At first, I found it really draining and difficult to quickly consolidate all the information given and work out a sensible plan for patients
Did I remember to book that blood test? Was that the right dose of antibiotic? These thoughts play havoc with my mind before drifting into a restless sleep until my alarm goes off at 6.30am. As the sleepy haze clears, one thought lodges stubbornly in my head: I am on my own today – an honorary ST1, registrar and consultant. With five months of experience in general medicine under my belt, I’m sure I’ll be fine.
Arriving at 8.30am, I prepare the list of patients, eyeball the latest test results and pending jobs for today. Once I’ve prioritised my jobs – those needing cardiology reviews will be top of the list, along with those requiring TTAs to go home – I will then start the ward round. During my round, new patients arriving in A&E will be handed over. At the start of my F1 year, I found it really draining and difficult to quickly consolidate all the information given and work out a sensible plan for patients. While walking on the ward, I sense calamity behind one of the curtains, and sure enough a sister runs out with a lorazepam vial: one of my patients is in status epilepticus.
There is nothing to compare with your first very sick patient or first arrest call. Within my first week on the wards I was faced with a hypoxic, hypotensive and febrile patient; all knowledge seemed to escape me. Keeping the principles in mind, I approach this with ABC. In the end the anaesthetist is called; he asks me: “Is this lady for HDU?” I answered with: “Of course!” Why would someone not be for HDU? Sometimes I feel so appallingly out of my depth. Predicting our patient’s prognosis and chances of recovering from life-threatening illness is terrifying, but luckily I have very supportive seniors to guide me through.
I take great comfort in the adage “sometimes cure, mostly treat, always comfort”
Lunch – it is easy to avoid lunch: this only makes you exhausted, physically and emotionally. This year has taught me the importance of self-preservation – there are always jobs to be done. My attitude has had to change – I take great comfort in the adage “sometimes cure, mostly treat, always comfort”. So I applied it to the rest of my afternoon – calling wards, bleeping specialties for advice, reviews, calling other hospitals, ensuring procedures are booked, talking to relatives. As Chuck Berry wisely sang: “It goes to show you never can tell” – I am never bored and this is what I adore about it.
Ward cover on-call stirs feelings of inadequacy and being dragged in all directions, similar to when I worked in an understaffed restaurant. Being on-call in A&E is a personal highlight. It is where I get to see patients “fresh in”, make decisions and diagnoses and get to perform procedures such as lumbar punctures and ascetic drains. It is a very stressful environment, but I enjoy the camaraderie of working with colleagues and friends. The day ends between 6–7.30pm. I go home for a hot bath, good food and the local pub. A wise professor at my hospital said: “Do you know the key to being a successful consultant? Being happy.” I keep happy by remembering why I became a doctor in the first place – there will always be downsides: the bureaucracy, the hours and difficult personalities. But at the end of the day, being a success as a doctor overrides all the negative points; all except that early start tomorrow.