Monday 4 June 2012

Hola Amigos

I did it again.

Vanished for a while.

No apologies from me though, I didn't really have much to say and I was quite simply so busy. Busy doing what, I'm not really sure? I don't feel like I've achieved much, but I was busy. Really.

I had my birthday last week and I am no longer a youth. I have hit the eyewateringly sensible sounding age of 25. I can only hope that if I keep watching Disney films and surrounding myself with all things childish that I'll actually reverse-age next year and become 24 again.

I am currently on a geriatrics placement. That means that except for when I'm on call and covering CDU my life is a giant ward round, board round and "social placement service". It's really not the career for me. I get so angry at all the granny-dumping that my blood is frequently boiling and there's steam coming out of my ears. I've also developed a massive fear of dementia.

Next week (probably after a lot of administrative drama) it is FY1 sign off time. Then I just have to sit my MRCPCH part 1 on the 12th (don't ask how revision is going, it's not.) and then it's time to chill out a little bit in the run up to becoming an FY2. I've done nearly all my on-calls already too so my last 2 months at work will not be as hectic last the previous 2.

My first FY2 job is in A&E. Really really looking forward to it as I currently love being on call covering the acute medical and geriatric takes. I am guessing that I won't have a life though, with the notorious "divorce rota" of A&E.

If I keep typing I'll run out of things to say for the next month or two (again), so I'm going to keep this entry short and sweet.

Here's hoping I blog again soon!

Dr Sunshine xXx

Sunday 1 April 2012

A Caring Doctor

A lot of people say that I care a little too much for my patients. I'll stay late to talk to relatives, hold patients hands while they are scared and shed a little tear sometimes when I'm home. I also care a lot for my friends, I find I'm often driving around on errands or having little cheer-up missions because although it sounds incredibly cheesy, it genuinely makes me happy to make other people happy. It's what I like to think of as a nice form of selfishness.

Recently I've let myself get a bit run down. I've had tummy aches, I've been tired, but most of all I have been grumpy as hell. I decided rather than moping, moaning and feeling sorry for myself, I should probably pull my finger out and do something about it. I needed to care for myself.

Step 1 was to register with a GP. Did that. Went to the registration appointment where the HCA basically called me a fat, lazy alcoholic. This is really unfair and quite innaccurate. I'm a binge drinker, not an alcoholic.

Step 1 failed. I didn't feel any better.

On to Step 2.

A girly night.

I hadn't had a proper girly night for ages. Don't get me wrong, I love nights out with a big mixture of people and spending weekends with the boyf are sometimes the only thing that keeps me going through a tough day in the week... but this time things were critical. I needed the girls.

The girls also needed me.

We've all had a bit of a stressful time recently. What with work, home dramas, family dramas and general life the 3 of us were a bit run down. With a little bit of co-ordinating we all managed to get together and it was AWESOME.

Saturday daytime we hit the shops and spent hrs trying on dresses and drinking coffee. We also all bought new PJs. We then hung out at the make-up counters and had a full makeover... leading us to part 2 of our girly time...

Curry!

Yes, curry and beer is a bit of a lad thing, so instead we had curry and wine... it was delicious. A couple of hours after arriving at the nicest Nepalese in town we left complete with food babies and high heels. Next stop was cocktails in my Dad's bar. Always awesome for a girly night as the presence of my Dad in the same room stops all the sleazy creeps chatting us up and means we can concentrate on what is important... judging everyone elses high heels.

In a true kickback to our younger years we then all changed into our PJs, piled into my bed and watched back to back Disney DVDs, crying our hearts out and singing along.

Granted I didn't do the revision I needed to do, nor did I finish my presentation for Tuesday but quite frankly I don't care. Sometimes a day chilling out can be worth a week of revision and I'll just have to do a bit more work tonight to get the presentation done. It was more than worth it.

This week I have another really busy schedule. Presentation Tuesday, new rotation Wednesday, first day of Medical on call on Wednesday and I have to get a move on with organising the final year mock OSCE. Thankfully I feel fully rejuventated after my weekend and then I have a 3 day weekend to look forward to. In fact I'm so chilled out that I can't even be grumpy about being on call on Easter Monday.

