Use the force luke..

I’d like to think I have some integrity, especially when it comes to promoting this blog. I have not shamelessly thrown in guaranteed words into my blog or tags which would likely increase my hit count, such as sex, porn or tits, as it would be probably classed as a cheap ploy. Nope I would never stoop that low…well sort of.

I thought. I’m a movie geek. People like movies.  How about using famous movie quotes to try and sum up each new blog entry. Naff you say. Probably, I say.

So, today, the first time since I started this job, I can say I enjoyed myself. I also finally got to do my first CVC, as well as another failed A-line- jeez they’re so fucking hard to do! It took the reg ages to get one in. Finally she got one into the brachial artery. Made me feel better, though I’ll be happier when I score a success.

I’ve always thought that a friendly, supportive and co-operative team will make one’s post more enjoyable and can help in choices for the future. So far, I’ve felt some of the reg’s have been unapproachable or smug and some of the consultants have been very intimidating.

Over the weekend, I had a cool reg, who probably thought I was crap, but taught me and showed me how to assess acutely ill patients on the ward. The consultant was very nice and friendly and supportive. From speaking to the reg, I had a better idea of what to do next- I need to learn how to assess acutely patients and go out with the Outreach team. Despite doing the cool procedure today, I am never going to be able to do it on a gen med ward, which is my career path, I think.

Let’s hope tomorrow continues OK…despite being on-call.

nhsdr

Wahey! Back to work…

The fact I’m getting to work with no real traffic problems, suggests to me that most average workers are taking extended holidays…bastards!

After getting advice of friends that have done ITU, I tried to be more enthusiastic for my job. Still feel like I’m totally inept and almost nauseated by my lack of confidence. One of the ST2’s managed to do two subclavian vascaths- git! I’m jealous everyone is getting the opportunities. Hopefully this weekend when I’m on-call, it isn’t so busy that I am able to do some lines and present some cases for CBD’s and CEX’s. Tried an A-line in the afternoon and failed, though the reg did struggle, though he did eventually get it into the brachial artery using the Seldinger technique.

I need to be more proactive with my days and try and get as much out of this job as possible.

Oh yeah! Happy New Year to everyone!

I was fortunate to go out this NYE, as last year I was on-call. Several drinks, music, random house party and poor sleep, resulted in dehydration and a “fuzzy” head. Though I have no plans to make any resolutions, I shall try and be a bit more healthier this year. Much as I loathe to join the gym, I will probably end up doing it…shit happens.

nhsdr

I’ve popped my A-line cherry…almost

So I finally got to an A-line today. Unfortunately, I picked the one patient who had a heart rate of approximately 130 bpm, and whom had been in hospital for 78 days and had a multitude if lines in him already. He did have an A-line in his brachial, but this kinked and needed to be changed.

So after chatting with an ST2 and reading technique in a book, I tried my first attempt, then second attempt at cannulating the left radial artery. Bugger me, I just couldn’t do it, though I think I managed to cannulate a vein. The ST2 tried the right radial artery, and he failed too.

Hopefully next weekend when I’m on-call, I’ll get the opportunity to do another one or two, and possibly try a central line, or hopefully intubate in theatre.

Once I get more proficient with these skills, my interest and enjoyment in ITU should hopefully increase.

The post Christmas sales start…and it’s back to work for me

While every crazy shopping mad fucker was queueing at 5am this morning for the post Xmas sales, I was almost out of bed in order to make my tedious journey to work today, and every other morning so far. Still feeling knackered before arriving at work, throughout the day and towards the end of the day. Still not feeling like I’m enjoying ITU yet. Hopefully things will get better when I’m back on the general ITU ward, as it’s a bit busier and time goes quicker. I’m on-call next weekend- hopefully it will be interesting and I’ll do some ‘cool’ procedures.

Just watched the final ‘Extras’. Cheesy, but OK. Never saw the 2nd series though. The Les Dennis episode from the 1st series was cringe worthy too the max.

Sad news today. The former PM (of Pakistan) Bhenazir Bhutto was assassinated today. I was shocked to find out this afternoon, after one of the Cardiothoracic reg’s mentioned it in passing. Hardly a great way to end the year. Things have already kicked off. Once again a fanatical minority has fucked it for the majority, and for the dreams of democracy.

