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.
