The Twelve Days of Initiation…..

So I am still a doctor. I have survived my first 12 days straight – two weeks and the weekend in the middle. It was as if time, life and anything outside of medicine ceased to exist for a while. I would wake up at 5.30am – in shock, crawl into something reasonably sensible and then blindly stumble to the train station. By 7am I am trying to claw together various blood test results, CT scans and referrals while simultaneously infusing as much coffee as I could into my depleted body. The first week was definitely more imposing than the second week just because I could see the weekend on-call (which means I am the junior doctor looking after ALL the surgical patients in the hospital while their regular teams have the weekend off) looming in the distance, teasing me at the challenges that lay ahead over those two days. But all in all I survived. Nobody died. I would even go so far to say that I enjoy being a doctor.

So let me paint a picture of a typical day for you. Well, I suppose I have already painted the picture for you up to 7am. From then I rush to ‘handover’ where we may pick up patients (I like to affectionately call them my punters) who may have come into the hospital via A&E overnight and be looked after by my team. After that it’s off for a ward-round with the consultant and the team. This can be a rapid affair that demands the superhuman skill of writing 200 words per second if you have any chance of keeping up with what is being said. Good arm strength is also a pre-requisite to help balance the piles of notes that you carry around (one patient had SIX sets of notes…which is a lot!). After the round the senior members of the team peel off to go and operate, while I and my junior team get to work on all the jobs. So – I bet you are thinking that I am about to tell you lots of exciting tasks and life-saving procedures….hmmm not quite! Our days consist of:

–          Taking bloods (lots of this!)

–          Inserting cannulas and urinary catheters

–          Performing arterial blood gases (where I stick a big needle into your radial artery)

–          Discharging patients

–          Prescribing pain relief and intravenous (inside your vein via the cannula tube) fluids

–          Assessing sick patients (surgical patients can deteriorate very rapidly)

–          Writing referrals to other teams to ask (well, beg) them to come and review a patient

–          Requesting (again, begging) clinical imaging to X-ray, CT or ultrasound our patients

–          Eating the nurses biscuits

–          Walking around with a stethoscope around our neck (that is actually hardly ever used)

Now don’t get me wrong, these things are all very important and it is a ‘right of passage’ of sorts. I watch with envy the senior members of the team making real medical decisions and I guess in the end it spurs you on. Plus, on the good side, I am a procedure junkie – I love poking and prodding patients, and what I like to call ‘chasing the vein’ to get a blood sample!

Memorable moments from my first 12 days have included two very unwell (septic) patients who I had to help stabilise, a kiss on the cheek from a 70 year old patient on discharge, being asked if I was the senior registrar on the team (I wish!), gaining access to the nurses stash of Cadbury’s Roses, and successfully cannulating both feet on one critically unwell patient. Low moments – being shouted at by the ITU registrar, not eating lunch for 3 days on the trot as it was just too busy, exhaustion and hallucination, the bizarre dreams I have every night about patients and procedures that need doing, and most definitely getting my stethoscope caught on the bannister and nearly strangling myself. I guess the three rectal exams I had to do in A&E on Friday afternoon weren’t all that fun either!

I can tell you with all certainty that the sleep on Friday night and subsequent lie-in on Saturday morning this weekend was by far and away the best of the year. I slept so deeply and so solidly that it scared me – I must have been utterly exhausted. With 24 hours off under my belt now I am looking forward to the next week of work. I’m proud to be a doctor, have a great team around me, and I you know what – I think I actually enjoy the chaos!

In other news I had a date today. This was however not a huge success, so I am somewhat licking my wounds this afternoon. At least medicine will keep me busy….

Have a great week.

Dr Nick

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