Night Ward Call

March 28 – May 1, 2016

5 weeks… 5 gruesome weeks of night shifts, being the only junior doctor covering nearly the entire hospital including: general medicine, general surgery, orthopaedics, cardiology, sub-acute geriatric evaluation, pallative care + oncology.

Let’s just say it was a lonesome time working mostly by yourself! Never another soul in the staff lounge when¬† you do have a few minutes to relax.

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There were many significant moments for me, including unexpected deterioration and deaths of patients, attending my first full-on resus (CPR, advanced life support – patient didn’t make it), managing many acutely unwell patients, etc!

One of the more fun moments – being approached by a nurse, “I don’t know what’s happening with this patient, but there’s all this blood on the floor after she’s gone to the toilet!”

My immediate reaction, “What?! What do you mean you don’t know?!” This was also right in the middle of reassessing a lady for a potential MET call. So the shift coordinatory (nurse in change) and I ran down to the other side of the ward to check on this other lady and was greeted by this wonderful sight:

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Don’t worry guys, she was fine! She just had a huge infected intra-abdominal abscess that was awaiting surgery when it finally exploded! She was actually feeling well with some of the pressure relieved!

So many memories from my 5 weeks on night ward call – it was definitely busy and sometimes incredibly stressful. But my medicine has definitely improved and I was happy for the experience.

Not to mention, I lost weight working nights and looked my best (ever) for our wedding! ūüėČ

What’s it like being a doctor?

How’s your job? Do you like it? Are the hours crazy? Are the nurses nice? Are the surgeons mean?

Just some of the repeated questions I’ve received from family and friends since starting work as a medical intern. ūüėČ

I was¬†on the General Medicine ward for my first 5 weeks. Then we went on our annual 5 week holiday (which I’ll definitely tell you more about later) and now I’m currently week 8/10 of another Gen Med rotation. Where has the time gone?!

First day on the job…¬†I knew absolutely nothing and no one, it was fantastic. (Not). I spent every¬†day imitating a sponge as best as I could. Trying really hard¬†not to look too much like a¬†fool¬†while absorbing everything I was seeing¬†around me. Trying to remember patients and their issues, staff members’ names and their roles, which forms to fill and how, where to find equipment and leave specimens, etc.

It was exhausting. For the entirety of my first week, I got home, ate dinner and immediately fell asleep.

However, like many other tasks in life, I gained familiarity and through that, confidence. With time and experience, I’ve even built some competence! ūüėČ These days, not only do I leave work on time, I also don’t take work home with me AND I can stay up for hours after having dinner!

Some of you may have heard the saying, “Interns are just pens with legs.”¬†The reality is, there is some truth in most medical stereotypes. I mean, we do have to…

  • Make sure the patient list is up to date
  • Write the chart notes during ward rounds and patient reviews
  • Fill out request forms, such as pathology, imaging, referrals, etc
  • Complete the discharge summaries

So yes, a lot of writing is involved. But can you imagine if this pen ran out of ink?

Who would keep people up to date with patient notes? How would patients get their required tests? How would GPs and other doctors know what happened to their patient and what follow up was required?

As the ones who¬†spend the most time on the ward, and through the above roles, we often end up spending a lot of time with patients and their families. We are¬†the first point of contact for nursing staff in caring for patients. We help¬†to clarify questions¬†and provide more information. We listen to and acknowledge concerns, even if only to provide a joke and share a smile. Not to say the senior doctors don’t do all the above and more, it’s still¬†a rewarding experience for us junior doctors.

So yes, we are at the bottom of the totem pole. Some days you feel it, but most days you’re definitely an essential part of the team.

Orientation Week

January 12-16, 2015

Looking back, our one week orientation in preparation for our new job as medical interns went by in a blur. Was it useful? I sure thought so at the time. But when you have so much information being thrown at you with the expectation that you will remember everything – sometimes it feels like pouring water over a duck’s head… nothing sticks.

Important aspects I remember:

  • A chance to meet our colleagues, the other new interns – at social events as well as part of orientation. It’s nice to start a new job as (at least) acquaintances rather than strangers. Also a good idea to socialise when you’ve just relocated to a new city ūüėČ
  • Meeting the staff of the Medical Education Unit (MEU) – they look after us and make sure we are alive and well… and still do!
  • Cultural Practice Program – an introduction to the culture and practices of those who identify as Aboriginal or¬†Torres Straight Islander. Amazingly, I have never received such a talk through out medical school. Even simple knowledge¬†like how their family hierarchy works can make¬†a difference in the care of those¬†patients.
  • Listening to a panel of 2014 interns sharing their tips – interesting at the time… but honestly can’t remember everything¬†everyone said.
  • Skills rotation – refreshing our suturing, cannulation skills, etc.
  • Spending time with the previous interns on the ward we are rostered to. Good to get handover and tips. Would’ve been even better to spend more time with them getting hands on experience prior to starting our first shift.

Everything else… can’t say I remember much of it now. Not to say I didn’t find it useful at the time, but we¬†really had to learn most aspects of our jobs on the go. Listening about how to do paperwork or order tests is never the same as going through the process of doing it yourself.

Then it was pretty much ‘hit the ground running’ on our first shift. Exhausting because you are so unfamiliar with everyone and everything. But by the end of first week, everyone gets the hang of things.

Do we become smarter? Knowledge-wise? …Maybe. Administratively? Most definitely!

People joke that medical interns are ‘pens with legs’ … sometimes, I don’t disagree! ūüėõ

Joking aside, my first few months working as a doctor has been great. Impossible to sum it up in a single blog post but I hope to share stories in the future!