Mastering the Skills of a Junior Doctor: Bending Time

Now I’m not going to lie, this week has been an eye-wateringly painful experience. You see I had the absolute pleasure of being the only junior doctor covering two different consultants’ teams…all week. This meant that I had a patient list longer than I could count to and a list of jobs that made me start to wish I had to become a vet. To cap it off I had to be on-call twice this week. What’s on call? Basically it means that when patients come to accident and emergency (A&E), and the A&E doctors feel it is a surgical issue – I, or one of the more senior doctors on-call, have to leave what we are doing on the wards (with our normal consultant’s team) and go to A&E to assess them and decide whether to admit them etc.

So what’s on this list of jobs? Well let me give you a snap shot of my last day of this week – one that I happened to be on-call for as well. Actually…hold up a second – I should add something – if I sound like I am having a tinsy bit of a whine…ok ok…maybe I am…but I have to say the whole thing is kind of a rush as well – you see, I see it like this – there are times as a doctor (especially a junior one) when you are asked to complete an impossible list of tasks. That’s the game – to make it possible, to not crack (and quit to retrain as a vet), and to essentially show the consultant that you can handle anything that they throw at you. Like I say, it’s all just a game.

Ah yes so the list on Friday! Well let’s see – to start with I had to complete a mammoth ward round with the consultant. This can often be the time where juggling skill and arm strength come in handy. Why? Well quite simply you have to run around the wards chasing the consultant as you carry 8 sets of clinical notes (all about 8 inches thick), carry spare paper, open-read-and interpret the bedside observations (like heart rate, blood pressure and body temperature) while also writing in the clinical notes in another folder, answering the Consultant’s questions about the latest CT scan or X-ray result…and then also telling the nurse what needs to be done differently now…without angering her (and I never want to anger the nurses for they run the hospital and have the ability to make your life hell). Oh and of course answering the team’s bleep – and the on-call bleep as well – both of which never stop ringing off. And of course…..you also need a wee. But fear not – no my bladder did not explode – for since I am unable to stop to have a drink of any kind, I quietly slip into acute kidney failure…and so no longer need a wee.

Ward round survived I start to eye up the list of jobs. Ok Nick, what do we have – 10 sets of bloods to take, 3 cannulas, 2 blood culture, 4 rectal examinations (that’s with my poor finger…in a glove thankfully), 6 sets of discharge forms to complete, 1 death certificate, 5 speciality referrals, 2 flexi sigmoidoscopy tests to order, 3 ultrasound scans to request, review the 3 patients who the nurses have informed me (simultaneously I might add – and on different wards) have just spiked temperatures and have become acutely unwell… and of course 4 patients in A&E who need urgent surgical assessment – the job for the on-call surgical junior – me. Haha. I loved it really but when I looked at the list and the time I had – I really wished that time could have been bent…as I really needed more! I was almost tempted to lick a few ward desks to see if I could get D&V and have to be sent home (D&V is short for diarrhoea and vomiting by the way!) So what did I do first? That’s simple – as I am, after-all, British – I had a cup of tea. I mean in crisis, what else is there to do!

In the end all the jobs got done. Win. I even got to go to A&E and diagnose an appendicitis in a young boy – it was surgical medicine from the text books coming to life! When I got home that day at 10pm (4th time for the week)…5 hours after my shift finished I was a mix of hatred and love for the job. I get why people do it and keep doing it – it IS addictive. I also don’t get why more people don’t quit, for it saps your life outside of medicine. Is there a balance between the two ends of the spectrum? Watch this space and I’ll tell you in time…

Have a great week.

Dr Nick

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