Saturday, 30 January 2010
So how would you describe that pain?
A long week. This week I have been "on take" twice and have been in for my earliest yet post take ward round at the horrific time of 7.15am. Ouch. It was actually quite cool in a way being in so early and wandering around MASU before they had even turned the main lights on. Our MASU (medical and surgical assesment unit - basically the first ward you end up on post A+E) has no windows so very hard for patients to work out what time of day it is and doesn't really help confused patients to get orientated. All the "daylight" is therefore created by bright white lights creating a very sterile hospital feel.
It was interesting to see the doctors who had clearly been on all night, they were a bit mroe casually dressed on the whole and often wearing scrub tops and trainers. I guess the patients you go to see in the middle of the night are the ones who are seriously sick and so aren't going care what you are wearing so you may as well stay comfortable.
"On take" as a medical student (or indeed doctor) refers to when your team is in charge of clerking in all of the new admissions and starting their treatment. As students we are supposed to spend a certain number of evenings/weekends doing this on certain rotations but realistically we never stay as many hours as the medical school wants us too as the doctors often sign us off early and tell us to go home because otherwise they feel obliged to teach us which takes up their time.
I was on take both one evening and Saturday afternoon/ evening this week. Its quite scary how much in the deep end we can get chucked in during these on takes, some doctors give us quite a lot of responsability when we clerk patients in and take our word for granted. Often our clerking in proformas end up in the patients notes which is quite strange when you see them there during the post take ward rounds being used as the main information. Sometimes I feel too young to be ready for this, other times it just makes be feel spun out about how grown up and mature we are expected to be. Yesterday I spent a long time clerking in a very lovely elderly patient (it only took a long time because she kept getting moved around or needing loo or having her relatives appear whilst I was trying to examine her). She was very lovely so I won't hold a grudge for the fact that she described her chest pain one way when talking to me and a completely different way when the doctor later came to see her with me which causes a completly different set of differential diagnoses to be most likely... The doctor didn't mind though and told me it always happens to him whenever he presents a patient to a consultant - when the consultant sees them the patient always says something completely different to the exact same set of questions.Patients you do not know how much power you have to make us look stupid in front of our superiors.
I was quite looking forward to seeing the bustle of a city A+E on a saturday night whilst on this on take.. but to be honest it was disappointingly empty and I ended up going home early again due to lack of patients for me to clerk.. I suppose I shouldn't really be disappointed about this as it means less people were ill last night which is a good thing, just not so much for my education or log book signings off, but I do realise thats not the important thing. Sometimes we get so obbessed with getting clincal skills signed off that it is easy to forget that.