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.

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

“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.

One month later…

As I am no longer unemployed, sitting on my arse watching daytime TV, i now seem to be less inclined/interested in updating my blog— guess i am being just lazy really! Anyway with that stupid statement, I am now paradoxically updating my blog, almost one month after my last one!

So, I’ve almost done my first month of Psychiatry as an F2 SHO. How has it been then? Well to be honest, the first 3 weeks was rubbish—why? —well my boss was away and thus there were no outpatient clinics and we seemed to have no ill patients. For 3 weeks, me and my F1 (PRHO) were bored out of my brains. Thankfully our boss returned and we were both plunged into doing our own clinics and i did my 1st of many dictated notes. The other massive hassle, which i have finally sorted out is a bloody audit which i’ve been trying to get registered. I hate doing audits, but i need to do at least one of these bloody audits to complete my F2 year!

As I am lucky to have my weekends off, i have been off visiting friends etc. So last bank holiday weekend, I went home, back to the new flat, to check out how things had progressed. I built more furniture and sorted out my room so it was more livable. I went out for my mates 29th birthday on Saturday and met up some old mates (from Sheffield Uni) at the Notting Hill Carnival 2006 . Bought more furniture in IKEA on Monday, and then took the wrong turn back home, so we had a scenic view of London back to Islington.

I am now sitting in my room of the hospital accomodation i am renting, for a bargin price. Luckily this rented house is only 8 minutes from work and i save money on petrol. I’m just about to watch the England vs Andorra match now. Played footy earlier in Warwick— I am now aching! I am so unfit!

Might check out Leamington tomorrow. Do my usual, non-specific, ambling around town and try and do some work later.

Gotta go!

HOT! HOt! hot! and other stuff going on…

Jeez! It’s steaming at the moment! The weather is amazing at the moment.

So what have i been doing since my last entry? More than usual, but not working, despite job offers all over the freaking country.

OK, first thing first—if i am getting all these job offers, why oh why am i not taking them and earning dosh and being a doctor?! Well…despite not having worked that much since December, and only doing two HO on-call weekends, i have not done any proper SHO on-calls and thus feel unconfident to be a lone medical SHO on-call at night or on a weekend in a unknown hospital. Therefore, i feel i am being responsible by turning down these jobs. I’ve only got 4 weeks till i start my 1st full time job in 8 months!

2 weeks back, i went to visit my mate John, who has recently moved from Chester to Shrewsbury. Shrewsbury is a small town, approximately 1 hour west from birmingham. The journey time up to Shrewsbury from Essex was bloody long and i was roasting in my mobile oven aka the car. For the last 100 miles i used country roads as the motorways were pissing me off!

The weekend consisted of visiting the sites of Shrewsbury which is apparently an old medieval town and drinking quite a bit, going to cheesy late night bars, meeting up with a friend whom i hadn’t seen in nearly 2 years, drinking some more and watching the England match in a bar with 10 screens, where unfortunately a whole contingent of noisy lesbians continually pissed us off by constantly getting and walking.

This weekend gone, I went to Harrogate and visited my friends to celebrate their engagement and have a BBQ. I also met up with someone who i’ve been chatting online with—i won’t go into to much detail yet, but will do soon. Harrogate is a wealthy town like Leamington Spa—lots of nice sports cars! I also visited Hull too.

Today, i caught up on some sleep, despite it being v hot and sweaty. Went to IKEA and bought some furniture. Looked at laptops in PC World, for my sister, as her desktop is coming to the end of it s computer life. Started re-watching ‘This Life’ DVD too which i got for free from a friend who didn’t want it—cool!

That’s all for now! Double bill of ‘Lost’ tonight!