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24 Hours On Call
MON 9:52PM One of the team's patients has cystic fibrosis (CF). Ryder explains
that CF patients "have very tenuous lung status, so [we] try and isolate them as
much as possible." Staff follow rigorous CF infection-control guidelines to avoid
spreading germs among patients, since the respiratory secretions of CF patients can
contain drug-resistant pathogens. For example, caregivers always wear a surgical
gown—like the one Ryder has on here—when they go into a CF patient's room.
DHMC houses the New Hampshire Cystic Fibrosis Center, which is accredited by the
Cystic Fibrosis Foundation. At DHMC's center, a multidisciplinary team of physicians,
nurses, physical therapists, respiratory therapists, nutritionists, social workers, and
psychologists provide comprehensive care for CF patients and their families.
MON 10:03PM Ryder has stopped
in a hallway to comfort the patient
who is being transferred to her unit
from the PACU. "I wanted this
patient to stay in ICU [intensive
care unit]-level care," says Ryder.
However, there are no ICU beds
available right at the moment.
MON 10:25PM Ryder is reading
an electrocardiogram for the patient
from the PACU while she's talking
on the phone with the hospital
official who is tonight's designated
administrative coordinator on site
(ACOS). The ACOS, a nurse supervisor
who sees that the hospital
runs smoothly after hours, must
authorize any nighttime patient
transfers. Ryder is still trying to
see when she can get the PACU
patient into an ICU. A few hours
later, she is able to have him
moved to the Coronary Care Unit,
an ICU for cardiac patients.
MON 11:52PM Fellow resident Martin Palmeri, who's also on
call tonight, accompanies Ryder to the Medical Center's latenight
deli. "There's always this debate around midnight,"
explains Ryder. "Do you get the caffeine? . . . Or do you stick
it out [and] try not to get the caffeine in the hopes that you'll
get to bed soon? I usually end up getting the caffeine."
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