Wednesday, 27 July 2011

European 48h laws... and those damn interesting patients!

I worked from 8AM till almost 9:30PM today. This is no rarity. I am tired, and I am beginning to regret certain choices in my life. I fought damn hard to get my life back from the claws of my past; and all I do is work. I don't feel like a hero, or 'special' because I'm the doctor. In reality many patients still can't comprehend the fact that women can be doctors too and call me 'nurse'. I have all respect for nurses, but if I wanted to be a nurse I would have gone to nursing school.

The best one?
Me: Goodmorning mrs Little old Lady, how are you doing today?
LOL: Morning Nurse, I'm fine, actually!
Me: Eh, Doctor...
LOL: Oh, sorry, Doctor. You know, I think it's so great that young women are doctors nowadays! Go Girls! But aren't you too young to be a doctor?
Me: Eh, thanks, and no, I'm the same age as most other graduates!
LOL: but you look so young!
Me: I suppose I'll appreciate that in ten years. Now, have you had any more black stool?
LOL: Not much, Nurse!

I spent the rest of the day talking drugs, infidelity and shit on the gastro/onco ward. Always fun!

Internist nr 1: So, if you were a little Clostridium spore, what would make you think 'Ah, this is great, I'm going to become a bacteria'?
Internist nr 2: Spores don't have brains.

Gastro doc: You have a colitis, but it's not bleeding anymore. We'll observe you for a bit, and if your stool is normal, we'll discharge you on Friday..
Old lady: Ok. So if I make a good poo, I can go home?
Me: Basically, yes...

But seriously. EU regulations state a 48h max work week for doctors, with good reason. I'm tired, and I'm regretting certain life choices, and working 65+h weeks isn't making me love medicine any more. Yesterday I was naughty and went home before 8PM. I paid the price, but I don't regret having time for a DVD. Today I spent the entire day running and talking, and I still had a lot of admin to do at 7:30PM. I went home when the system stopped responding.
Monday I left the hospital at 10:01PM. One of my patients died at 7:15PM. I came home close to tears, not because she died, because that's what cancer patients do. I came home close to tears because all I had time for was a shower and a quick cuddle with my rats... and then sleep and the whole thing would just start over again. I want to go pick up a new rat at the shelter, but I don't have the time for it.

The problem is, roughly, that there aren't enough doctors to take care of the patients in 48h a week. Mind you, I don't even have time for the discharge letters, and meanwhile specialists and secretaries are moaning about unfinished letters. I have no idea when I'm supposed to do them.

Sunday, 24 July 2011

Tips for Junior Doctors part 4: do your wondering beforehand

New patient got transferred to my ward with a hypo (insert every electrolyte here). And oh, yeah, something with his thumb. Now the hypokalaemia, hypocalcaemia, hypophosphataemia, hypomagnesaemia, hypoalbuminaemia, hypochloraemia and hyponatraemia and oh, the diarrhoea he had as a result of the phosphate suppletion were things I'm supposed to be able to deal with as a medical SHO. The resulting hyperkalaemia too.
Thumbs, however, are too difficult. The chart read 'consult plastics'.

I phoned my colleague who took care of said patient to find out if plastics have been consulted. No, they haven't.

So; I phoned Plastics, who, I might add, only have consultants. Said consultant was operating.

Me: 'Eh, I have a consult for you. Mr X has been admitted with about every possible electrolyte disturbance after quitting alcohol. Now I just got him on my ward, and I also discovered that you haven't been phoned yet for his *reads chart* eh... chronically grown in thumb nail'

Right. I just phoned an operating plastic surgeon to come and see a grown in nail. 


Dr Silicone: 'Right, I'll come see him Monday on my round'

My return and my primary school; they're completely correlated.

Oh, by the way, I'm returning to the Blogosphere. Just so you know.

Also, just so you know, I'm fascinated by the random search terms that lead to my blog.

