Weeks pass by and we're now firmly entrenched in summer - my blogging is never going to become as regular as it was when I was a lazy student with nowt better to do (
) so we're all going have to be adults about this and make do.
From an anaesthetic viewpoint, I've moved on from being the "Theatres" House Officer and have become the "General Duties" House Officer. What this has meant in reality is that I've now got the generalised awfullness that is the pre-assessment clinic and exercise testing session on Monday and Friday mornings. I have to endure a lot of waiting around whilst the specialist nurses take the history and bloods from the patient - I am then wheeled in like a well practiced performing monkey and asked to examine the patient. The vast majority of the time, I find absolutely nothing of any concern but, on the odd occasion, I have turned up an undiagnosed murmur/carotid bruit/pneumonia. Oh, and I sometimes get shouted at by rude GPs for daring to suggest that they review a patient's medication when a routine blood has thrown up an issue.... By and large though, I use these sessions to catch up on reading novels and generally get quite bored.
A couple of my days have been filled with maternity cover. My experiences with maternity as a student had been overwhelmingly negative so I didn't expect much from the time spent on labour ward... suffice to say that I was not surprised. Essentially, the midwives seem to view the anaesthetic staff as being epidural & spinal technicians. The level of hormones presents adds an unwanted tension to make things that bit more "interesting". I had a go at siting a few spinals with varying degrees of success and, I can safely atest, I sweat even more when there are two patients involved!
When I'm not in the clinic or covering maternity, I'm back in theatre although even that's been a little hit and miss recently. Various rota issues have meant that there have been vast periods when I've not actually existed as far the directorate is concerned! At first, the opportunity to have an afternoon in the library was great but it rapidly grew boring and I found myself butting in on lists that weren't expecting me - less than ideal really.
That said, I've seen some interesting cases (such as the lady whose bowel kept bursting during a diagnostic laparotomy or the 11 year old with persistant refusal disorder) and have had the opportunity to develop my basic skills to the point where I'm now pretty confident managing most of the stuff I come across during a typical list. I'm particularly pleased with my intubation - I've gone from knowing the theory but having no real skill to being pretty slick. I still hold my breath when I tube a patient though!