Dr Sunshine xXx

Monday 26 March 2012

Retrospect

Unlike in most medical TV programmes I can safely say that my seniors are pretty lovely. Yes they can be snappy and sometimes intimidating without meaning to, but they all not only teach us but also chat with us.

The other day I was sitting I the mess and my boss asked me if I thought he'd made the right choice regarding a specific intervention with a patient now that we were a few months down the line.

I had one of those scary moments. Was I supposed to blindly say that my consultant made the right choice? Obviously that would be the "safe" option. Who am I a mere F1 to say that my vastly experienced consultant was in the wrong.

I paused and thought.

I actually didn't know. Would I have done the same thing? It makes me wish we had a medical time machine and that we could see all the possible different outcomes of our decisions. I'm sure with the benefit of hindsight there will always be time where we think that on balance our initial choices may not have been the best.

I said as much to my boss and he just nodded.

Later he gave me a great piece of advice.

Looking back with hindsight can be useful, but as long as you know you made a safe decision in the best interests of the patient that it doesn't matter if things don't always work out exactly as planned.

I hope I can remember that next time I'm thinking what if?

Dr Sunshine xXx

Tuesday 13 March 2012

Surgical Week Day on Call.

People seem to like it when I go through what I actually do rather than rambling during a post. I've already covered what I do on a weekend on call, so I today you're going to get a blow-by-blow account of one of my weekdays on call...

07.53 - Arrive in the mess early enough for a cup of tea. Fluid balance, especially ones own, is the key to FY1 success.

08.04 - Moan about the lateness of the rest of the team and feel ranty. Spend the extra time trying to securely tape the battery into the on call bleep as it keeps falling out.

08.11 - Joined by the rest of the team for Ward Round. Traipse around the wards with my pile of blood results and scan results. Get the medical students to write in the notes while I keep a detailed list of jobs. This is the awesome thing about having medical students, it gives you extra hands to be more organised.

08.47 - Awkward bad joke moment where consultant tells patient they are being referred to gynae by explaining "I don't deal with ladies bits... at least not professionally". I actually snort in laughter. Patient looks mildly, but pleasantly confused.

09.50 - Still on ward round. Silently thank the gods of medicine that as this is surgery it's almost over.

10.07 - Quick cup of tea in the mess while splitting the jobs with the rest of the team. Have to reassure students that the ward round banter is the consultant liking them as opposed to bullying them. It really is him liking them... our team just has quite a harsh sense of humour. Have to constantly remind SHO that I'm on call as well as looking after the ward jobs so I don't get totally dumped on.

10.20 - Prioritise. This is an important buzz word. For morning job I prioritise as follows; If a patient is really really sick look after them first. Sounds silly and obvious but it's all to easy to leave a sick patient just to order a scan or write a quick discharge. I'm quite anal about getting the sick patients sorted before anything non-urgent is done. Lucky for me this morning all my patients are stable. So then the order in which I do things is firstly order all the scans I need. Secondly order all the bloods I need. Nicely ask the med students to bleed the patients. While they do that I refer all the patients who need other team input early in the day before they get too busy and chug through my discharge notifications. Once that's done I go and have a bash at any of the bloods/cannulae the medical students couldn't do.

All of our surgical house officers work as a team and if you don't have anything to do because your jobs get finished early we ask the people with more patients if they need a hand. Yesterday I had the most patients, but through a mixture of robotic like efficiency and a fantastic team we got it all done by lunch time.

12.30 - Had a look at what was on offer in the canteen. Looked like dog food warmed up. Went for a sandwich and some fruit instead. Getting something to eat while on call is also really important. By this point of the day I was a little worried that I hadn't fixed the on call bleep as it had been calm. Bleeped myself twice to be sure. It was working.

13.10 - Chased blood and scan results and generally pottered about. Did a little bit of OSCE teaching too to pass the time. Kept looking at the bleep wondering why it was so quiet.

15.27 - Realise steth is broken. Look devestated. Take my steth to see the surgical SpR who performed surgery. He did a bottomoftubingotomy and replaced the end. It works but is a little short. I was very grateful.

