A Toxic Hospital System

I had been a hospitalist for the same system for 17 years. My supervising doc and I were solid. We were slow but good. We were slow for 2 reasons: we were older and we cared. It had been a terrible, understaffed weekend with too many codes and RRTs. But we worked hard and did our best. We actually saved some lives. But on Monday, we received this:

Night dr had 3 left for her when she started night shift last night at FH. I'm covering FH today and tomorrow.

There was a census of 28 yesterday. There were 2 providers. This was not the first day on service for either provider. They did have to pick up the patients that had been seen by Matt the previous day, but the census was not greater than the threshold where we would consider FH to need 3 providers. I realize that this threshold number is up for debate.

One of the patients was accepted to the hospitalist team at 1450.

One was accepted at 1339.

One was called to the hospitalist team at 1121, 1256, and the ER didn't get a callback from the hospitalist till 1317.

With a census of 28 and 2 providers not new to service, this is not acceptable and I'm hoping there was some sort of extreme extenuating circumstance that caused this to occur.

Shame. And it was intentional. We (PAs) were expected to do the work the docs refused; what they didn't want to do. And if we didn't get it all done, we sucked. We were bad and UNACCEPTABLE. Somehow the docs never were unacceptable as we were. And I and our other APPS left that toxic system for greener pastures.