Friday, November 26, 2004
Of Being a Registrar
Just got back from Medical Admission Unit. Got called there to see a 44 year old woman in acute exarcebation of asthma.
Doesn't matter what I did there, bottomline is I AM NOT THERE TO DO YOUR JOB !!!!.
"Please could we have your review with regards to managing this patient in intensive care unit" Sign, Dr G.
Bollocks! I got there and thought well ok yeah she needs to go to the unit, she's tiring herself and kept having this apnoiec attacks. So the medical registrar grinned the grin of yea-she-is-now-your-patient-take-her-away-quick-before-my-tea-gets-cold.
He had heavily stained teeth. Is it tea or smoking?
I looked at the treatment chart and something was not quite right. This is somebody who had been to the ITU so many times so much so that when I mentioned her name to the staff, they remembered her. So you would think that when she started wheezing, barking, semi-popping her eyeballs like a fish flunked of the water by some pussycat, trying to get some decent amount of oxygen in, they would have given the nebuliser back to back and maybe Magnesium Sulphate as well.
Fuh that was a long sentence. The pizza was hard and slightly stale. Must be the four cheeses.
Instead? The patient was on 24% oxygen, (this is asthma for crying out loud, not blimming COPD), the nebulisers had not been given, and she's on aminophylline which is so out of fashion.
Clarified this with the medical registrar and even went on the British Thoracic Society guideline homepage to show him the evidence based practice.
Crap! I sound old and pedantic. Kiasu +++++
We got there in the end and we were going to hold fire with her as she was more settled. See how she goes for the next 4 hours. I mean fair enough she tiring with all that extra work of breathing but we have not given her the maximum treatment medically have we? So really you guys ought to do your job properly. (The last phrase got stuck in my throat so, no, had not been nasty to medical people).
4 hours? I'd be home by then. That's the main idea really.
Had a weirdest feeling ever as I was reading the comment by Dr. G though.
"Discussed with the intensive care registrar (Dr. N Ahmad), who is happy to review the patient".
Now, I am quite happy doing this job minus the cold-sweat-breaking-moments I get from time to time, but being called a registrar sends chill down my spine. I don't believe I am reaching that stage already. No..no..no...
Should I feel sad, happy or equivocal? I shall just feel sleepy for now, Another 2 bloody hours till buggering off time.
Doesn't matter what I did there, bottomline is I AM NOT THERE TO DO YOUR JOB !!!!.
"Please could we have your review with regards to managing this patient in intensive care unit" Sign, Dr G.
Bollocks! I got there and thought well ok yeah she needs to go to the unit, she's tiring herself and kept having this apnoiec attacks. So the medical registrar grinned the grin of yea-she-is-now-your-patient-take-her-away-quick-before-my-tea-gets-cold.
He had heavily stained teeth. Is it tea or smoking?
I looked at the treatment chart and something was not quite right. This is somebody who had been to the ITU so many times so much so that when I mentioned her name to the staff, they remembered her. So you would think that when she started wheezing, barking, semi-popping her eyeballs like a fish flunked of the water by some pussycat, trying to get some decent amount of oxygen in, they would have given the nebuliser back to back and maybe Magnesium Sulphate as well.
Fuh that was a long sentence. The pizza was hard and slightly stale. Must be the four cheeses.
Instead? The patient was on 24% oxygen, (this is asthma for crying out loud, not blimming COPD), the nebulisers had not been given, and she's on aminophylline which is so out of fashion.
Clarified this with the medical registrar and even went on the British Thoracic Society guideline homepage to show him the evidence based practice.
Crap! I sound old and pedantic. Kiasu +++++
We got there in the end and we were going to hold fire with her as she was more settled. See how she goes for the next 4 hours. I mean fair enough she tiring with all that extra work of breathing but we have not given her the maximum treatment medically have we? So really you guys ought to do your job properly. (The last phrase got stuck in my throat so, no, had not been nasty to medical people).
4 hours? I'd be home by then. That's the main idea really.
Had a weirdest feeling ever as I was reading the comment by Dr. G though.
"Discussed with the intensive care registrar (Dr. N Ahmad), who is happy to review the patient".
Now, I am quite happy doing this job minus the cold-sweat-breaking-moments I get from time to time, but being called a registrar sends chill down my spine. I don't believe I am reaching that stage already. No..no..no...
Should I feel sad, happy or equivocal? I shall just feel sleepy for now, Another 2 bloody hours till buggering off time.
