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Weblogs

Welcome to the Medical Blogs (Weblogs) section of New Media Medicine. Here you can read about Medical Students, Medical School Applicants and Doctors who have kept an online diary, or 'blog' of their medical experiences.

Anyone can start a blog. It's very simple and free. Just register for the site and start a 'new thread' here in the weblogs forum.


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Old 08-10-2008, 01:15 AM   #401 (permalink)
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Join Date: Jun 2003
Location: Hull
Posts: 3,286
A month since my last post and I really don't feel as though as I've stopped - it's been bloody busy with one thing and another!

My last week of on call nights was generally, a poor show. My first night was filled with loads of those small jobs that take an eternity to accomplish without really stretching the grey matter. At some stage, I was phoned to be informed that I'd be cross covering the cardiology wards as well as my own block of elderly care wards. This was fine - I'd had some cardiology experience as a House Officer and covered the sickies on Coronary Care when I did my nights as a locum so I felt like I could cope. That changed when the wards started bleeping me about a man with a femoral sheath in place following angiography - easy peasy, thinks Mark - the sheath comes out and lots of pressure is applied at the site by a helpful passing HCA... Apparently this is not the case at Hull. There's a device that appears to be based on a toilet ballcock which requires a complicated process of pressure inflations and pulse checks and really seems to be a waste of time. Never mind though, I did as I was told and managed to survive my night of carrying two bleeps.

The next night was going to be better. I'd decided that I was going to get a bit of sleep and be stronger if asked to carry the bleep of another SHO. Predictably, this was not the case. The registrar covering the admissions unit phoned to say that the ward registrar (there are 2 SpRs on call overnight in Hull since the ward teams and the admitting teams are separate, unlike at York) would not be available and, unless my patients were in extremis, he'd not be available other than on the phone. Again, not a massive problem - irritating that the support seemed to be lacking but not something that we could do an awful lot about. So, I sucked it up and got on with managing patients as best I could until I got another call at half 1 in the morning. I was being summoned to the admissions unit since they were busy and missing an SHO. I was mildly annoyed, it's fair to say, but I did as told and traipsed over to "The Dungeon" (AAU has no windows and thus never sees natural light) to start clerking the backlog. The request that I see "just one patient" turned rapidly into a case of "while you're here" and it was suddenly half 5. No sleep at all and, crucially, no thanks. Hmph. More on this a bit later...


Another successful clerking?

The third night was a joy to behold. 5 hours sleep and some lovely night nurses!

But during the fourth night, I paid the price for a nice one. Cross covering renal was the first issue - I hate renal. Nephrology patients are, invariably, very sick and, invariably, very complicated. Most renal consultants are also very precious of their patients so it's not a great place to work when you're not experienced. It's even worse when you're tired and on nights in an unfamiliar hospital. Possibly the worst thing is that renal patients can arrive on the ward without passing through the admissions unit and they often do! I ended up admitting a chap who'd been transferred from another hospital without any clear idea why he'd been moved to us - he was no wiser than the rest of us so I made sure he was safe and left it for the day team to decide what to do with him. My night got worse at that point as I was crash bleeped to my home ward to deal with a patient having a seizure. A bit of diazepam quickly solved the acute problem but this chap had never had a fit before and basic bloods and examination revealed nothing obvious. I phoned the ward reg for advice and he promised to come over but hinted that I was about to be bleeped by the admissions unit... he wasn't wrong and I was order to, once again, get my arse to the dungeon to become a clerking machine.

Thoroughly pissed off with it all, I went home the next day and had my weekend off.

Monday brought a pleasant surprise in the form of a green envelope with beautiful copperplate handwriting. Inside was a thank you card (my first!) from a lady I'd clerked and managed during my first night(mare) on AAU. Heartwarming stuff and it made my week of hell worth it.
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F2 SHO, Hull & East Yorkshire Hospitals NHS Trust

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Old 12-11-2008, 04:07 AM   #402 (permalink)
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Go me - another month has passed by since a posting.

