BIRMINGHAM, AL – After briefly weighing the risks and benefits of using an ill-fitting small N95 mask that’s already there versus trying to search the ward for the right-sized regular one before entering into the room of a patient highly suspicious for tuberculosis (TB), third-year resident Mitch Milburn has made his decision.
“Fit test shmit test,” Milburn shrugged off, placing the small N95 mask over his mouth, coming well short of forming a tight seal around his face. “It’s not like he’s coughing that much, and when he does it’s not that much blood. Plus, I’ll only be in there for a few minutes max.”
According to Milburn, there are effective treatments for both latent TB infection and active pulmonary TB, whereas a regular-sized N95 mask may be nowhere to be found on this floor. “I can’t take that chance,” he said.
“Can you imagine what would happen if I go to both medical supply rooms on this floor and neither have a regular-sized N95?” Milburn asked aloud, justifying his decision to no one in particular. “I’d have to call central supply or, worse, go to another floor and perform the same search, and who’s to say I won’t come back empty handed again? That’s an awful lot of energy to expel. Is it really necessary?”
Milburn makes a point. A truly jaded resident’s goal during his or her final year of residency is to come as close to hibernation as humanly possible. Energy conservation is the name of the game, no matter what the consequences.
The patient was also being ruled out for C. diff, so Milburn proceeded to put on a contact precaution gown. Just as he reached for gloves, he noticed that all the glove boxes were empty: small, medium, and large.
No hesitation.
“There are effective treatments for C. diff, whether it’s mild or severe,” Milburn explained, knocking on the door as he entered into the room bare-handed while preparing to hold his breath.
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