New York, NY – On her first overnight call, internal medicine intern Dr. Erica Dalton has realized the entire hospital staff is sundowning. “I first started to suspect sundowing when the on-call attending Dr. Mohar told me I was his ‘tormentor’ and then threw a patient’s pudding cup at me,” recalls Dalton. “I know what you’re thinking, it’’s perfectly normal for attendings to throw things at residents, and I agree, but Dr. Mohar wasn’t ever much of a thrower, he always favored verbal abuse instead, so this was very out of character.”
Dalton then began to notice increasing agitation among the housestaff, “nurses weren’t filling my orders, like– the septic patient in 15 still needs his IV antibiotics started, but the nurse for that room has been just been yelling obscenities at the pyxis for the past 2 hours.”
Dalton attempted to orient some of her fellow residents, but met significant resistance after the on-call surgery residents threw their scalpels at her. “Thank God I didn’t try it with the GI fellows” she sighed.
Thankfully, 4 years of medical school training and a month of residency had prepared Dalton for the delicate and complex matter of dealing with delirium. Using her expert intern abilities, Dalton ran around the hospital for most of the night giving IM Haldol like a champ. “I like the blow gun approach for the ones that are hard to pin down,” she remarked.
As the darkness started to break and dawn drew near, the hospital was quiet. Residents rested peacefully next to the piles of feces they no longer intended to throw, and Dalton’s quick thinking had been a success. “If there’s one thing I learned from last night,” Dalton reflected, “it’s that I should always think to use IM Haldol sooner, maybe even consider IM Benadryl, that sounds like a great idea!”