Tuesday, 4 October 2011

Dr Doctor on call again.

Late shifts on call again this week, and the last two have been a combination of marathon running, fire fighting, patient bleeding, nurse dodging and cardiology registrar disgruntling.

Number of bleeps - innumerable.
Number of flights of stairs traversed at speed - 20
Number of patients spiking temperatures requiring septic screens - 8
Number of times had to run to a different ward to find equipment for taking blood cultures - 4
Number of bloods needing checking according to afternoon handover - 12
Number of bloods handed to me to do by slightly slacking SHO - 3
Number of deranged U&E results requiring action - 2
Number of INR needing checked and warfarin prescribing - 5
Number of bloods needing repeating due to underfilled/haemolysed/lost/mislabelled - 3
Number of cannulas inserted - 3
Number of radiological investigations needing review - 5
Number of patients falling off their perches - 3
Number of times accosted by marauding nurses brandishing drugs charts/incomplete sets of obs - 7
Number of minutes spent in doctors' mess inhaling sandwich and cup of tea - 15
Number of minutes spent regretting such indulgence - 0 (no time!)

Helpfully, one patient decided to fall off their perch around 9pm, 1 hour before handover to the night team. They needed to be examined, septic screened (bloods, blood cultures, CXR, urine dip, microscopy&culture), writing up for antibiotics based on my examination findings (focus of infection probably chest), a cannula inserting and fluids prescribing, handover to nursing staff and handover at handover. In my haste to get on and determine that he was septic and instigate the septic screen and some treatment before handover I didnt have time to look through the notes to determine why he was in hospital or his past medical history or whether he was for resus. My handover to the night SHO as a result was somewhat incomplete, which drew much criticism from the night cardiology registrar (cleverly masked behind the phrase "I'm not criticising..") and much cringing from me who should have done better.

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