Friday, September 02, 2005

Day One of Bloglife

As this is a personal blog about my job and my life I should start by telling you about my day. Today actually started at about 2pm for me as that is when I woke up and it was September 2nd. I did a night shift last night on MAAU and although Thursday isn't usually a bad day this one had it's exceptions. A&E was bursting at the seams by approx. 10pm so all urgent, yet not life-threatening cases were diverted to another admissions unit, at a different hospital to the one I work in. We got all the patients who had been kicked out of A&E, often without treatment or the appropriate tests/examinations just so the patient didn't breach the 4 hour government guideline and of course our unit doesn't have guidelines or deadlines to keep to so as long as we have the bed space, the patients keep coming.

So of the best patients I had the pleasure of treating last night included a 57-year-old male who had suffered a suspected myocardial infarction and had been taken to A&E by ambulance. Once there he had received treatment including 'clot busting' meds and an ECG all of which had pointed to the above diagnosis and eased his symptoms. He was transferred to us by ambulance yet on arrival his ECG results and entire A&E notes had disappeared. Cue another ECG and long telephone calls to A&E to ascertain quantity and strength of drugs. Not a pleasant experience when A&E receptionists put you on hold because they cannot find a doctor to talk to you, despite the fact that they, or a nurse, could access the information perfectly easily and give you the required information. All of which would save a lot of time and energy because let's face it, who wants to bother to talk to an incompetent medic in a different hospital who has lost some medical notes when you already have far too many patients in your care and not enough time to grab a cup of coffee at 11pm when you've been working flat out for gods-knows how many hours? Not me, that's for starters. The patient is stable and has been transferred to Coronary Care where he'll be a lot better off.

Another wonderful character I had the pleasure of meeting last night was a 23-year-old female with multiple injuries to her face due to assault. She was in MAAU for observation after a head injury and had a suspected skull fracture which couldn't be diagnosed in A&E because the radiographer had gone home (never need a CT scan after 6pm on weekdays, or at all at weekends) and had been transferred to us in the meantime. Unfortunately she came with a couple of police officers who wanted to question her in relation to the assault and her response to everyone was to "fuck off, I don't need your help". The patient was also a drug addict and therefore had atrocious veinous access so trying to place a cannula in her arm in case we needed an emergency line was impossible. On the fourth attempt (this time in her foot) she kicked out in pain and told me to find a qualified person to put the line in (or similar words to that effect). Unfortunately I was the only SHO on duty last night and I had a Pre-Registration House Officer (PRHO) on duty with me. Basically a fresh-faced lad who only graduated and stepped into the big wide world of non-student medicine a month ago, or I had the Registrar (SpR) on-call. The SpR would have been my first port of call except I learnt the hard way in my first couple of years that a senior doctor does not like to be bleeped in the middle of the night for a cardiac arrest, let alone something as simple as a cannula). Out of kindness I let the PRHO try and to my annoyance he managed to find a perfectly suitable vein first time, just shows that a month as a PRHO where your sole job appears to be cannulas when you start pays off, he'll be a whizz when he leaves us in 5 months time. I'll have to ask him more often and save myself the sheer embarrassment.

Embarrassment... a word that is usually, ironically, reserved for PRHOs!

2 comments:

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DrGano said...

"Bye, bye Miss American pie...
Sometimes odd things happen and you just can't say why. I ended my blog last week by quoting Don McLean's song Vincent , and today, after Hurricane Katrina, the first words that came into my mind as I sat down ...
Blogging is fun! You have a nice one. If you drink coffee then I would consider switching to healthy coffee