Monday, 20 August 2012

Like a baby log

Not sleepy, but totally exhausted. I had two nights in a row where I’ve fallen asleep before I’m ready for bed. One night I slept the whole night with only half my pyjamas on because I fell asleep whilst getting changed. That kind of total exhaustion only ever happens after exams (occasionally), and always for one night only.

I have not been this exhausted since the weekend after Freshers’ week when I first started university seven years ago. That was a week of moving house (into halls), new experiences, meeting new people, getting my head around the work, just as the last few weeks have been. Except this time it’s a lot less social, and a great deal more work focused. To say this is the most tired I’ve been in seven years is no understatement. Jetlag is nothing compared to the past week.

I have been an Olympics-aholic the past few weeks, watching every possible moment in the evenings and at weekends, following TeamGB on Twitter, and yet I was so exhausted that I slept through half of the closing ceremony. I was gutted – I wanted to watch the whole thing, but no matter how hard I tried, it wasn’t going to happen.

This kind of tired will wear off – it has to, doctors couldn’t function like this long term! Once I get more confident in what I’m doing, and once the voice in the back of my head saying “ohmygod do I know how to do this/am I allowed to do this/do I know what this drug is/can I prescribe this medication/what the hell is wrong with this patient and what can I possibly do about it” every time a nurse asks me to do something has decreased in volume, the job will be less mentally exhausting. I will be less tired – I am determined to be. I have to be.

Wednesday, 15 August 2012

Human again

I've just been out for a lovely dinner with my new colleagues. Suddenly I feel like a person again, like there is so much more to me than being a doctor, once again. There is more to life than being pestered over patient discharges.

I laughed more this evening than I have in ages. It's lovely to feel more normal again. I need to remember this next time I'm worked to the ground (ie next weekend I'm on call, if not sooner).

But now that I'm unfrazzled, I'm no longer totally shattered, and emotionally and mentally tired. So I can't sleep.

Tuesday, 14 August 2012

Down at Frazzle Rock

I've now been a doctor for two weeks. It's not been the best two weeks of my life. I am totally frazzled, exhausted and mentally drained.
The on call weekend was 38 hours work in three days, much of it on my own; the three other doctors away on other wards, at emergencies, and in operating theatre. There was too much work for one F1 junior doctor to manage, including emergency assessments patients of my own. Some pushy nurses didn't help, but kind and helpful nurses can make all the difference.
I'm sure it will get better. I'll improve my clinical skills (like blood taking and cannulation - I haven't had a single successful cannula yet), learn to see patients more quickly - hopefully without spending less valuable time with patients, learn to call for help more promptly and to recognise when I need help. And learn to take a break, drink, and eat lunch. I didn't eat til 5.30pm the other day, having started at 8am.
It will get better, at some point.
This week's been good, however. More SHOs (slightly less junior doctors) means work is spread more evenly and I leave work at a sensible time. Long may that continue.                          
* Frazzled = exhausted, knackered, not burnt out but going in that direction.
Fraggle Rock = muppets-like TV show. I was once told I look like a Fraggle...                                          
The picture isn't a Fraggle, but it's near enough!

Sunday, 5 August 2012

The first emergency

My first emergency as a qualified doctor did not come, as one might suspect, in the hospital, but instead on the street, at night, in a different city.

It was a horrible "oh god I think I need to stop... don't I? should I?" moment, not quite sure what to do but thinking I probably should do something. I walked past as if to scout out the situation, and a bystander was on the phone, clearly to an ambulance. When I heard them say "... seizure..." my heart sank as I realised it wasn't just some drunken japes and I would need to get involved.

I was relieved to realise I recognised one of the bystanders, the person on the phone - a medical student who I'd got to know a few months ago, when they were in third year. This meant that hopefully anything immediately lifesaving that needed to be done, such as opening the airway, would have already been done. That's a nice emergency to arrive at.

Though it was all under control, I stayed around, partly because once you've arrived you can't really leave, and partly because I thought the others might want me to stick around. Much as I was relieved to see medical students there, I imagine they were considerably more relieved to see me - if I was a third year medical student attending an emergency, I would have breathed a huge sigh of relief if a medical student or junior doctor two years my senior turned up. So I guess that was a nice role to play, even if I didn't do a great deal medically, except stop the patient from rolling over, check every now and then that he was still responsive (ish) and talk to his relative.

The patient and relative had recently left hospital, and I can't help but wonder if the fact they were still wearing hospital pyjama trousers meant they had self-discharged... I think it's likely, which made me a bit more clued up to the situation.

For some reason the police arrived before the ambulance, even though the students called the ambulance, (maybe they send police to anything that might be alcohol related?). Another thing I don't understand is that the ambulance people on the phone said to roll the patient onto his left. He was nicely in the recovery position on his right hand side, and since rolling him onto his left would have involved rolling him into the road, they left him as he was, but I have no idea why the left would be better.

Anyway, the ambulance person arrived and was happy for us to go, so we left, after I'd had a bit of a catch-up with the medical student I knew, and I hope I made clear to them both that they'd done a good job. I realised later that I didn't tell the ambulance person that I'm a doctor, and maybe, since they were on their own, they might have wanted me to stick around and help had they known that, but never mind - they're experienced at working on their own I'm sure.

Despite the anxiety whilst walking up the situation, I'm quite relieved by the quiet, mild confidence I felt whilst looking after the patient - hopefully that will stay with me when something more traumatic happens in the hospital.

Saturday, 4 August 2012

The small things

Yesterday, my sister, who is autistic, got a bus for the first time since being diagnosed with epilepsy. Yes, she's got buses on her own before, for the last year or two, but not since her seizures.

This is an important step towards regaining, and continuing to develop, her independence. It's a small thing, getting a bus, but at the same time it's a big thing. 

I think in the medical profession, we're often quick to overlook the small things, the life things, the less directly medical things, and never notice that to patients (and their families) they can be big things.