Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries
Related Posts:
- My First Night Shift Covering Medical 4 / Medical 5 / Infectious Disease Ward In Sarawak General Hospital – Housemanship Diaries
- The Most Enjoyable and Tiring Day In Medical 3
- My Next 6 Months (Post Housemanship)
- Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
- Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
- My Evening Routine In The Medical Posting | Housemanship Diaries
- My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
- My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
- Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
- My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
- 1 Year Of Housemanship Update – Housemanship Diaries
- Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
- Enjoying The Journey – Housemanship Diaries
The shift that I have always dreaded but enjoyed the most were the night shifts. I dreaded it because I knew that I would be alone most of the time and afraid that I would not be able to cope with the adrenaline rush or anxiety or the craziness that might ensue. However, I enjoyed it because that meant that I will be able to sleep in prior to going for my shift and the following day at 7am, the morning team will start arriving and I am not alone anymore.
The Medical posting in general is a “heavy” posting because of the patient load. Almost all of the patients are so-called “Medical” patients once Surgical, Orthopaedic, Psychiatric or other causes have been ruled out, and it could stem from something as simple as electrolyte imbalance to myocardial infarction or stroke.
Thus, imagine the amount of coming mornings.
Prior to entering this posting, I’ve always enquired and listened to my fellow colleagues’ input and experiences. Most of them would say that “In the Medical posting, the rule of thumb for surviving the night shift is to start taking the bloods as soon as you arrive for the night shift”.
True enough. That is something I have practiced since and even in other postings as you do not know just when something may happen and next thing you know, the sun is rising and your coming mornings are late and the morning team have arrived and the bloods are still pending or not in the system or yet to be taken and the medical officers and specialists have arrived.
Sadly, when there is a delay in the blood investigations, there is a delay in management.
Thus, it is a tachycardic moment for me. Prior to entering my shift, I would screen through the coming morning list and upon arriving, I would usually prep my trolley, ensure my coming mornings are divided and arranged according to their cubicles, ensure enough syringes and needles are set aside as well as the alcohol swabs and cotton swabs.
Then, I will begin taking my coming mornings, usually working my way from the back of the ward then towards the front cubicle, subacute cubicle and finally, ending with the acute cubicle.
Usually in between, something will occur, maybe a patient newly admitted into ward or a patient will suddenly be hypotensive or hypertensive or hypoglycaemic or starts throwing up or wants to have a small talk.
Normally, I would not mind entertaining them. However, if I’m still due to complete my coming mornings, I would proceed to complete it and I usually will not rest until I do. At least I’ll be rest assured that should anything occur in between, I would not have to worry about the completion of my coming mornings.
The night shifts can be rather unpredictable as one minute it can seem rather quiet and calm at first and hectic the next. At times, it can get overwhelming as well.
However, have faith and know that help is always nearby and start taking your bloods as early as possible.
Related Posts:
- My First Night Shift Covering Medical 4 / Medical 5 / Infectious Disease Ward In Sarawak General Hospital – Housemanship Diaries
- The Most Enjoyable and Tiring Day In Medical 3
- My Next 6 Months (Post Housemanship)
- Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
- Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
- My Evening Routine In The Medical Posting | Housemanship Diaries
- My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
- My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
- Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
- My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
- 1 Year Of Housemanship Update – Housemanship Diaries
- Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
- Enjoying The Journey – Housemanship Diaries
YouTube | Instagram | Pinterest | Facebook | Spotify
About Me | Privacy Policy | Contact Me
#article #Articles #Blog #blogging #dailyprompt #dailyprompt1804 #dailyprompt1826 #dailyprompt1834 #dailyprompt1839 #dailyprompt1843 #dailyprompt1852 #dailyprompt1854 #dailyprompt1857 #dailyprompt1858 #dailyprompt1861 #dailyprompt1865 #dailyprompt1950 #dailyprompt1952 #dailyprompt1957 #dailyprompt1959 #dailyprompt1964 #dailyprompt1968 #doctor #doctors #healthcare #hospitalUmumSarawak #houseOfficer #housemanship #kuching #medical #medicalPosting #Medicine #nightShift #sarawak #sarawakGeneralHospital #writing
Fifth Posting (Medical) – The Theoretical Doctor
Posts about Fifth Posting (Medical) written by Dr. Jewel NambiarThe Theoretical Doctor
The Most Enjoyable and Tiring Day In Medical 3
Related Posts:
- My Next 6 Months (Post Housemanship)
- Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
- Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
- My Evening Routine In The Medical Posting | Housemanship Diaries
- My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
- My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
- Reflection Of The Surgical Posting | Housemanship Diaries
- My First Night Shift In Surgery | Housemanship Diaries
- Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
- My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
- 1 Year Of Housemanship Update – Housemanship Diaries
- Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
- Enjoying The Journey – Housemanship Diaries
I can’t remember which day it was but it was probably during the weekend or a public holiday as I remembered that I was allocated on call who was in charge of this ward.
I was allocated to “General” on that day and was I was alone at that time. I remembered sitting at the other end of the ward at around 11am when one of my colleagues who was allocated to be covering the “Neuro” patients went to have lunch.
The medical officer on call at that time, a rather “happy-go-lucky” and rather jovial person struts into the respiratory cubicle and asked if there were any house officers available?
To which I responded, we’re right here and he came over. He asked for the person who was in charge of the front cubicles which happened to be my colleague who went for lunch. I asked what’s wrong, is there anything I can help with?