17.06 - Got a bleep. Got a bit peeved. Patient who had an Hb of 6.1 in the morning. Day team had written in notes that the patient was hard to cannulate and that they were organising a transfusion and getting the anaesthetist to cannulate. Firstly... why couldnt they have bleeped the day team who knew about it 7 minutes earlier when they were still working? Secondly why did noone from the day team hand this over? Had to go and properly assess the patient, cannulate and order blood to transfuse. At least this filled up some time.

17.55 - Just as I was finishing writing in the notes the trauma bleep goes off  "Trauma call to a&e in 15 minutes..." Time to grab a quick glass of squash before heading to a&e.

18.15 - Lady fallen off horse arrives in a&e. Realise I am the most senior member of surgical team. SpR is in theatre and SHO isn't answering the bleep. Put in a cannula and thoroughly annoy the a&e SpR as my bleep goes off 8 times in the space of about 3 minutes. Escape to answer bleep. Get an ear bashing from SHO who wants to know where I am and why I'm not answering my bleep. Inform him "I'm at a trauma call in resus... where the hell are you?!" - Turns out his bleep actually isn't working.

18.20 - SHO turns up at trauma call. Patient is surgically OK but has broken a leg. Ortho takes over. SHO sends me up to paediatric ward to take some paediatric bloods and explain a scan result to a patient and their Mummy. Everyone knows how much I like paeds and how much the paeds ward likes me, so I often get this job. They have nice biscuits up there. Noms.

19.00 - Get bleeped by harassed looking SpR. He has lots of patients to review. Asked to come and help.

19.02 - Arrive in ITU to review patient who is "bleeding everywhere..." They have a small trickle of blood escaping their dressing and a really tiny little vessel that hasn't been cauterised. I make myself sterile and hold a piece of cotton wool on it for 5 minutes. This is my first (and probably last) surgical intervention as a doctor. It was a success. I feel unneccessarily pleased with myself. A 5 yr old could have done the same. SpR finds my self satisfaction amusing.

19.15 - Arrive on medical ward to see patient with upper GI bleed that can't be stopped with endoscopy. They are stable which is good but the SHO from their team can't get blood, which is bad. They're just about to go for a femoral stab when I see a big juicy wrist vein. I get blood from that vein. Feeling rather pleased with myself again. It's not often that things go that well for me repeatedly over the day.

19.45 - Run to a&e to help snowed under SHO chase bloods on the patients he's seen, do 2 ABGs and write the list for handover...

20.25 - Print list for handover, make well deserved cup of tea.

20.31 - Bleep goes off in handover. SHO steals bleep and throws the battery away. He's very strict about finishing on call on time. I sneak away to answer the bleep. No need... bleeped by mistake.

20.45 - Handover done. Time for home... remarkably on time for an on call!

Dr Sunshine xXx

Sunday 11 March 2012

Weekend Guilt

Part of this could be because I'm Catholic (and we're trained to feel guilty about EVERYTHING), but at this time on the weekend I'm always overwhelmed with guilt.

Guilt that I've not tidied, guilt that I've not ironed, guilt from lack of ePortfolio work and lack of revision guilt. I also have too much yummy food guilt and quite often post-cocktail guilt.

I'm now torn with putting away my washing, washing my hair and then doing an hour of eportfolio before bed, or throwing caution to the wind and watching the new Disney DVD I bought over the weekend. I am so rock 'n roll.

This week is going to be a toughie with 3 on calls and 3 days post-take (including post-take from the weekend tomorrow). For those of you who don't know the terminology post-take is the day after the team has been on call, where we have to see ALL the new patients and make sure they all have good management plans. After the weekend this can be actually insane.

Lucky for me I have two rather lovely, clever and pretty medical students.  Not only does this mean they should be good to work with as they seem to have common sense and want to learn stuff, but the fact they are pretty means that they might be able to sweet talk radiology into scans and porters into getting the patients there for the scans. Fingers crossed.

