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…

I have a job…but do I have a career?

Bit of a serious post here.

On Weds, I start a new job, which is 4 months long, then i do another 4 month post to complete my FTSTA1 year. But things were much different a month or two ago. I was pretty much buggered, like a lot of other docs in the NHS, in that I potentially could have been unemployed (again).

I’m not going to go into the details, but a lot of docs in the NHS have been screwed by the government, a crap ‘idea’ called MMC and a crapper website called MTAS. There has been a lot of disillusionment and docs have either left the country or quit altogether. Though I don’t have any ties, i.e. girlfriend, wife, kids, illegitimate kids, animals, I still can’t just leave the country and bugger of to Oz for example. In the past, docs used to be able to go for a year or two and gain great experience and have a laugh too, but now you can’t do that anymore…which is a shame. To get an idea of how pissed of docs are, anyone who is a member of Doctors.net website should check it out.

Anyway, back to me.

So, in a few days time I start a new job. Prior to a month or so ago, I applied for every relevant job to my grade on the NHS jobs website, went to a few interviews, did OK, but didn’t get the job and thought I’d be unemployed. I, as well as many other docs like me, were fortunate enough to have been given temporary extension jobs with the trusts that employed them (me) last year till August. So for 4 months, I have been employed.

Next year, I have to go through the job application system again, but this time I don’t have to use a computer, though I and most docs don’t know how.

So why the pessimistic title. I have a job for the next 8 months, and I’ve been working 3 years in the NHS so far, but I may not have a career, because the job I am in next does not guarantee me any future opportunity to progress. My trouble is, I don’t have a definite speciality I want to do, though I do want to do medicine of some sort.

I think I’m rambling…

I hope this future is brighter. I’ve been a bit lucky so far, as I’ve got two jobs so far without interviews. Thankfully, I’ve been through the interview process. Let’s hope I don’t fuck up the application process this time though.

nhsdr