Life is so bloody busy at the moment. I do seem to be permanently on nights/long days/weekends and when I'm not working, I just cannot be bothered to put pen to paper (or, more accurately, finger to keyboard) in order to put down some musings. I will try harder but, as always, life has to come first.

Lots of exciting stuff to waffle on about - I am now an expert at managing the renal failure patients that the renal boys won't touch (for whatever reason). That some of these patients tend to languish and then die a few weeks later from aspiration pneumonia (why, oh why do they all aspirate?!) is neither here nor there - they have perfect u&es.

I have also perfected running to crash calls without actually running - it's embarrassing for the tower block teams when I'm able to arrive before them having clambered up 6 floors (care of the elderly isn't honoured enough to have wards in the monolith - we're stuck in blocks at the front and back of the site). My one "successful" arrest has turned out to be less of a success than I thought - he's a massive great advert for DNAR decisions - totally dependent due to the watershed stroke that followed his arrest and with no prospect of meaningful recovery. Great.

I've been a slave to the admissions unit when on call - frequently being dragged there to bolster a failing team (what sort of doctor just fails to show up to work without telling anybody?!) and, in the midst of the norovirus crisis, clerking in the corridors... happy days!

I have, thus far, avoided catching the deadly diarrhoea. That is all.
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F2 SHO, Hull & East Yorkshire Hospitals NHS Trust

Currently I am a... Paediatric SHO

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Old 20-11-2008, 03:45 AM   #403 (permalink)
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Location: Hull
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Today, I learned that I am "the most evil doctor on Earth" which was nice.

I had an afternoon of nonsense in clinic and my final patient was a ward follow up that I vaguely recalled from August. He'd been in with a collapse ?cause (a very common care of the elderly presentation) and had stayed long enough for us to rule out the sinister and acute problems. At the time, we'd done an MMSE which had demonstrated moderate memory impairment. A repeat today showed it to be worse and both his children agreed that their dad was losing his way slightly.

They moved onto his still driving at 92 and remarked that journeys that used to take 10 minutes in the car were now taking upwards of an hour - something he flatly denied. Along with the dangerous driving, he clearly demonstrated a number of other features suggestive of dementia. I discussed the case with the consultant and we agreed that a referral to the memory bods and a strong suggestion to stop driving were appropriate.

This is what makes me evil.

Apparently, taking away Mr 92's car from him means he can't see his girlfriend any more.

92 year olds have girlfriends?!
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F2 SHO, Hull & East Yorkshire Hospitals NHS Trust

Currently I am a... Paediatric SHO

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Old 28-11-2008, 01:15 PM   #404 (permalink)
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Location: Hull
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Good god, I feel miserable this morning.

Final hour of a nightmarish week of on calls - ostensibly as ward cover in Elderly Care but, in reality, clerking people in the dungeon at the same time as covering 120 old folk. For 10, terrifying hours, I was responsible for every medical patient not on the admissions unit - 4 crash bleeps on my belt, I was primed for the dolby surround sound moment of stereo cardiac arrest calls.

Luckily, there was no call (handy that too, not sure how effective my ALS would have been with just the one of me) but that's where luck ended. With the admissions unit at melting point, I've had no break overnight and have possibly ruined my relationship with one particular ward by calling them useless (in fairness, they are pretty awful) - I don't really care right now.

I need sleep.
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Mark

F2 SHO, Hull & East Yorkshire Hospitals NHS Trust

Currently I am a... Paediatric SHO

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Old 03-12-2008, 04:14 AM   #405 (permalink)
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Care of the elderly is done with and I'm going to miss it (well, most of it!).

Tomorrow night, I am thrown to the wolves when I start my 4 months as a paediatric SHO. I've done no paediatrics since I was a final year student. I cannot take blood from children. I cannot cannulate small children. I will be carrying an arrest bleep having last done paediatric ILS 2 years ago.

I am scared.
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F2 SHO, Hull & East Yorkshire Hospitals NHS Trust

Currently I am a... Paediatric SHO

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