Although the my week ends with a Friday evening on call I then have a 3 day weekend (hurrah for annual leave). This is the first St Patrick's day that I'm not working and I'm old enough to drink, so I shall be celebrating my socks off... starting with watching the rugby and then seeing where the day takes us.

Before then I have (another) presentation to do, as well as all the on calls and post-takes and to top it all off one of the consultants wants me to write a letter to the NEJM about the criticisms we have for a paper I reviewd in journal club. Not too sure how well these criticisms will go down from an FY1...

Dr Sunshine xXx

Thursday 8 March 2012

Awkward!

A weird thing happened to me the other day. One of those things that I should have guessed would happen since I work so close to where I grew up.

I bumped into an ex boyfriend in town who said "Oh, you were the doctor who looked after my housemate when he had his surgery last week."

I had been so busy blustering about that even when I'd spoken to the guy I just hadn't placed him as someone I know through a friend. It also left me with one of those awkward confidentiality moments. I spent the week afterwards thinking to myself "Must not accidentally mention perianal abscesses..."

Feeling a bit relieved now. Just saw it posted all over Facebook that everyone knows that's what happened. The only thing I now have to feel awkward about in the pub is having seen his bum.

At least I didn't give him a PR like someone else I know.

I'll definitely be avoiding going to their house for a while.

Dr Sunshine xXx

Wednesday 7 March 2012

Not Quite A Love Letter

Quite often I find it really hard to say what's on my mind, especially to people I care about. Although on the surface I seem eternally cheerful and full of confidence, like most people, that's not always entirely true.

At the moment there are a lot of things I want to say to my boyfriend but I can't. I'm afraid he'll think I'm silly, I'm vastly overreacting, I'm nuts or that quite simply I'm not for him.

A large part of me wants him to read this, but I feel like I can write it and share it with you guys pretty safe in the knowledge that he won't.

Dear Hairy-Man,

I don't want this to come across as an attack. I can't stand relationships where anyone thrives on making their loved one feel bad about themselves. That's why I'm going to start by telling you how much I appreciate the lovely things you do for me. I love the fact you text and call me everyday just to see how I am. I love how you send me flowers just because and how you travel all the way to my house and put up with my crazy extended family when you're exhausted after a holiday. It's great waking up curled up next to you and your cute sleepy grumpy face always makes me smile when I'm trying to wake you up.

Sometimes I get really stroppy with you and you don't understand why. Saturday was one of those days. Looking at it in perspective I should be over it by now, but I'm not. It just felt so awful to make an effort to look nice and then you didn't even want to dance with me but you were happy to dance with some (gorgeous) random girl. It felt like such a snub. I know it's selfish but I want to be the only girl you look at, I want to feel like I'm the most special, most fanciable, most lovely girl you know.

I pretend all the flirting with your female friends doesn't bother me, and when I do feel like you love me and you want me it doesn't bother me that much. When I don't feel as wanted it makes me feel sick in the pit of my stomach. It's probably paranoia but it's hard to think rationally when I feel so low about myself. Sometimes I just need a little reassurance.

I wish I could say all of this out loud to your face, or even that I would have the guts to email this to you but I won't. I don't want the confrontation. I don't want to face the fact that maybe some of the girls you flirt with are more special to you than I am.

Dr Sunshine xXx

Tuesday 6 March 2012

Buried Deep

As per usual it seems like I have so much to do and not enough hours in the day.

I just can never seem to say no when asked to do things and even now, snowed under as I feel, I'm still taking on yet more and more bits and bobs around the hospital.

This week alone I have to write a Journal Club presentation, write a mortality meeting presentation, finally get around to processing the data for audit 1, collect the data for audit 2, start planning the final year OSCE, do a mess shop, plan a mess dinner and find a new car.

I could also do with doing some washing, cleaning my bathroom and having dinner with my Dad at some point.

I shouldn't forget that I also have an actual job to do and revision for this dreaded exam in June.

So much for work being less busy than university...

I'm now at the point where I'm seriously looking forward to July as the student OSCE will be done, my exam will be done, my eportfolio will be done and I can just do my job and otherwise have fun. No doubt I'll find something else to take on.

