attrition

these are the days that wear you down.  i can think of nothing particularly good that i did today, not a moment where i felt like i had accomplished anything of value.  mainly i just ran myself into the ground.  two of my patients didn't have enough urine output.  two others had systolic BPs in the 90s. my 81 year old s/p fall wanted some vicodin, which i knew they wouldn't give to her, so i didn't even bother asking.  and then of course there was the typical routine of adversity: missing meds from pharmacy, rude medical students, a patient who repeatedly called after discharge, etc.  as i finished up all my charting, i listened as the night nurses paged doctors on three of my four patients.  and although i never stopped running during my shift, it was as if i had done nothing at all.  as i walked out to my car, wondering if i was going to cry before i started drinking or vice versa, i had to move aside for five nurses moving an ICU patient.  she was vented with about eight bags of fluids hanging, and the nurses that accompanied her moved with purpose.  like they do something worthwhile.  and when they put their own needs aside during the shift, and give way more than they have for the sake of someone else, i bet it's worth it.  to look at a patient that's more tubes than skin, and to think 'i am keeping this person alive'.  and i run around all day for what?  cups of ice and pillowcases.  and as i sit here, in quiet despair, i can't say that those things are worth feeling like this.