Pt. in persistent AF c RVR. Had two doses of Diltiazem, was on a Dilt gtt, got 0.5 of Dig. Slowed down for a little while after each med, but after a bit was back to his old tricks in the 140s-150s. Totally asymptomatic, but yes I do understand the importance of rate control despite lack of symptoms. In fact, I explained this concept to the patient when he asked why he couldn't just go home and live in a rapid rate, since he didn't feel anything.
Hospitalist comes in, sees rate on monitor, says to me "So he's at a rapid rate and we're not doing anything for him?".
I dunno, maybe look at the chart. Maybe talk to the ER doc. Maybe ask me the question in a different way, in a different tone of voice?
Totally unnecessary to come in here and flip me attitude, like it's my fault the guy is refractory to everything we've done.
I know in hindsight that I should have calmly and methodically reviewed the chart with the hospitalist and told her everything I had done so far and what the results had been, but I was pretty taken aback by her attitude, had stayed an hour late because things were so busy, and really felt attacked. I'll do better next time.