I was wondering if anyone fancied being my PA for a few months?

Dr Sunshine xXx

Tuesday 28 February 2012

Car Drama

Last week my car died. A few days later the mechanic said that he couldn't resuscitate it. It's being scrapped tomorrow. Even though I used to moan about what a rust bucket it is, I am pretty upset.

What is more upsetting is my current lack of funds. Granted I could use my small bit of cash to put a deposit on a nice car and pay it back monthly, but as I don't enjoy cars that much I would really begrudge spending that money on a car. Especially since I wanted to save for a Mulberry handbag.

When push comes to shove I now have an £800 - £1000 budget, and I'm lucky enough to have a friend who is a mechanic to car hunt for me. I'm also lucky enough to have a Dad with an 18 yr old Volvo estate who is willing to lend it to me until I get a car.

I still feel in wayyyy over my head.

Why can't public transport be better where I live?!

Dr Sunshine xXx

Sunday 26 February 2012

Moving Again and Again and Again...

I don't feel like much of a grown up. In fact when I went to see The Muppets this weekend I was probably laughing and enjoying it more than most of the children. Even though I've graduated and started working I feel like much more of a child than I did this time last year... I blame this all on moving home for my fy1 year.

In 5 months I am going to have to make the step to being proper grown up. I'm going to have to move away from home (again).

ARGH.

It seems like a silly thing to worry about but it's been 4 yrs since I've had to flat hunt. The thought of dragging my tired self around countless flats while I try to eye up whether or not the others there are complete psychopaths, or would actually make nice flatmates fills me with dread.

I've never lived with someone I didn't know first before.

How do you decide if you'll like someone in 10 minutes? How do they decide that they like me? Should I bring cake to all my flat viewings just in case? And when do I need to start looking?

What's even scarier is that I'll have to do it all over again in a year when I move to London. Hopefully then I can stay put for a couple of years.

I really think life would just be much simpler if I bought a caravan.

Dr Sunshine xXx

Saturday 25 February 2012

The Long Snooze

Last night I slept for 14 hrs. I went for a little Disco-Nap at 8pm and woke up just after 10am. I must have really needed that sleep. It felt so good! Unfortunately it hasn't really made me any more productive than usual. I did however have a great dream that I had built an entire village of treehouses that myself and all my friends had moved into. It's an awesome idea.

I've mostly spent today bumming around waiting for a friend who may or may not come shopping with me today. I really want a second opinion when I'm buying some new glasses so I've been putting it off for months. I also have to get a new car this weekend... too much shopping pressure.

So much for making the most of my free time, but it feels so luxurious to be doing pretty much nothing after the week I have had. Next week is another week with 2 on calls so I'm guessing that I'll be having a similar massive snooze next Friday.

I had the surreal experience of spending a couple of hours yesterday at work with 6th formers who want to apply to medicine, 2 of whom were younger brothers of my school friends. It was great to see all of these 16-17 yr olds who were working hard and trying their best to get into medical school, but it was so hard to articulate the reality of being a doctor. On one hand I wanted to be honest and give them the negative sides, but I love my job so much that I couldn't help but enthuse over all the fantastic aspects as well. I definitely gave a biased-towards studying medicine outlook.

I did however feel like making them go and have a sniff of one of the wards I'm working on at the moment. It's a colorectal ward and it has the worst ventilation ever so it constantly stinks like a massive poo-bomb has exploded. It's so awful that I'm convinced I smell of poo when I get home.

Anyway I'm off to try and hunt down this friend who promised me a trip to the shops before they all close... perhaps I should look at buying myself some new perfume!

Thursday 23 February 2012

Awkward, much?

I always find talking about certain bodily things a little awkward.

I'm not quite sure why, but I find explaining a rectal examination much more awkward than actually doing one. In fact doing a rectal exam doesn't embarass me in the slightest. There is something intrinsicly awful about explaining to someone years my senior exactly where I am going to put my finger.

I still haven't decided the best way to say it. To tell someone I am going to examine their back passage just seems cringeworthy, but apparently telling someone I am going to stick a finger up their bottom is a little too blunt.

