Wednesday, 21 December 2016

Another Set of Nights

So another set of nights.

Oh how I'll miss medical nights. My lonesome figure patrolling the long corridors of the hospital, travelling from ward to ward.

Weekend nights are worse than weekday nights. Fact.  

If it's quiet and there aren’t many jobs (which doesn’t happen often) it can feel painstakingly long. On the flipside if there are many jobs then it becomes hard to squeeze a break in.

I'm up and down, prescribing fluids and rewriting prescription charts. Why that needs to be rewritten at 11:45 pm is beyond me. I could stand there and argue why some of the requests are not appropriate but there are three 12 hour shifts and I need to pace myself.

It's sometimes difficult when I'm asked to change a medication or prescribe something new for a patient I don't know. I have to pause, go through the notes and try to understand what the regular team were thinking. Get into their thought process. Essentially, I'm taking over a patient's care from their regular team. Some of the notes are barely legible but it's my only form of communication between me and the consultant who was on the ward round 12 hours before. I try to understand their rationale, what their thinking was, baring in mind I have no specialist knowledge on the patient's condition. If a family member has a concern, I'm the person they speak to. It's me. I try not to think about it too much, but it's a lot of responsibility.

It's difficult to prioritise sometimes. I understand it's problematic for the nurses as well. To them the patient that's in front of them is the priority. I have more have more than 200 patients. Obviously not all of them will need something in the middle of the night. Friday was fine because the jobs come up on the computer system sporadically. So there's a fair few but nothing too urgent and some quite easy tasks. Compare that to Sunday. Bless the day team they have a worse deal than I do, but they often handover a list of things they weren't able to get done. This list happened to be quite hefty on Sunday. So I had that list plus the list of jobs that nurses were putting on the computer system. I had a steady 10 jobs going at any one time. I would click a few off as done and refresh the page, hoping it would have gone down to single figures only to realise that a few more have been added on. Made my heart sink. Thankfully, the registrars handled some of the complicated ones.

Then there are the acutely ill patients. I was called to someone who was agitated.  I tried to assess him as well as I could and found that he was hypoxic*. Everything I gave him wasn't helping and I couldn't move on onto I got his oxygen saturations right. So I was stuck. And in that moment, where I haven’t been able to examine him properly and I'm unsure what the cause is I don't know what to do.  I don't know what the problem is and I don't know how to get him better. All I am certain is that the patient in front of me is unwell.  I did as much as I could before calling the medical registrar: Xray, ABG, sent bloods off etc. and it's a relief when she arrives.

On a Sunday night, the one shred of hope I hold on to is that in a few hours, the hospital will be fully staffed, the doctors will be back and everything is back to normal.


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