“Doctor Ruettinger, OB is holding on line 2 for you.” I look around, curious who the doctor with my last name is. I am quick to realize that this is me now. I am one month into residency and I am still trying to figure out if I go by “Doctor Ruettinger” or “Chris”. I started my residency working nights, where staffing is lower, and things seemed to move fast at times. I was just starting one of my first shifts at around 10pm. I see a child being pushed in a wheelchair past me, crying hysterically; I look up to see if any of my senior residents are rushing to this room, and no one is to be found. I nervously sign up for the patient and walk into the room. Standing back, hoping the nurses take the lead on this one, I try to observe the situation. With a deer in headlights look, I gather my own nerves and take my own pulse first. The mother is equally as worked up as the child is, wanting something to ease the child’s pain. She anxiously asks if someone will do something. The nurse points to me with: “he’s the doctor, we need him to ask for something.” Feeling slightly thrown under the bus, I responded with: “weight-based Tylenol sounds good” – fortunately, the nurse knew that was not the correct answer and didn’t give the Tylenol. After searching for the right tool in my toolbox, I struggled to find the answer but the kid finally calmed down; I knew I wasn’t thrown under the bus . . . this is my responsibility now.
Most of my shifts went well. During each one I learned new information and was challenged in ways that I thought were never possible. I had a career before this, and I thought that it would make everything easier, but I have been humbled with each patient. The nights had its own elements of fatigue: I would wake up from my light sleep to think about how I should’ve used this medication or that, and would rush to my computer to read about which one would be better. Many times, I awoke thinking I should have put this in the note or questioned my medical thinking. I was quick to research all my questions, wanting to free my mind and fall back asleep during the bright hot summer day. The worst was when you realize you forgot to assess something or provide the patient with something because there was not a second chance, each day realizing what you didn’t know and slowly improving.
The first month has gone by and I am 1/36th done with residency. I don’t know if I am counting down the time because I want it to be over or if I am not wanting it to be over. Each day I walk into my shift nervous but excited, ready but ill-prepared, rested but fatigued, feeling many dichotomies of emotions. Though I still feel like I know nothing, I have learned a great deal in my first month working nights. I have learned that energy drinks are bad for you but great for patient care. Blackout curtains and air conditioning are a must for night shift. Even after working many random jobs, I still get nervous starting new ones. What I learned most this month is that I am now “Doctor Ruettinger” and that I still have a ton to learn. I would like to thank everyone, nurses, techs, attendings, and most importantly my patients for being my tutor this last month and for the next 35/36th of residency.
Check out reflections by some of Dr. Ruettinger's colleagues: Dr. Tribull, Dr. Mak, and Dr. Rys