He casually replied, nothing much, just walked in and saw a patient’s pulse oximeter reading 70% under room air. Then he laughed.
Me and my friend who happened to be there at that time were shocked and rushed to the patient. True enough, the pulse oximeter reading was 70%, well, 68%. Oddly enough, the patient seemed rather comfortable and not tachypnoeic. In fact, he was surprised as we crowded around his bed, looking concerned.
I asked him if he was having any difficulty breathing which he was not. Thus, our first instinct was probably the machine was faulty and proceeded to check with another vital signs machine.
This time, it was 65%.
I proceeded to take full set of bloods while my medical officer was writing his review and my friend attempted to call my colleague.
I ran his arterial blood gas and it showed Type 1 Respiratory Failure. Considering he did not have a baseline during this admission, we do not know if this was near his baseline or a sudden deterioration.
We called the Peri ICU team and referred the patient for non-invasive ventilatory support (NIV). Imagine, not knowing why this long stay patient was ever here in the first place to summarising the reason for admission down to his current progress. It turns out, he was due to be stepped down to a district hospital for continuation of antibiotics.
Well now, he can’t.
We transferred hum to the acute cubicle for closer monitoring while awaiting the Peri ICU team.
While awaiting, my medical officer decided to check on a patient who was handover to him for afternoon reviews.
This lady was in her 60’s and was admitted for left pleural abscess, meaning there’s pus in her lungs and for this patient, the whole left lung was completely filled. Clinically, she seemed well, speaking in full sentences and laughing to her family members as well in the morning.
In fact. I was even taking her bloods that morning only to have it splashed all over me after attempting to fill the blood culture and sensitivity bottle.
I recalled walking past her as I made my way to the front of the ward and she seemed alright. However, the moment me and my medical officer oncall stood in front of her. She desaturated an started being tachypnoeic.
Well, here’s another one.
There goes the next referral to the Peri ICU team for intubation and also Urology for emergency suprapubic catheter insertion as we attempted to insert a urinary catheter multiple times but failed.
Now, all these events happened very fast but at the same time, time flew by fast. The second patient was intubated and we inserted a femoral venous catheter. My medical officer then wanted to excuse himself to settle the pending discharges in his other ward. However, the first patient wasn’t saturating well under NIV and needed to be intubated.
There goes another intubation as well as another femoral venous catheter insertion. Finally, after all the chaos, things began to finally settle down.
I proceeded to trace my coming mornings, considering that I was the only one in charge of “General” that day and nobody would be helping me. Finally, I proceeded to begin my oncall reviews. This was around 8pm by that time.
After completing my in all reviews with intermittent disturbance in between. I proceeded to aid my friend in preparation of her coming mornings.
It was close to 11pm, I was just clearing my stuffs and getting ready to go when a nurse informed me that a patient seemed rather tachypnoeic.
Annoyed and tired, I attended STAT to find a patient sitting at the side of the bed with his BiPAP machine unlatched and hanging at the side of the bed. The patient beside him then told me, he removed it himself an hour ago.
Boy… Why am I not surprised?
This is another impending intubation.
At this rate, I might as well not leave anymore.
The day was busy enough. I sometimes wonder why is it that we feel guilty to even desire to return home on time? To walk out with the family members watching us finally ecstatic to return home for the day while their family members are stuck in the hospital?
Back to that patient, I didn’t left him gasping on his own of course, I fixed back the BiPAP machine, took an arterial blood gas and alerted my night colleague and medical officer oncall to which they attended STAT.
Thankfully, the following day, I was allocated as night shift. Thus, despite returning home late, I was able to sleep in and recuperate a little before returning back to work that night.
It was a busy day but considerably a rather fun one considering that I happened to work with a rather jovial medical officer oncall and my colleague stayed back to accompany me despite her shift being till 6pm.
Working with certain people definitely helps alleviate some of the pressure of the day.
Related Posts:
- My Next 6 Months (Post Housemanship)
- Part 1 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | The Emergency Department
- Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
- My Evening Routine In The Medical Posting | Housemanship Diaries
- My First Day In Medical Posting – Tagging Day 1 | Housemanship Diaries
- My Morning Routine Being A House Officer Leader In The Surgical Posting | Housemanship Diaries
- Reflection Of The Surgical Posting | Housemanship Diaries
- My First Night Shift In Surgery | Housemanship Diaries
- Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
- My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
- 1 Year Of Housemanship Update – Housemanship Diaries
- Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
- Enjoying The Journey – Housemanship Diaries
YouTube | Instagram | Pinterest | Facebook | Spotify
About Me | Privacy Policy | Contact Me
#article #Articles #Blog #blogging #dailyprompt #dailyprompt1804 #dailyprompt1826 #dailyprompt1833 #dailyprompt1834 #dailyprompt1838 #dailyprompt1921 #dailyprompt1939 #dailyprompt1941 #dailyprompt1942 #dailyprompt1946 #dailyprompt1947 #dailyprompt1948 #dailyprompt1949 #dailyprompt1951 #dailyprompt1953 #dailyprompt1954 #dailyprompt1955 #dailyprompt1957 #dailyprompt1959 #dailyprompt1963 #dailyprompt1971 #desaturation #doctor #enjoyable #hospitalUmumSarawak #houseOfficer #housemanship #kuching #medical #Medicine #sarawak #sarawakGeneralHospital #tiring #writing
My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
An article regarding the ATFL injury I suffered shortly after a month into my Fourth Posting as a House Officer.The Theoretical Doctor
