All In A Day’s Work

For the past week, it has been extremely busy. I attribute this to the deck phone I’m holding, the patient load my team has, and just being unlucky.

Firstly, the deck phone; it’s a blocky black and grey phone, which vibrates, and plays a ring tone that makes me shudder in fear every time it rings. It’s constantly like a lottery, except it’s a lottery of bad luck. If I’m “lucky”, I might just get a call about giving a phone order for Paracetamol. If I’m “unlucky”, I might get asked to see a patient who has chest pains, or someone who is short of breath (as I was told to just this morning).

My deck phone is extremely efficient; at creating more work that is. For some reason, I’m always the one holding it, even though there is a registrar and another intern on the team. If the registrar borrows the phone to call someone, it will somehow always make its way back to me. Same with when the intern “borrows” the phone. It will be handed straight back to me. Perhaps the most amusing incident was this morning, when the registrar said to me “since you’re on phone duties, would you like to make the phone call for transport services to get this patient transported to the metropolitan hospital?” Since I’m on phone duty…. I never wanted to be on phone duty actually, but I’m always being handed the phone by you guys anyway.

On my first day on the team, I told the intern, “I’ll take the phone today, but let’s take turns holding the phones on alternate days.” Seems that somehow this conversation was forgotten. I suppose partly it is my fault in not enforcing this upon the intern.

Today was particularly bad however. As I got on the lift to see a patient downstairs, my phone rings. I need to put a cannula in a patient. The patient needs protective equipment used (gloves and gowns). Starting the procedure, and all gowned up, the phone rings. I am not allowed to answer the phone because I’m gowned up, and because I’ve already started the procedure. The phone rings once for about 20 seconds, and then hangs up. This is followed by another two times. I think that it must be urgent given how many times I was called. Is a patient dying? Finishing the procedure, I call back, only to find that I needed to write up some eye drops for a patient. 3 phone calls missed consecutively, just to write up some eye drops? My goodness, I am scared to find out how many times the phone would ring if I was unable to answer it, and it truly was for a patient that was sick/dying.

Aside from the deck phone, the patient load seems to be quite a bit lately. We’ve been getting a few patients with some being a little bit sick.

There was one patient that I had to see yesterday who was tachypneic. A very anxious elderly lady who was essentially palliative, having a left mid ureteric stone, urosepsis and end stage COPD. She was deemed too great an anaesthetic risk to have her kidney stone operated on. So, having tachypnea of 32, and then later finding out her phosphate levels were critical, and then later finding out her troponin was elevated presented a major nightmare. In addition, the consultant wanted CTPA (her kidneys were too shot to be safe for the contrast) and the patient had refused a V/Q scan. So not really knowing, I ended up just putting the patient on therapeutic clexane. But wait, the patient had haematuria a few days prior….

When I saw the patient yesterday with her daughter, I explained to her about her deterioration, and why I was giving her IV phosphate. She asked me if I could euthanize her yesterday. She still asked me if I could euthanize her again today. I had to politely explain to her that in Australia, euthanasia was illegal, and I certainly was not going to euthanize her. I ended up phoning my consultant for further management, and spoke to the ICU reg in regards to placing the patient on CPAP. I suppose the patient appreciated that I was doing what I could to help settle her SOB and tachypnea, and when my consultant came around, she told him “this doctor is really good, he’s been running around everywhere to help me”. That was perhaps one of the more uplifting moments for today for what was a relatively crappy day.

It was about 3:45 pm, and my back was aching from the busy day. Just one more patient to see. But upon seeing the final patient, they seem to have had it for me. The patient had been on isolation precautions, given that she could have had respiratory viruses. Having been visited by masked nurses, and told to stay in bed likely, I can understand the patient’s frustruation. I was just unlucky enough to come in and get blasted to smithereens by this patient’s frustration.

When it comes finally time for home time, I decide to check my email and find out the new updated roster. The person doing the rosters had decided to put me working on Sunday now, without contacting me at all. It’s almost like I’m indispensable, and not doing anything on Sunday. I email her, and tell her that I already had plans on Sunday, and to schedule me in on such short notice, the very least she could have done was call me first. Yea, I doubt I’ll have this coming Sunday off. Best crappy end to the day of a very busy day.

Now, onto the dreaded tomorrow; the intern will be off tomorrow, so it will be just me and the registrar…. I really need that Sunday off….

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