I'm nearly done with my apartment, was just sorting out my jewellery. I found some stuff I haven't seen in years, including my very first pair of stud earrings. I had my ears done when I was 8. They're blue, to match my blue school uniform.

Speaking of which, my grade 3 teacher still teaches grade 3. I used to be scared of her, she was a notorious slapper. In hindsight, she was fair and only hit you when you actually did something wrong. For the record, in the 1990s South-Africa, physical punishment of children was the most normal thing in the world. The school as a whole has gotten smaller. It's not a private school. They have 3 classes per year now, we had 5 and we were already somewhere between 30 and 40 in a class.
In Africa we didn't get the whole pedagogic schooling European kids got. We went to school to learn; child rearing was our families' job. I got homework from grade 1 onward, and from grade 4 onward I was responsible for getting myself to class and making sure I got the right books with me AND that my homework was done. (At this point, we were past Mandela, and physical punishment was technically not allowed, but detention was allowed...) Imagine the shock I went through when I set foot in a primary school here! I was turning 12, and the kids didn't get homework, they didn't have to bring books to school... they just had to bring their food and drinks for breaktime... which was placed near the sink so they don't lose it. The result was that I dropped out of primary school, skipped a year and went to secondary school.

Many of the teachers still work there. A bunch of others look like they're my age. Ah, the joys of internet! All I wanted was a pic of my uniform, to demonstrate it's blue-ness.
Luckily this bloke used his daughter in one of his flicks, and coincidentally he also sent his children to my school (the school's in the background!)
http://www.youtube.com/watch?v=STIKcVFQ53w&feature=related

A Good Work Out

I'm a runner turned gym bunny.

(And while typing this, I'm watching BBC's Robin Hood; and wondering how likely it is that his Merry Men had crucifixes tattooed on their arms in medieval times....)

Anyway. So I'm a runner turned gym bunny who also suffers from sub-clinical ADHD. Apparently.

I miss running. I miss being outside, but not as much as I would have if we had an actual summer this year. I was at the gym, doing the Fit and Fun Circuit and meanwhile watching the WC swimming in China something. (No sound, and I was too far away to read it). Then that made me miss swimming.

I did a BodyCombat class. Then, I did the 10 minute ab workout. Then, I did two rounds of the Fit and Fun circuit. Then, just for the sake of it, I did a 10-minute trot on a treadmill. I want to retrain those running legs; but the legs themselves seem to be the problem.

At least, being a gym bunny, I can work on my fitness without busting my still fragile IT-band again, and then, when the time is right, I'll be able to run again, and run fast.

In the meantime I suppose I'm wearing my running tights and running shorts to the gym; and while it's fun to run in the rain once in a while, it's been doing nothing but raining lately. Also, my gym shoes are in better condition than my running shoes (wonder why...) and my funds are slightly low these days... so it's good to know I'm making the running shoes last a bit longer!

Sunday, 17 July 2011

Tips for Junior Doctors part 3: remember everything.

I'm on a ward with mostly oncology and gastroenterology patients. (However, pretty few gastroenterological oncology patients, they tend to hang out at the Colon Cutters). It's not my favourite ward to work on; patients are complicated, time demanding and everything else is chaotic because I have 3 different supervisors. Apart from that, a certain nurse drives me nuts.

But that aside; I made the mistake of forgetting to fill out the paperwork to send a CD with a scan to another hospital. To err is human, but to be a doctor is to be superhuman, you see.
Ever since the oncologist who ordered me to fill out said paperwork keeps on telling me to write everything on my list.
To the point where simply prescribing the drug then and there would be easier than writing it down and then prescribing it.

And then I have to go find the nurses to do stuff; and they're always nowhere to be found.

Saturday, 9 July 2011

New apartment!

Yes, I've been MIA.
And yes, I have a very good reason: I just moved and I have no internet at home yet, and my phone sucks. I promise I'll be back! And a great July to you all!