Osmolality, or How I Kept My Cool

Patient X has Q6 osmo's and sodiums. He's in the SICU, and I don't know/care what else he has. All I know is that during the night, the ICU nurses have ordered Q2 Osmo's and Na's. But they don't want them. Rather than simply cancelling the order in the computer, they simply turn us away all night long. No biggie since I'm asleep at home when this is happpening.
Change of shift in the lab. I get report that the ICU has been carrying on like this, but that they finally cancelled the Q2 orders. Patient X has a 0600 Basic Metabolic Panel which has included in it a sodium level. We do this, but for some reason the 0600 Osmo and sodium were cancelled along with the Q2 orders. Since the nursing staff now wants the tests Q6 at 0600, 1200, and so on, we need to reorder the osmo which we do. By the time we get to the floor to do a slightly late 600 osmolality, Mr. X has gone to CT. The nurse irately explains to the phleb that they don't want osmos except at 0600 and 1200. Wisely the phleb deflects the spittle from yonder moronicus giganticus. He hops on the phone and yells at me, 'Osmo's? We don't need no stinkin osmo's", well he would have if I'd been Gene Wilder in Blazing Saddles. He actually berated me for sending someone up.
I tried explaining that we were actually trying to perform his precious 0600 Osmo, but that the patient had been in CT. Since it was 0715, and the patient had returned, I felt it requisite to draw the blood as ordered. He stammered incoherently and tried to make me understand, using his best patronizing tone, that he only wanted them at 0600 and 1200. Yes, massah I replied. I then reached into the phone, and dug my finger into Nurse Moronicus' ear. Feeling the wrath of the lab, he backed off, and apologized. I told him that we were doing the best we could to comply with their orders, and that if he wanted an 0600 osmo, he would have to let us draw it. If not, we'd be more than happy to cancel it. My cool, impassive mien and unflappable Harrison Ford voice let him know who really was in charge. He might be all bluster, but Cool Hand Lab Man wasn't takin' no crap from nobody, nohow.

editor's note: In the interests of factual accuracy, Lab Man was in fact exquisitely polite, did not physically harm the nurse, and the situation resolved itself peacefully. Had it not been so, there would have been a Wild West showdown in the halls behind SICU. We all know who would have drawn his pearl handled six shooter fastest too.....

Descent from Cloud 9

Now the high is wearing off. I keep surfing SDN every day, posting on the allopathic boards that I can in good conscience frequent. I'm trying to figure out where we can live, which neighborhoods to avoid, but which are an acceptable distance from SLU. Never having lived in a big city in a non-missionary capacity, I don't really have what you'd call "street smarts". There are quite a few of my classmates on SDN, we'll see how long we can remain anonymous. It appears that classes are beginning on August 13, but that the white coat ceremony is on Aug 5. I think that mindy and I are going to move in late june, but spend a few weeks at camp before driving down to St. Louis for good.

I sent my acceptance of their acceptance in as soon a humanly possible. Two days later I got a letter saying I was enrolled in the class of 2011 at SLU!!! I'm still on Cloud 9, and I keep saying "I'm going to medical school" because it doesn't feel real. I can't really fathom it all right now, since it's been occupying most of my waking hours for the last 3 years. It hasn't really sunk in that I have been accepted.

SUCCESS!!!!!!!!!

OK, here's the skinny. I"M going to be a doctor!!!! I got into Saint Louis University School of Medicine today!!!!! I have to retro post a lot of stuff, but I'm going to be a doctor!!!!

Verbal Exchanges, problem solving.

So, in my post a few minutes ago, I was bemoaning my lack of verbal problem solving techiques. I have only to cast my mind back to thismorning when I was conversing with a nurse on the phone. She was calling regarding a hemogram on patient X in PACU (post-op in other words). Here is a transcript of what I said, more or less.
Nurse: I'm calling about a hemogram on Mr. X, it was drawn about a half hour ago.
Me: (looking in computer for info on X's labs). Was it the one we drew at about 1211 ? (this exchange is occuring at 1240)
Nurse: NO, it was the one half an hour ago!
Me: (short puzzled silence, since there was no trace of sarcasm in her voice). Well, let's look at the hemogram from 1211.
Nurse: I want the results! All it shows in my computer is that the specimen is being processed!
Omnitient narrator: When LastWord, the nursing program for tracking and entering patient data, including labs, shows "in process", it means that the specimen is literally being tested at that very moment, and that nothing can accellerate the testing process. Once a hemogram is on the machine, no amount of righteous indignation will speed the test!
Me: ( looking directly at the results in the computer), Well, I'm showing that not only has the spec. been processed, but it's been resulted.
Nurse: (Fury with the insufferable puke at the other end of the line showing in every word), Well where do I look for results!!!!
Me: (trying to be diplomatic, but barely containing my mirth at her incompetance). I don't use LastWord, you might try looking where you would otherwise normally look for lab results. ( I said it this way because I was sure that this wasn't the first time she'd looked up a lab. It was quite a gamble, I know, but I thought it worth a try.)
Nurse: (looking at her computer presumably). Oh! there they are. thanks.
Me: You're welcome. Please, do me a favor and try to reign in the temptation to squawk angrily when you're in the wrong.