Christmas approaches…but life in the hospital continues

I live in rented shared accommodation. Most of my flatmates have the Xmas period off to enjoy the holiday. Most of them are professionals like me, but unlike them, I work in a place which needs to be open 24/7, 365 days per year, without fail. Banks, shops, post offices, even the GP surgery, are all closed over the main Xmas days, except hospitals.

Usually, I am lumbered with working either Xmas day or NYE, but alas, this year, for once, I have both off. But some of my colleagues are less fortunate. And with ITU, there is always going to be critically ill patients.

No real plans of what I’m going to do. Try and see family.

Destroyed…but it’s a learning experience

Yesterday, I did one of the other SHO’s a favour a did his on-call as he’d done the first weekend and a few others already.

After only a few days on ITU, I still hadn’t really found my feet and felt like i was like a house officer again or at worst a medical student.

The trouble with our ward rounds at the moment is, there are too many docs, which is a good thing now, but means it is split between two teams of reg’s, so you don’t fully know what’s going on till the consultant comes along.

The usual intake on the gen ITU ward is 1-3 patients. Yesterday we were swamped with 6 patients, which we have to double admit i.e on paper and on the computer, which takes ages. I felt i became even slower and kept on apologising to the on-call reg and then the night team. I felt like a total twat, and just totally hated my first on-call experience. Totally reckoned ITU was not for me. Had an extended journey home as i got lost, but thank god for my SatNav, which got me back within an hour.

Today, thankfully things were a bit better, though i still feel like a little fish in a very wide and deep ocean. The lunchtime critical care teaching allayed some of my fears.

Ultimately, i have to use this as a learning experience, and hope i get better. I need to start doing some practical skills and opening appraisal, and hopefully i’ll start to settle a bit and gain confidence…i hope.

nhsdr

Dry run

I’m off to do a dry run in my car to my work in a bit. I’ll be using the SatNav and hope it works as well as it did last time.

For the first 3 days of my new job, I took the train to work. I’ve never had to take a train into work in this region of the country as I’ve always driven in. Now, I know what local trains in or near London are like- late, but frequent.

After 3 days of taking the train, I’ve had enough. Late arrivals and departures. Stupid excuses- two days in a row, we were delayed because the train driver hadn’t arrived. What the fuck?

At the moment now, my SatNav has obviously got bored with the waiting and is “driving” the route itself. Better get going, I don’t want to it to do a HAL on my ass and start talking to me proper.

Weather sucks. This should be interesting.

“Rabbit in your headlights”

These last 3 days at work, I’ve been feeling like I’m a medical student again. I started my new SHO job last Weds in Critical Care/ITU Medicine, and it’s like i’ve entered a whole new world.

Everyday, I hear beeps, boops, burps, buzzs, or something like that. There are loads of gadgets everywhere, stuff which i have no idea how they work, but which keep critically ill patients alive. And there are a shit load of new abbreviations: PEEP, CPAP, BiPAP, SIMV, M&M and numbers and physics—aaaaahhh!

I’ve watched several cool procedures this week, none of which i have the confidence to perform yet, but would love to do.

On Fri, I was assigned two patients to “look after”, i.e order all the investigations and check up on them later, but was so freakin slow, as i didn’t know where any of the radiological dept’s where in the hospital. By the time i sorted the investigations for my first patient, the registrar saw the other patient already. Slow slow slow.

Hopefully next week, i’ll become more useful to the other docs on ITU.

A sweet ending…

Today is the last day for most junior docs in their present 4 month post. Tomorrow I start a new job, in a new hospital, and unfortunately have to wake up at a new/earlier time.

Traditionally and unofficially, the last day of the job is when us docs give the staff and secretaries a gift, usually chocolates, to say thanks for supporting, helping, whingeing, not reporting us to the GMC etc. I’ve just bought a box of Celebrations which will be demolished by the ward staff in approximately 2 hours- and they all say they’re on a diet. yeah right! not when it comes to chocolate or doing exercise.

The last day also means everyone is a bit apathetic and can’t be arsed to really see everyone because we’re not around the next day.

I just have to remember to leave a patient list, give my bleep back, tell security to cancel my car park permit, have farewell (soft) drinks at the local and amble off home.

Surgeons- your life in their hands…