Monday, August 27, 2007

It doesn't matter where you are in the country...

Bank Holidays working in A&E are on the whole always the same. Full of DIY accidents, sporting accidents, drunks, people who have had accidents whilst drunk, overprotective parents bringing their kids in 'cause they can't get to see a GP and all the time people telling you to hurry up because it's a Bank Holiday and they don't want to spend all day in A&E.

Well, guess what? It wasn't my first choice of location to spend August Bank Holiday either, but I had no choice in the matter, unlike the majority of the patients I saw who could have waited until they got a GP appointment in the morning. So don't moan at me, because the mood I was in today, I was highly likely to moan back at you and the general public doesn't like that!

Got a day off tomorrow and then start a week of nights on Wednesday. I haven't done a whole week of nights in my new job yet. I've done a couple here and one there but not a whole week of working 8pm until 8am. I guess I'm a little scared as it's new territory for me, and I was scared starting at this hospital with the usual self-confidence doubts, but I've had good feedback from the rest of the staff, so I just have to let the positives prevail and push the negatives away. Sounds easy on paper!

Friday, August 24, 2007

But how strange the change, from major to minor

I spent most of the day in the minors department today, as opposed to the rest of the week where I was in majors. Now unlike most of my colleagues, I don't actually mind working in minors, I believe it is part of my job and I tend to get annoyed with people who work in A&E for all the adrenaline rush of a Casualty episode, and sometimes minors can be as interesting as majors.

I do however, get annoyed wth Emergency Nurse Practitioners (ENPs) telling me how to do my job in the minors department. Unfortunately minors seems to be overrun with ENPs, apparently it speeds things up and allows for more patients to be seen, in essence though it slows things down and means that I cannot get on with whatever I am attending to. Today I was told by an ENP how to check for concussion and that the patient that has arrived in minors didn't need a CT scan to rule anything out as "minors don't refer to CT, if triage think they need a CT then they get sent to majors" and "they've only had a minor bump on the head". Just a minor bump on the head that left them forgetting all of yesterday evening and meant that their left pupil wasn't reacting at the same speed as their right one today.

The same ENP then called me away from my patients 8 times in the space of 4 hours to ask me my opinion on her patients. I have no problem with people requesting a second opinion, in fact I'd rather have an ENP ask me my opinion on a case than assume they can deal with it and miss something dangerous. The department has quite a lot of ENPs in minors though and if everyone of them asked for my opinion (or another doctor's) twice an hour then the doctors wouldn't get round to seeing any patients.

ENPs are meant to be able to see patients alongside doctors and therefore clear the minors waiting area in half the time, but if this particular ENP was anything to go by then the waiting area would clog up and go twice as slowly. I'm sure they do a very valued job and I'm probably being unreasonably unfair but when I start to assess or treat a patient, I quite like to complete the treatment without that many interruptions (within due reason) and I don't like being interrupted by the same person so often. Maybe she saw me as a soft touch, or maybe Friday was just my turn to be her oracle. I guess I'll never know.

Thursday, August 23, 2007


For those of you who are interested, and those who are not, I finally found out what the backing music to the TfL "You're Better Off By Bike" advert is.

Straight Lines by Dawn Landes.

Hallelujah!!! It's been driving me mad for weeks.

Sunday, August 19, 2007

Long time, no see, and all that jazz

Gosh, it's been a while. I don't really know where to start. I'll start by saying that I was one of the lucky ones, I have a training post in London, in Emergency Medicine. It's in a busy hospital and isn't one I'd come across before (I studied in London) although I did know of it. They are also encouraging me to sit my MCEM exams which is good as I have said before that my previous workplaces weren't that bothered about my post-grad credentials and thus led me to believe that I wasn't worthwhile when it came to exams etc.

The fiance and I are no longer. He is working in Birmingham at the Defence Medical Centre and in the last few months had become so obsessed with his job, and possible promotion, and trying to get sent back out to active service (something I coudn't understand) that we barely spoke to each other either by text, phone or email, let alone saw each other. We decided that a long distance relationship wasn't going to work out and he seemed more concerned with his career than he did with the idea of marriage so we called it a day. I did all the screaming, crying, sulking malarky and am now feeling quite relieved and free. I quite like being single again, sometimes it's nice to go into a bar and flirt with people and tease them a little, whilst having absolutely no intention of taking it any further. Oh dear, I've just realised that could make me sound like a slutty, bitchy tart, which of course I'm not, I just haven't been single for oh such a long time.

I am refreshed to say that I am slightly more enlightened with being a doctor than I was 3 months ago. I think most doctors can say that now. I know a couple of people who have emigrated to find a job, a few who were unsuccessful in finding a training post, one guy who has had a change of career entirely and has decided to become a teacher and one girl who gave birth to a baby girl earlier this week so doesn't care about her career at present. It's been a rough time for the medical profession and I am alarmed to say that the majority of Joe Public has had absolutely no idea what it is like. I have had comments of "it's healthy competition, you get it in every job" and "it's only bringing medicine in line with the rest of the employment system" thrown at me over the period that MMC was in crisis. Let me say that I know what the rest of the world is like and I know that job-hunting is tough, but I don't think you can assess doctors on their ability to write creative answers to stupid, inanane questions without looking at their qualifications, experience and medical abilities. I just hope the government has learnt from this mistake, although I get the impression that because the NHS hasn't ground to a halt this month they probably think that it was a successful process!

I did however, have a horrible incident in the department yesterday. One I have never experienced before, and hope not to again. It was an anti-semitic attack against me. I have worked in lots of hospitals and no one has cared about my religion. My surname is very stereotypically Jewish and when I went to treat the man yesterday he spat in my face and told me he wasn't going to be treated by a hook-nosed terrorist like myself. Charming. The hospital have barred him from the department on racial discrimination grounds but it scared me. Anti-semitism is becoming amazingly more common of late and that scares me too. The Jewish cemetery near where I live had been vandalised, my aunt's house has had graffiti sprayed on it, I know my cousins have been subjected to abuse on their way to school and the local synagogue is running at a much higher security level than ever before.

In other news, can anyone in the London area please tell me what the backing music to the Transport for London "You're Better Off By Bike" TV advert is? It's driving me mad. All help mucho appreciated, ta!