Posted by: Jas | February 25, 2012

Nights.

Sometimes I wonder if HR hates me. My first rotation was “to be advised”, and I was notified of what I was doing only 5 days prior to me having to start. They allocated me to nights for 3 weeks, so with 2 weeks already allocated to ED on my initial roster, it meant that I still had nothing for the remaining 5 weeks. They offered that to me as leave without pay, which I refused, because all I needed was a week to attend Tiff & Frank’s wedding. Things kinda worked out because my night buddy wanted her last few nights off so that she could make it to a wedding in the US in time, so I got my leave, nights (again) in the last week of the rotation, and gastro cover for one week as the intern is going on conference leave. That leaves me 2 weeks of the unknown, and they have asked me to do a medical cover this coming Monday, with the rest of the week as on call for any unexpected leave. At least she did say they will pay me for the minimum 76h for the fortnight. It’s not as if I’ve done anything bad last year or made life difficult for them by calling in sick/asking for leave. SIGHS.

Anyway, I’ve actually enjoyed nights. Gonna miss my helpful night buddies, whom I’m thankful for :) Was a little apprehensive at first, because I had to cover certain specialties that I haven’t had any experience with since we’ve only done gen med during internship. But I learnt on-the-go, and it’s amazing how much new knowledge I’ve gained in this short span of time. Other than that, it’s been pretty straightforward things like high BSLs, hypertension, IV fluid orders, and analgesia. Because there are so few doctors in the hospital overnight, we go to all the MET calls/Code blues, so I’ve become more proficient in obtaining IV access in such situations now, yay.

I’ve also realised that small simple things that you don’t think about during the day do cause quite an inconvenience to the night people. For example, on the same night, I had to do 2 IV bungs at midnight because the patients were fasting for procedures the next day and had IV fluids written up to start at midnight yet no bung. Seriously, whoever wrote up the fluids should be responsible for making sure that the patient had a bung. Don’t even get me started on IV fluids that ran out in the middle of the night. I remember I was quite conscious of that when I did surg last year. It really isn’t that hard to count the hours and make sure your patient has enough fluids till the morning. I suppose it makes me more aware of such things now and I will certainly bear in mind when I’m back to working days. I wonder if other people are as considerate as me.

Part of my job includes doing admissions, and I actually quite enjoy doing them. Which brings me back to the point that I like being the first person to see a patient. Sometimes based on my assessment I can make a diagnosis, and hence come up with a management plan. Sometimes I don’t, but at least I get to think about what tests to order, how to next proceed. It doesn’t quite bother me not knowing what eventually happens, I’m just happy to know that I have stabilised the patient and kept them alive / prolonged the time for someone else to work things out further. The more I think about it, the more I’m inclined towards ED. But it’s still early days, we’ll see.

On my last night we were doing Endo & ID questions with our med reg, as he was preparing for his physician exams. It reminded me of my study group times, testing each other on the random sandfly/tsetse fly/freshwater snails questions, hahaha. Miss you guys!

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