What is the most awkward thing is having to explain to someone you know from school that they need a rectal examination. Then, worse than that, them saying "Well I'd rather you just did it now, otherwise I'll be waiting ages for another doctor."

Mind boggling how much this person trusted me. It must be so weird being a doctor in a small community where this would happen lots.

Dr Sunshine xXx

Wednesday 22 February 2012

And So It Continues...

While I was a student I thought I led a pretty stressful life. Exams, lectures and lectures all taking up hours of what I thought would be my free time. Now I knew that when I graduated I'd still have a lot of work, but at the moment it really feels like I'm doing even more academic work than usual...

I'm revising for a postgraduate exam. I'm doing 2 audits. I'm writing a review paper. I'm making powerpoint presentations for peer teaching and medical student teaching. Somehow in amongst all of that I'm working 48 hours (although looking at my rota it averages at nearer 60) every week.

How do I do it?!

I don't. I just stress about my inability to get it done and spend the little amount of free time I have trying to maintain some kind of relationship with my friends. I also make sure I keep up to date with Desperate Housewives, this is nearly as important to me as passing my postgraduate exams.

I do enjoy it (when I'm not dying of exhaustion), and I keep telling myself it will all be worth it this time next year when I have a job offer and I can chill out for a couple of months. I just have to try and survive that long...

Dr Sunshine xXx

Monday 20 February 2012

Should Have Bought a Ford

My car is the laughing stock of all the other cars at work. This doesn't bother me too much as I don't measure my own worth by the car I drive. For me I just want something with 4 wheels that starts in the morning and gets me to and from work.

Apparently now even this is too much to ask.

I drive a 9 yr old Rover 25.

The seals on the doors let water in.

The light behind the dashboard doesn't work.

The windows aren't electric.

The boot doesn't shut properly.

The exhaust fell off once.

There is no heating.

In fact this morning the inside of my car was so cold I had to scrape the ice off the inside of the windscreen. My hands then went completely numb during the drive in and the thermometer inside the car read -1.

All this aside as long as it got me to and from work I didn't really care.

Today it died. It died on a large roundabout, in the middle of said large roundabout. The mechanic isn't sure if it can be resurrected. I have a 15 mile drive either way to and from work each day. Erp.

I bet this wouldn't have happened if I'd got a Ford.

Dr Sunshine xXx

Wednesday 15 February 2012

Taking The Piss

Somewhere among all the piles of paperwork that I seem to spend all my days at work ploughing through are the little joys that are practical skills. After 2 hours of writing discharge notifications, even the satisfaction of getting a cannula in is enough to make my heart do a little leap of joy.

Weirdly there is one skill that I look forward to more than any others.

Catheterisation.

Before you get too worried I don't have some weird kink about sticking things up willies. In fact I generally don't really like getting up close and personal with strangers genitalia. There's just something intrinsically satisfying about the instant relief given to a patient in urinary retention when you pop in a catheter.

Those of you who have put a catheter in someone who is retaining urine will know exactly what I mean, for those who haven't I'll try to explain. Think about how bad it feels when you're desperate for a wee. Now multiply that by 10. In fact imagine you need a wee so bad that your abdomen becomes so distended that your whole belly is stretched tight and the pain is excruciating. Then imagine how awesome it feels when someone pops a little tube in and all of a sudden all that pressure and pain is gone. Then imagine how great it must feel to see the look on your patient's face when you realise that's what you've done for them.

Awesome.

NB: this feeling is less awesome if you are unprepared and hose yourself in urine. (Thankfully I learnt from a friend's mistake).

Dr Sunshine xXx

Tuesday 14 February 2012

Valentine's Humbug

I'm pretty sure that this post won't go down too well with all the Valentine's scrooges. Sod it. I really like Valentine's day. I know that all the lovey-dovey stuff was invented by card companies to make extra money, but I simply don't care. I think it's awesome. So meh to all of those people who say it's a stupid day.

