So This Is What Normal People Do

As the surgical SHO, one of my jobs from time to time is to act as the receiving surgeon. On those weeks, I see all the patients who come into hospital with a potentially surgical problem and implement an initial plan, then I try to keep them straight both in my head and on my obsessive list so that I can present them to the consultant on the ward round and some actual decisions can be made. In the between times, I call my registrar a lot. One of us does that all day. One of us does it all night. Those are the weeks when I really don’t sit down much.

*

With a patient in ED, going through my usual list of “and now I’m going to ask a few general questions that might seem irrelevant but I ask everyone just to make sure I’ve not missed anything” questions:

ME: Any tummy upsets or problems with the bowels?

PATIENT: No.

ME: Any trouble with the waterworks?

PATIENT: … well, not really, but … now that you come to mention it … there was a day last week when I went to the loo after work and I realised that it was the first time I’d been since I left the house in the morning … and that’s not normal, is it?

ME: Huh. Really?

*

In evening handover, with a very lovely and enthusiastic third year medical student who had asked where we might best be found when they came in the following day.

ME: It depends. At about what time are you going to come in?

STUDENT: I’m not sure. What time do you come in?

ME: I come in at eight. Don’t.

STUDENT: At eight o’clock in the morning?

ME: Yeah.

STUDENT: Have you been here since eight o’clock this morning?

ME: Um. Yes?

STUDENT: But… How?!

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8 comments

  1. An ordinary day in the life of Dr. Beth, in which her patients drink not enough water, and her interns do not enough work. And in which our Beth is not enough at home, apparently…

    • Oh, no, I must be clear, the British equivalent of my interns – my FY1s – work very hard and very long and many of them need to be reminded to eat. The role of the medical student in Britain is very different from my understanding of the role of the medical student in the US and Canada, with less emphasis on service and far more emphasis on training.

  2. I’d like to do an audit on medical and nursing staff on receiving wards, recording their observations and MEWS at the start and at the end of the shift. We’d be at a minimum of 3 for urine output alone.

    I measure how busy a day has been by how infrequently I need to use the bathroom. Surgical FY1 here…we have the joy of spending 7×12 hour days taking GP referrals to surgery. It’s not fun in any way and I’m glad to say I now know my FY2 jobs and know I never have to do general surgery ever again! Unless my career plans take a drastic U-turn.

    We’ve some medical students around and when they ask what time time we start I always say “8am….but don’t come in before 9am!” They should sleep while they can.

    • Our MEWS charts don’t have urine output on them, but I remember a weekend of medical ward cover in FY1 when I had a patient whose creatinine was >400 and had been handed over to me as being anuric. I’m not saying there was a *lot* in her catheter bag, but she was less anuric than me!

      The only time I think that students should be in at 8am is if they want to come on the ward round, and that’s mostly because I think if you’re going to come on it then it’s rude to turn up in the middle.


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