Overnight fun in the ED

Just finished my second overnight in the ED. Started out with a 12-year old male with ingrown toenails. The attending wanted to do wedge resections so I start on the digital blocks of his two large toes. The kid starts crying. Foster mom asks if I can give him something for the pain - she suggests valium because "he's going into shock!" No, actually, he's just crying. 1 toe down, 1 to go, but I pause to give him some Tyco. She finds me and asks if I can put him to sleep to block the other toe. "So... you want me to do his local anesthesia under... GENERAL anesthesia??" I didn't say that exactly but diplomatically said that we generally don't do that for local nerve blocks, the risks would outweigh the benefits, and just suck it up. I'm in the second toe when I get called to push contrast on my appy upstairs. I run up, push the contrast (thank goodness no SVT like with the first patient I ever pushed contrast on), and run down to finish the medial side of the second toe. Wedge resection by the attending then goes beautifully. Didn't feel a thing. In fact he's smiling, watching the nail get resected. Punk.

Spent the rest of the night trying to catch up on all the patients that were waiting while I was working on him. Later saw 3 adults through the night. I thought this was a Children's Hospital...?! Can't wait until tonight's shift.