Granted if you are single it can suck a bit to see everyone loved up, but I like to make the most of it. I like to send cards to my best friends because I love them. I love the fact the kiddies in my close family send me cards too. In fact this year I got a card of a girly friend, 3 cards off the kids, a tin of love heart sweeties from the kiddies and a wibbly turtle from my Papa.

I'm also lucky enough that this year I got to wake up next to someone special and enjoy croissants with raspberry jam. It was an even bigger surprise that when I got home there was a big bunch of flowers waiting for me. Yay!

While I'm still feeling mushy I also want to say thanks for all the lovely comments on my last 2 posts. It's really got me in the mood for blogging. In fact I'm in such an awesome mood all round that even the thought of getting up early tomorrow morning for work can't get me down. Nor can the fact that I'm on call and I have ePortfolio dramas.
                
On a completely unrelated note I get to be a balloon animal making clown at a charity fundraiser soon. Is that not the coolest thing ever? I am beyond excited!

Dr Sunshine xXx                                                                                                   

Sunday 12 February 2012

"Hello... Its Sunshine the Surgical F1 On Call..."

You have no idea how many times I have uttered that phrase this weekend. In fact I said it so much that when I answered my mobile phone halfway through Sunday afternoon I said exactly the same thing. What a pleb.

If you're reading this you're probably at least vaguely interested in what it is I do all day, especially on call, so in honor of my last ever surgical weekend on call I shall tell you all about my weekend.

Our on call weekends as juniors at my hospital are Friday, Saturday and Sunday. Friday is much like an ordinary day at the start. We just do our own team ward round and do our own jobs. As the F1 on call I do have to help clerking surgical patients in A&E if the SHO gets busy though. This Friday was insane. Not only was the surgical SHO scrubbed in for most of the afternoon we were insanely busy. I single handedly clerked at least 6 patients and saw some others with the SHO and reg as well as doing all my ward jobs. Although I was so exhausted I pathetically crawled into bed when I got home at 10pm, it was actually awesome. My day to day ward jobs mostly involve paperwork and taking bloods, so it's fantastic to clerk and examine patients and get to use my brain a little to work out a management plan.

Saturday mornings on call are generally a struggle. It's hard to face getting up when you know that you're not even half way. It's made infinitely harder when your car is as crap as mine. The internal lights don't work, first gear is a bit dodgy, the heater doesn't work and neither do the washer bits on my windscreen. This meant stopping 3 times on the way to work to scrape the ice that had refrozen off my windscreen. My feet were numb. Thankfully our surgical team are quite laid back so our handover is in the mess which means a chance to have 2 coffees and warm up.

Weekend ward rounds are epic. We have to see EVERY surgical patient in the hospital.  This means becoming a writing ninja, and being able to write in all the notes at lightening speed. Thankfully most entries are along the lines of "pt afebrile and stable, bowels open, eating + drinking, continue weekend plan". Because the ward rounds are sooooooooo long they don't finish until lunchtime. In fact lunchtime is a misnomer as it's unusual to get lunch before 5pm.

After epic ward round is jobs time. We don't have phlebotomists (blood takers) on the weekend and most of our nurses haven't been trained to do bloods.This means my own little phlebotomy round. The bad thing is that it's really boring, the good thing is that I'm now really quick at bloods. I tend to try and make it more bearable by having nice chats with the patients, this has the added benefit of earning me sweeties from all the grannies as I take their bloods. This partially makes up for the lack of lunch and is the only thing that keeps me from keeling over.

After bloods I usually have a couple of scans to argue with the radiologist for. I quite enjoy this, it's a real challenge to get the radiologists to agree to anything. I get really worried once they agree though as they clearly think the patient is quite sick too.

Then it's discharge time where I get the joyous task of writing discharges for all the patients going home. Another boring but necessary task. On weekends it's beyond frustrating when complex patients who have been in for months get discharged and the team looking after them haven't started the discharge letter. I can usually be found hunched over a computer muttering about how I'm going to kill someone on the team. I never do. If I was crueler I'd note down who it was and make sure I hadn't prepared discharge letters for their weekends, as it is I'm simply too soft for that.

All the while I'm doing this I get bleeped for various tasks.

Some bleeps are downright stupid...

