Monday, 29 February 2016

My First Night Shift

To be frank, I wasn't looking forward to it. I had failed to haggle a day off before the night shift unfortunately, which in hindsight is probably fair enough. But I did manage to get a day off after. Thank goodness for small mercies. Anyway, I wasn't looking forward to Thursday night at all. By Tuesday, I could already feel a cold coming on. That tickly feeling in my throat, which  was only slightly uncomfortable, was a warning of a greater doom impending. 'Please, not now', I prayed. In actual fact I could have postponed the night shift. I had just needed to do one, it was not specified exactly when. I still had one more week of the placement left to choose a night from. But I had planned it specifically for this Thursday, so that I could take the Friday off and have the weekend to recover. And I couldn't miss next Friday. So, I decided to stick to the plan.

Now, the preparation. I had to be in on Wednesday as normal. I did the ward round, which was excruciatingly long. 4 hours of standing and trailing behind the consultant as we weaved in and out of rooms and curtains. And as it stretched out I knew I was definitely coming down with something. My body was feeling a bit achy and heavy, but not a great deal.

Finally ward round ended. And I'd decided by then, to go home. Thinking it through, I was doing a 12 hour night shift the next day and I was getting ill. If I tired myself out now, I wouldn't be able to survive it. So I left.

I got home and just slept, which was weird. I must have been really tired. Fast forward to 2 hours later, I woke up blurry eyed and feeling very much refreshed, ready to begin my preparation. My plan was to stay awake all Wednesday night, so that I could fall asleep Thursday morning and  wake up refreshed to take on Thursday night. For this task I needed help; snacks, remote control, cups of tea/coffee, blanket, laptop. It was a long night

The next day I woke up and got ready for my night shift.

The beginning of the night was ok. Just a bunch of routine jobs that needed doing. I was tagging along with one of the FY doctors. He was really chilled out and funny, so we had a laugh.

Then things went downhill pretty quickly. We were called to see someone who supposedly had post ictal confusion. I wasn't expecting anything major, I thought we would go down help out a little and be back on our merry way. When we arrived the patient was pacing around the room, rambling and shouting about someone being swapped for someone else and then repeatedly pulling at the emergency buzzer on the wall. Every time she did the whole ward would pulse with this red glow and the alarm would go off. She was definitely agitated.  It was now three in the morning and we'd been there for an hour and a half at this point. Eventually the F1 prescribed some sedation. We ummed and arhed about which one would be the best, but in the back of our minds we're wandering how we will persuade her to take it. Thankfully, she required minimal restraining. We came back an hour later, to check up on her. She was fast asleep.

'We  need to take her bloods'. What? The patient was asleep, the nurses were finally getting back to their jobs, the ward was quiet and peaceful and now we were going to wake up the acutely psychotic patient and stick a needle in her arm. I was slightly apprehensive. But it went better than expected.
The next call was to see an elderly patient who had fallen and nursing staff was querying a seizure. It was a small elderly lady who was very frail. We couldn’t feel a pulse or take a blood pressure reading so we had to put a crash call out. They were trying to take blood but they couldn't get a radial pulse, or a brachial pulse and just barely managed a femoral pulse.

It was difficult to get a cannula in. Once they did, we all set about squeezing 500 ml saline bags as hard as we could to propel some fluids into her system. Gradually, all her observations started picking up and thankfully she improved. Her husband came to see her. We left them to it.
By that time. The sun had risen, and was shining in all its glory.

We did a few other menial tasks. And finished off the shift.

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