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Wilkommen to my blog - my name is Karin Purshouse, and I'm a doctor in the UK. If you're looking for ramblings on life as a junior doctor, my attempts to dual-moonlight as a scientist and balancing all that madness with a life, you've come to the right place. I'm currently a doctor/research trainee in oncology after spending a year doing research in the USA. All original content is licensed under a Creative Commons Attribution 4.0 International License.

Wednesday, 21 November 2012

Weekend-a-geddon +2

Day 6: Saturday morning.  Slept terribly, got to bed late and awake at 6am. At work I am delighted to find I have a senior person to review patients who we've been asked to review over the weekend.  This is excellent news as it leaves me free to do the more menial jobs of chasing blood tests and receiving the rather endless stream of bleeps.  We're doing well (with just one crash call to run to) and by the time he goes home at 5pm, I've even eaten some food, had some fluids and feel vaguely on top of things.

Post 5pm, I'm on my own to mop up the remnant jobs and address any arising issues.  The problem is, there's only one of me, and I only have two hands.  The hospital has been so busy that a lot of the patients I've been asked to check bloods for over the weekend have been moved (many to the other side of the hospital), but their blood test cards haven't, so it's down to me to find out where they've gone and do the blood tests myself.  In addition to that, there's patients who are unwell, drips that need replacing and families who want updates.  My bleep is going off every five minutes and I've no sooner started a job than my bleep goes off again.  I have to risk-stratify my list of jobs and decide which ones I will have to hand over.  I get to 9.30pm and I am beaten.  A few tears are shed, not because someone has upset me, but just because I am tired and frustrated with myself.  My seniors always remind me that I need to just CHILL and accept that I can't do everything; although I know that, it's just frustrating that that's the case and ultimately, it's irrelevant to the patient or nurse at the end of that bleep you've just received that you've been on the go for 12 hours.  Just as we sit to hand over, an arrest call goes out and we all peg it to the relevant ward to start CPR. We're unsuccessful and it's a slightly sombre end to the day.

After all of that, I go back to my own ward to check a couple of things and leave hospital after 10.  Home after 11.  Quick pizza dinner, bed.  Same again tomorrow.

Day 7: Sunday morning.  Cream crackered and eat the remnants of last night's pizza for breakfast before heading into work.  Classy.

The ward registrar and I get tactical - I hate being disorganised and today I've consolidated the ten sheets of hand over patients into one 'ultimate list of lists'.  It's pretty frantic for the first five hours as we go round reviewing the patients we've been asked to review, chasing bloods, the odd cannula and trying valiantly to encourage people to put non-urgent jobs in a ward-based book rather than bleeping me all the time.  Another crash call takes us jogging into A and E - this patient survives.  When the ward registrar leaves at 5, I've got a fairly manageable to-do list.  I'm majorly flagging but there are still bloods to take and chase, and just at the end of the day, I'm asked to review someone who's breathing has changed.  It's quite a satisfying bit of teamwork as we get his bloods, ECG, chest x-ray and diagnosis within the space of about an hour.  The night junior doctor greets me with a cup of tea.  My hero.
An accidental snap, but accurately reflects the fatigue!

Day 8: Monday.  Everyone else is looking bright eyed and bushy tailed - the week is no shorter if you've done the weekend on call so I'd better keep up the pace!  Over the weekend my ward has essentially discharged half of its patients so it's all new faces - but luckily I know a lot of them because I've been involved in their management over the weekend.

My registrar and senior house officer are both on call today in the admissions unit so we're a team until midday and after that I'm on my own.  There are only a couple of patients left to see, a few discharges to sort out and the care for everybody else to coordinate.  Finish about 6pm and the boss turns up - luckily I have something useful to say about the day!  Time to head home, walk in the door about 7.30pm.  First time I've been in the door before 11.30pm since Thursday.  And then to the pub.

Day 9: Tuesday.  An unusual week this week as I'm at a meeting today for the whole day.  Although it's still a full day of work, it's refreshing to think about something else (although it is still basically medicine chat).  Issues discussed include women in medicine, something I feel increasingly passionate about.  It is different being a female doctor, because ultimately, I predominantly serve an age group of population for whom female doctors was a rarity.  Persuading them that I'm a doctor can be a challenge.

Get home no earlier than if I'd been at my normal day job and go to a friend's house for dinner.  Inevitably, medical chat predominates, although we reflect a lot on how we got to being here and how it's going to impact on the rest of our lives.  It's funny to think that we chose a career when we were just teenagers, and it's one which almost defines my whole identity now.  We talk about our respective 'Medical Finals breakdown moments' - the two weeks when I was doing my final exams at medical school were absolutely painful for my family to have to hear about over the phone.  It's weird how now that I'm doing it as a job, I don't feel they need to hear about the bad days.  They've done their time, and they don't need the worry of a wailing daughter down the phone!

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