Nurse "I know you said this patient can have anything that is a fluid... is tea OK?"
Me "yes"
Nurse "How about tea with milk?"
Me "yes"
Nurse "What about fruit juice"
Me "Juice is also a fluid..."

Some bleeps are necessary but demoralising...

"Please can you come to this ward and write the 3 discharge notifications, rewrite 2 drug charts and that manual evacuation is back from xray if you want to do it now..."

Some bleeps are downright scary...

Nurse "Can you please come to see Mrs Smith on ward X, she's collapsed but is now concious..."
Me *thinks shhiiittt Mrs Smith is the woman who I've just seen has an hb of 7.2 post op*
       "eep! Does she have venous access? What are her obs? Start some fluids and I'm on my way..."

But the best bleeps are like this...

SpR "What are you doing? I need you urgently now!"
Me "Eep, nothing! Where? Why?"
Spr "In the mess, the cup of tea I made you is getting cold and it's 5pm and you haven't stopped for lunch"

My favourite moments of on calls are the evening handovers though. For some reason the exhaustion sends everyone a little bit loopy and they turn into the funniest randomest moments, mostly taking the mickey out of each other for stupid things we have said or done. I'm lucky enough to do my on calls with different teams than my own team so it gives me a great opportunity to get to know the others really well. There is nothing quite as bonding as an on call shift.

Dr Sunshine xXx

Thursday 9 February 2012

Why Not?

Since I started this blog I've made lots of excuses as to why I haven't been updating as much as I used to update the old blog. In fact I half fooled myself that the main reason was how busy I am. The truth is, even when I've been curled up at home, I just haven't had the motivation to blog.

I love blogging. So why did it suddenly feel like a chore?

To be honest, I'm scared.

Since I've started this blog I've been much more open about the fact I blog. My Dad reads it, my boyfriend reads it, my friends read it, for all I know people I work with read it. This petrifies me. I could be totally honest before, opening up about everything without worrying. Now I feel everything I write is superficial rubbish.

I've been worried what people would think if I was honest about sitting in my car and sobbing after a day at work where I stroked a patient's hair as she died? If people would think I'm stupid for feeling physically ill every time I have to look after a patient in the room my Mum died in? If people would judge me for the lack of morals of saving my ash cash for a handbag?

I'm scared about writing about the pressures of living back at home in case it upsets my Dad and scared about writing about having a long distance relationship with someone 16 years my senior just in case it upsets him. In the same way I'm scared about writing all the hundreds of things about the boyfriend that make me smile just in case it comes across as a little bunny-boilerish.

I'm scared about opening up about my hopes and dreams for the future and about my fears and feelings from the past. Blogging really is taking the whole heart-on-your-sleeve thing one step further.

I really have 2 options. Firstly I can man up and face my fears, write from my heart and just deal with the fall out. Secondly I might just have to give up blogging.

I don't know if I'm brave enough for the first, but I really want to try.

Dr Sunshine xXx

Monday 9 January 2012

New Year New Attitude

I know this is over a week late, but better late than never.

I got New Year's weekend off, which was lovely after the hard work I put in over Christmas. I'm not sure if it was celebrating New Year or having 3 days off in a row that was more enjoyable? Must have been a great combination of the two.

I've got over 1/4 of the way through my surgical rotation. Hurrah!

I need to pull my finger out a bit, and get some of the assessments for my ePortfolio done, but it's actually going OK. With all of the on calls I did over the festive period I made a resolution to myself. To relax a bit.

I'm learning more and more that getting stressed out doesn't help things, so the best thing is to just chill out. Stressing doesn't make my patients better. Stressing doesn't get my jobs done faster. Stressing certainly doesn't put a smile on my face.

For the last week I've managed to not let things get me down. If I have a lot of jobs I prioritise. If the nurses shout at me for urgent discharge notifications I don't let it get to me. We all have a job to do, it's not personal. I do the most important stuff first and quite simply that's all that matters.

On the whole this has made me a pretty chilled out and cheerful surgical f1. Let's hope that I can maintain this attitude for the next 40 years.

Dr Sunshine xXx