August 18, 2012

What an Extra-Ordinary Nerve-Racking Medical Week!


What a week it has been! From the near-nerve-wracking weekend call to my usual Tuesday Unit Emergency Room call (ER take) and then, the Consultants ward-round bashing the very next day, with students looking on with eyes full of pity for me. What can I say? Its been an all-round bashing spree for me from both patients and senior colleagues. Boy, I've never had it this rough before now.

Last Sunday:
Last weekend was the roughest call I ever had - admitted over 15 patients in one night, Sunday night - with more than half of them critically ill and requiring regular monitoring. The morning and early afternoon periods had been fairly quiet, and I'd hoped it'd remain that way.

How wrong I could be!

Later that same afternoon, patients started trickling in in droves. Four diabetic emergencies meant i was responsible for the hourly monitoring of blood sugar, electrolytes (although this never comes back from the lab in time for a timely review) and, also hourly administrations of soluble insulin (never used a continuous insulin pump before because they just aren't available here).

Three cases of hypertensive encephalopathy, an acute severe asthma and six HIV patients presenting acutely with serious complications meant I was on my toes all through the night clerking, examining, prescribing, administering medications, and arranging for blood transfusions.

Perhaps, if I still had a houseman on call with me in the casualty, it may not have been so bad. But my unit now had only one houseman, and he was busy looking after patients in the male and female medical wards at the same time.
Just two weeks ago, we had three housemen, but two of them had concluded their postings, and left one after the other the week before the weekend call.

So I was all alone in the A&E. What a night it was!

And to think I'd been happy my name showed up on the roster for that day, because Sunday calls are call duties I usually look forward to being that they are usually quiet for me, so I end up doing my own thing - either sleeping, studying or the more likely option, blogging.

The next day, Monday:
Either by design or omission, I was due to present a postgraduate seminar the very next day i.e. Monday afternoon. This was extremely tough against the backdrop of the previous day's hectic call.

Did I mention my consultants? The very next morning, after a not-too-bad morning review session where I presented all admitted cases to the department, I prepared for my unit ward-rounds.

I'm always apprehensive of my unit rounds, because I constantly get verbal lashings from my current consultants in front on medical students and patients alike, no matter how well I answer their questions. Last Monday was no exception.

I can't help thinking that my consultants never see anything good in whatever any resident does. It just didn't matter how hard you worked (or studied), they always found out faults and leave you feeling empty and inadequate. Boy, they hit me very hard this time...and left a sickening feeling in the pit of my stomach.

Tuesday clinic and call:
Tuesday is the day my unit runs its clinic - the cardiology / gastroenterology clinics - and also its weekly call day. Call starts from 8am Tuesday morning and ends 7.59am Wednesday morning. Although, my unit runs the Tuesday joint clinics from 10am till 3pm, the resident on-call (whose name's on the roster) still has to leave clinic briefly to attend to any emergency that comes up in the casualty before 3pm.

Last Tuesday's clinic was fair, thank God. Right after clinic, i went for my call again...but this time, i was to cover the wards. Another resident was covering in the casualty. The surprising thing here was that the wards became alive that Tuesday night with unstable patients, further depriving me of sleep.

Its been an extremely hectic week...and i thanked God after the Wednesday's consultants ward-round. There was now opportunity at last for me to go grab several hours of sleep without any fear of being called up the very next minute. Boy, I hit my bed that afternoon, after my hospital work, with a very nostalgic feeling.

I look forward to the day this will all end - the harsh calls, the sleep deprivations, the constant verbal bashings during ward-rounds, and the many other unpalatable things i have to endure as a resident. I honestly can't wait to conclude my training, and begin practice as a consultant physician.

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