make a mistake, and I have to go to court, then it's on my shoulders."

"Well, I guess we have higher standards here."

"I know. We do. And I think it's good. But I think sometimes you guys go overboard. Look, you guys got Paul and Steve up on the edge. They're to the point they hate you. I mean, I know it's not you, you're just doing what you're told, but since you're the one leaving all the notes, you're the one they are going to hate."

"My boss," she said, "makes me do this. He wants me to keep track of every note I write, and if I write six notes then I have to write you guys up for now on. That's why I called you here. I want you to be more careful."

"Boss, if you do that, then you'll have to fire us all. We aren't perfect. You're just opening up a can of worms."

"Hmm, worms, that sounds delicious," said the dragon. Just kidding. She said, "I just do what my bosses tell me."

"Well, if you write us up for every notes, then that means we'll get a verbal warning, and then, the third time, we get fired. By the end of the year you'll have a 100% turnover rate of RTs. We'd all be fired."

"Why is it you have to argue with everything I say." She beamed at me. I jumped back. There was no fire, but I could see it was close to exploding.

"I don't mean to, but we have a right to disagree with you. There's more than just one opinion in this department, and I think we are having a good discussion. There's no way you can make progress, in my opinion, without discussing. Don't you think?"

"You have a good point."

Whew. "Well, I think your bosses should come down here and work like we do, and they'd see how not easy it is to be perfect. They are so far removed from the real work, it's easy for them to make such frivolous policy for you. If they had your job, they wouldn't do what they make you do. "

"That's very true. They wouldn't. And, when Gary had my job, he didn't do any of this. He has me going over every chart, every day, writing down every little mistake I find. It's very exhausting, especially when I have to hear it from... well, not you, but Steve and Paul."

"Gary only has you doing all this stuff because you act as a shield. When us RTs get mad at you, you get the brunt of the spears. Your bosses feel no pain."

"Wow," she said, and smiled. "You hit the nail on the head."

The RT Dragons: They are abounding.

Preparing for a busy night, hoping for a good night; and a brief review of the new Underdog movie

Another nice thing about working 12 hour shifts is your wife can work on your days off and you get plenty of time to spend with the kids, and they never have to go to day care. Then again, there are times when I only see my wife in passing.

After working 12 last night, she trudged into the house this morning with red eyes, slurring her words, and she said, "Sarah said she feels bad for you. She said it's so busy that she had to have someone come in at two in the morning to help her."

"That bad, hey," I said.

"Yep. As she was talking to us she was paged three times."

After driving the boy to school, my wife went to bed and was out almost instantaneously. That left the girl and I home alone, and we decided to watch a movie we rented called Underdog.

Many of you probably don't remember that old cartoon, but back in the day when cartoons weren't on 24 hours a day, my brothers and I used to look forward to Saturday so we could watch cartoons all day. We would even sacrifice sleep and get up early.

At six in the morning we'd sneak off into the livingroom, click on the boob tube, and watch either Bull Winkle, Johhny Quest or Underdog. We loved those shows, however simple they were. They were good entertainment.

Usually I find myself disappointed when Hollywood gets a hold of a classic. When I was a kid I loved the Dukes of Hazzard, but when I took my son to see the movie I found myself wanting to leave the studio after there was sex in the first scene. I suffered through it. I hope this experience didn't scar my son for life.

I expected the Hollywood version of Underdog to be equally disapointing, but it turned out to be pretty good. It was, in my opinion, very fair to the original show.

Fortunately for this RT who has to work all night tonight, my daughter is still at that glorious age where she likes to do the same thing over and over and over and over and over again, and still get the same enjoyment out of it each time.

That in mind, I'm going to put Underdog back in, turn the volume down, and try to take a nap. Sometimes this works with four year old girls. However, sometimes she likes to make sure I'm alive every ten minutes or so by giving me a big kiss and saying something like, "I love you daddy."

Whatever kind of rest I can get, I'll take it, especially considering I'm not rightly looking forward to going to work tonight. And being my first night back after my bi-weekly mini vacation, I'm bound to be awfully tired.

I can handle it, though. I'll just put on my running shoes, plan for the best and hope for the worse... er, plan for the hope and... well, you know what I mean: prepare myself for worse and hope for a good night.

Ever dread going to work one more night?

Do you ever have a day you simply dread going to work? That's about where I sit right now as I write this. My wife worked last night, and she said it is a complete zoo there. And she was not referring to OB, even though they too are busy.

I do feel a certain amount of joy that I will be needed. And I do feel joy knowing that I will provide a solution to some person's problems tonight, be it a patient or a nurse or both. I do feel joy in knowing that I will be really working tonight and earning my keep, as opposed to those many days recently where I had so much time as to watch several TV shows on the Internet.

However, I dread the idea that I will be beeped every time I sit down to chart, and I dread the idea that when I sit down to chart again I will again be paged, and when I sit down to chart again I will be paged. I know this sounds redundant, but that's exactly how my nights have been lately.

I have already promised myself that no matter how frivolous the reason for paging me is, I will not complain. I will be happy. I will smile. (fingers crossed)

Well, I say that, but we'll have to wait and see. Usually when I get irritated at getting paged for stupid things, like a treatment that is not indicated, or an EKG on a patient that came in because she stubbed her toe, I grumble and gripe to myself if at all, and by the time I get to my destination I never say anything to the nurse.

And, expecially when I enter the patient's room, I know that I left my attitude, if I had one, at the door. I'll have to remind myself about this more than once tonight, as I still am burned out from the weekend from hell. And we had a wee bit trouble sleeping last night after sleeping until 1:00 yesterday. Whoops. I shouldn't have done that.

Oh well. I can say oh well, and I can rest pretty assured that I will stay in a relatively good mood tonight if only for the simple truth that I know I will not have to return to work tomorrow for my regularly scheduled final night before my six day off stretch. I say this because tomorrow I'm taking off so that I can leave for Florida Friday morning. Yippee.

Yet, a part of me still dreads that I have to work one more night. The burned out sensation that runs through my veins and has worked its way to through my muscles to the core of my bones, especially in my feet, wants me to stay far, far away from that place.

Songs like "One More Night," will rail through my head, reminding myself that it will be over soon. But soon, sometimes during hellish nights, seems like a long time while it's happening.

Do you ever dread going to work like that? I'm not talking about hating your job, but just wishing you could take that final day off, like a Friday per se for people who work normal eight hour shifts with no weekends.

Ever? I bet you do.