Hectic ICU Call

Coming back again after almost a year. Residency has been tough. 2nd year is tougher than intern year. A lot of stuff have happened. Between my personal life to professional, my professional life has been more steady. Al though some days like yesterday, I came home after finishing 24hr ICU call on Sunday. I was exhausted! I started my day with a sign out from the other senior. I spent time rounding with my Program Director till 4 pm. In between, I admitted a Jehovah's Witness who was bleeding to death. Then at night, I ended up seeing a stupid consult and admitted another patient at 0300. I slept for an hour between 0500 and 0600. I get paged 45 mins before the end of my shift for two admissions by the ER physician. Seriously I was pissed off and told her politely that I can do one and I won't be able to admit two since my shift is ending at 0745. Then I spent the next 4 hours signing out to the intensivist and the ICU senior resident. After 11 am, I was finishing up my two H and P.

In the meanwhile, the nurse comes and tells the on call senior that the intern is having trouble with putting in a femoral line. On call senior asks me to go help him (officially off duty). I walked in to the room and the intern is trying to thread a new guidewire into the femoral line which he placed. He told me that he placed the line but it was too far out although it was flushing. So, the nurse told him to place the femoral line properly. So, he asked for a new guidewire and put that wire in the line so he can guide the femoral line over it but now he is stuck. I went out immediately and asked the intensivit to come over. Then the intensivist somehow managed to take the femoral line out and told the intern to place it on the other side. Fifteen minutes later, Nurse told the on call senior to supervise the intern since the intern was still unsuccessful in placing the line on the other. She went in the room and came back. She asked me to supervise the intern since she already started the official rounds with the other intern and the attending. I was seriously pissed off but I went to help him any ways. When I saw him putting the line, I said to him to stop after watching him struggle for 5 mins. He had no *****ing clue as to how to place a femoral line. I was upset and angry but too tired to express those emotions. When I took over, I stuck the patient twice and could'nt get the line. Then I stopped since I was too tired for this crap. Intensivist came to our rescue. I went out of the ICU room and finished whatever documentation was left. Finally they placed the line. Couple of lessons.  If you are an intern, do not lie that you have done lines independently. For seniors, do not run away from your responsibility and supervise your intern. In my personal opinion, if the other on call senior would have stayed with the intern, the whole mess could have been easily avoided. I should have told the other senior politely that I am too tired for any supervision. I am at fault as well.