Thursday, June 12, 2008

Almost ready. At least, I think. Well, maybe.

I finish my job shadowing tomorrow. It's been an ok week - my lazy F1 palmed me off to the other T&O F1 for most of the week, and he is very sweet and hardworking, and gives me jobs to do. And having something to do makes me feel useful, and therefore content. Even a big pile of TTOs to drawl through makes me happy. Easily pleased, moi? Hell yes!

The trauma meetings every morning are great - especially when the trauma board is quiet, and the consultant leading the meeting starts a teaching discussion. They start with me - as the student I get the easy job of 'Describe this film'. I can usually acquit myself well. Then the focus moves to one of the F1s 'How would you manage this patient in A&E? What would you look for on examination?', then to the SHOs with 'How would you definitively manage this patient?' and finally onto the registrars when I really lose the plot as they begin quoting papers and reviews and the like at each other to discuss the pros and cons of various techniques. I may not know what going on at this point, but the x-rays are still cool!

Today one of our patients started to go off. In a bad way. My F1, who thinks I am really rather useless but is loath to actually do any work, sent me to do an ABG (arterial blood gas) on the patient. I was nervous about this - I've never done it unsupervised and I'm a bit rubbish at it, but I got it first go (big plus as reduced discomfort for the patient - I felt mean doing it even the once, as she really wasn't well, and it really is very unpleasant) and returned within moments to present him with my little tube of arterial blood. He didn't look impressed, and dispatched me to A&E with extremely vague instuctions to use the ABG machine. I was wetting myself because, as students, we've had so many lectures telling us horror stories about the damn things, mainly how easy they are to break and how expensive they are. I did not want to get it wrong. I eventually persuaded a nurse to help, but she wasn't happy, and even less happy as I squirted blood all over the floor in my attempt to expel any remaining trace of air. I know, I'm cool. She also stood over me as I cleaned it up, which pissed me off. I am not the kind of person to leave a mess behind me, not at work, its too important, and I would hardly have left a puddle of blood on the floor in resus. But, I guess she doesn't know me, and safety dictates she should tar me with the 'all doctors are lazy bastards' brush.

Anyway, to cut a long story short, I got the results back, the patient got more oxygen, she got a wee bit better. Job done.

I think the most important thing I've learnt this week is that I am ready for the job. I want to be making a patient list, writing down jobs, prioritising, getting on and doing things, and feeling the satisfaction of a job well done. I want to be able to sign my own TTOs and drug charts, and not have to trail around after someone with the power. I'm ready to answer my bleep and run to save someone's life. Well, maybe write up some fluids anyway!

Don't get me wrong, I still terrified about actually being a doctor, but I'm also really excited about it too. I'm really looking forward to starting work, to having patients what are mine, and to being of some real use on the wards, instead of a spare part.

Wooo! Roll on August!


The Little Medic said...

I'm glad you feel ready because now I know that I'm actually going to be a doctor I'm terrified!

Anna said...

Wooo! TLM passed! The terror wears off when you job shadow and just want to get stuck in. Honest.

Marysienka said...

I've always appreciated nurses a lot. But this week? lemme tell you, they were a pain to me. Ugh. Yea I may be a student, but so what? do with it.

anyway, rant over. It's cool for the ABG (succeeding on the first try, that is!). You go girl! I haven't tried this one yet. I'm trying to find a guinea pig (someone that is not a patient!) at the hospital so that I can practice on them first he he he.

Finally, I really think radiology is for you. I will never enjoy reading x-rays... eeew never.

Anna said...

Marysienka,finding someone to practice venepuncture or cannulation = not a prob (I've been a guinea pig for a number of friends). But ABGs? Hell no! What you want is to find a nice unconscious patient who won't feel it...

I love x rays :). Plain films are the best, and I love love love trauma films. The messier the better. Well, not for the patient obv, but for me, well, nothing beats it.