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


  1. I know this probably isn't the response you're looking for, but that sounds awesome! #superkeenfirstyearmedstudent It does sound very tiring though, I bet your feet are killing you from traipsing around the hospital all weekend. It's good to hear what you actually get up to at work :)

  2. Love it!!

    LOOOL!! 'Juice is also a fluid'

    and 2nd bleep 'Shiiiit'...LOL!!

    I'm glad you're enjoying yourself. It really is a joy to be able to read about what you get up to on the wards. Insightful and encouraging. Thank you for writing. =) xXx

  3. Well, you can't complain about your job! It sounds AWESOME!! Love it how you manage to find all the positive bits of everything and try to make sure you enjoy all the parts of your jobs :) If I ever need a doctor, I want you as mine :)


  4. Sounds like the saying "No Pain, No Gain" applies to learning too.

    I'm glad people are making you tea & appreciating your hard work too.

    I had a comment like your fluid situation - As i handed her the cake (have a look at the photos on facebook if you get a chance, you're colleagues will love you even more!) I said "This is Vegan" the reply? "Vegan? what's that?" said not in the sense of not knowing at all, but just totally unsure of what dietary restrictions it entailed. I like to teach others things too, don't you?

  5. Interesting weekend, no wonder you needed your bed afterwards. Although I had to smile at the fact nurses do not take bloods, what on earth? Would it be so difficult to train them to draw blood!

  6. Pah, luxury, when I were a lad we used to do 72hrs at a stretch on a weekend, and my on call room were a 'ole in't ground covered wi' a tarpaulin. We used to have to get up an hour before we went to bed, etc etc.
    Seriously though, if you think it is bad now think what it will be like if the dinosaurs succeed in getting you exempt from the working time directive and you go back to the bad old days. In fact we did use to do 72 hour shifts!

  7. A fantastic read, and sounds really exciting! Thanks for getting back into posting :)

  8. I really like your blog. its really well written and personal. Scares the shit out of me as a finalist that this will be my life in less than 6 months......
    But also makes me wonder what It'd have been like if I followed plan A and worked in singapore (long story) where they still have the old system and HO's get worked to the bone.....