Friday, September 28, 2012

Instant Tea

What counts as "tea" has long been matter for contention. Tea purists will insist that only beverages brewed from the leaves of the tea plant deserve the name "tea", whereas some free thinkers believe they can add any old leaves to hot water and say they have a cup of tea. Camomile tea, mint tea, stinging nettle tea.

But I think even they would meet their match in the medical break room ...

Salt and pepper tea, anyone?

Saturday, September 22, 2012


I put in my first urinary catheter today. Hey, I'm a late starter.

I was trying to arrange transfer for a dialysis patient who I've come to know well. Speaking with the physician on the phone, I was on top of things - I knew his vitals, knew his blood results, knew all of his medications. Hell, I even knew what kind of car he drove (not that they asked).

And then the physician threw me with one question.

"Is he making urine?"

I heard him tell the nurse that he passes urine, so I answer "yes".

"How much?"

He doesn't pee in a bottle near the bed. He doesn't have a catheter. He goes to the bathroom all by himself. It isn't measured.

He's a dialysis patient, so I hazard, "minimal amounts?"

"Then why is he on dialysis if he's still producing urine?!"

"Because ... the renal physicians started him on dialysis?"

And then he tells me the patient will need a urinary catheter before he's transferred. I quickly set up and tell the patient what's happening. I do all the right things - sterile technique, clean the 'area', lignocaine gel, catheter. It's all straightforward.

Except there's no trickle or gush of urine through the catheter. The bladder is empty.

I feel bad for the patient who's now got a catheter in his willy for no good reason. I've just made a fool of myself, but that's nothing new. But then I see it - a tiny little blob of urine sitting in the catheter. If that's not "minimal amounts", I don't know what is.


Consultant, presenting a new patient in multidisciplinary meeting: "This is a 79-year-old gentleman who normally lives at home with some supports"

Nurse: "Actually he's in a high-care nursing home"



Friday, September 21, 2012

Medical Intern: A Day In The Life

Not a typical day so far, but an accurate recount of today:

0745: arrive first, print out patient lists and start writing some discharge scripts
0750: make self coffee and sit down to check patient list
0755: put hand in coffee mug and spill coffee all over paperwork
0800: sit down for multidisciplinary meeting and rip side of dress so the pocket is now just a gap
0800 - 0845: muddle through meeting and present the few patients that you can remember from yesterday's ward round, because you've had a few days off and forgotten everybody else.
0845: learn that your consultant has clinic all day and you'll be running ward round. It's ok, you have a final-year student to help you
0845-1600: ward round, interspersed with nurses harassing you to discharge random patients because of bed pressure, and patients discharging themselves of their own accord
1600: dismiss student because you feel bad making them stay late on a Friday
1600-1700: frantic last-minute paperwork that needs to be finished in business hours
See ex with blonde medical student
Call it a day and leave hospital.
1706-1707: drive home (because you're a rural intern)
1708-1715: search for running shoes
1716-1720: go for a run, get puffed, go home
1721-1750: set up Wii Boxing and work out frustration in a more sheltered setting
1751: call from nurse asking you to urgently come back to work and do a discharge summary for a patient who is transferring to a city hospital RIGHT NOW. And you haven't done it yet because you spent the whole day pretending to be a consultant
1752: back at work doing the discharge summary (ok you showered first). Fax to city hospital
1755: learn that the patient dropped his BP at the airport and Flying Docs aren't happy to put him on the plane. He's coming back to the hospital.
(Cry a little on the inside)
1800: pizza with the nurses
1830: patient back on ward. Spend next few hours trying to fix everything - on phone with consultant and Flying Docs, and in discussion with ED staff who will cover the ward overnight. Learn that patient's blood pressure is back to normal and he is walking around all by himself. Learn that patient will not be retrieved tonight and will probably lose his bed in city hospital.
(Cry a little on the inside)
2100: Night nurse comes in and asks, "what, did you sh*t your bed and can't go home?"
2101: Go home

This is why we get paid the big bucks random amounts of pay and never see our payslips.

Wednesday, September 19, 2012

Hello? Is it me you're looking for?

Phone call from the locum pharmacist:

"Can I speak with Dr S please?"
Me: "Yep, that's me!"
"Thank you"
Me: "Um, that's me"
"That. Is. Me."

New Stamp

I was pretty devastated when the surgical interns told me I'd missed Journal Club today - I'd been counting on those free sandwiches for my lunch.

As I trudged back to the medical ward, the pharmacist intercepted me in the hallway. I braced myself for the worst - the pharmacists usually only chase me to point out my mistakes. But not today - today she gave me a brand new stamp with my name and provider number on it!

Now skipping back to the office, I opened up the stamp ... and promptly got ink all over my hands. Never mind. There's a hand bason in the nurses' station. And that's where I learnt two valuable lessons:

1. That ink is so permanent it pretty much gets into your genes
2. If you turn the tap off too far, it turns back on again and wets the front of your clothes

By the time I made it back to the office I was so glum that the RMO gave me a cupcake and sent me to do a mini-mental on our sweetly demented old patient.

He got 15/30, the cupcake was delicious, and the day got better.