A Meditation On The Never-Ending Shift

I am a newly minted SHO, on my first weekend of FY2 nights.

It is a couple of minutes after one o’clock in the morning.

I have been at work for nearly five hours already and things are mostly under control. I’ve checked in with the seven wards that are my responsibility, chased a few bloods and a CT scan, admitted someone who had been transferred from another hospital in the late evening, seen a couple of sick people, answered a phone call from my registrar who is on call from home and wanted to check in with me before she went to her bed.

The staff on this ward have made me a cup of tea and encouraged me to help myself to the box of Quality Street on the desk as I write them up some paracetamol and routine fluids.

My tea-and-chocolate-and-fluid-prescribing is interrupted by my bleep, shrill in the night shift quiet.

A patient on another ward has spiked a temperature. It isn’t unexpected, but can I please go up and do the appropriate things? I go, dropping off my fluid chart at the nurses’ station on the way.

Upstairs, the patient I have been called about is reasonably well with their temperature. I examine them and explain what I’m going to do. It is a hospital where we have regular patients, and for this person it is not their first time at this particular rodeo. They are ruefully accepting. I look through their notes and obs, take bloods and blood cultures, and prescribe antibiotics and a bag of fast saline. I make a plan with the nursing staff that I’ll review them again later in the night, after the antibiotics have gone through; but they’ll bleep me before that if they are worried.

The radio that I carry on these shifts squawks at me. The shift coordinator wonders if I can put in a venflon — the patient is due medication, and our clinical support worker is busy and anyway in a building on the other side of the hospital campus. Yes, of course I can. The procedure is straightforward and done quickly. I check my jobs list, and rewrite a prescription chart and update some fluid prescriptions while I’m there.

I cut through the ward next door on my way back downstairs. I am intercepted by a member of the nursing staff. A person has died. We speak about whether the death was expected — yes — and the patient was comfortable — yes — and the family were there — no, but they are on their way back. I go into the room and spend a few minutes with the person, and perform the last offices of my profession. Afterwards, I locate their medical notes and document my findings. Rest in peace, I write.

I arrive back at my now stone cold cup of tea. I have been away for an hour.

It is still a couple of minutes past one o’clock in the morning.

Keep watch, dear Lord, over those who worked and watched and wept this night.

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