Lmst

The Worst Morning Shift In General Surgery | Housemanship Diaries

Related Posts:

I can’t really remember when as at the time of writing this article, I am about to cross into the second week of 2025.

Perhaps it was somewhere in October last year or early November.

It happened to be the day shift on a weekday and we were lack of manpower. 3 House Officers in the Male Surgical Ward, 2 House Officers in the Female Surgical Ward. Out of the 5 of us, I am the senior and the rest are first posters, three of which are only Day 3 into their housemanship life.

Oh dear…

We all know how busy Surgical can get and being the only senior that day surrounded by newbies, it was as good as being alone as they were not familiar with the system or the work or the procedures.

Learning does take time.

The day started with me taking care of the acute beds. The acute beds in the ward is considered the most unstable, hence it only made sense to allocate the senior, which is myself there, followed by the subacute cubicles.

The front cubicles and back cubicles are relatively stable patients. Hence, I allocated my juniors there. Usually for first posters in their first week of life, I would not allocate them independently to take care of a cubicle. However, we were desperately short staffed that day and taking care of the front or back cubicles are not easy either especially if you’ve just entered.

The day was busy enough. Started with me following rounds at acute and subacute with my medical officers and again with the ward surgeon, only to leave midway as the Hepatobiliary Team (HPB) had their own separate rounds and I was the HPB house officer for that day.

After rounds, it is the completion of the joblists. Amidst trying to complete the joblists, we had to transfer in new patients, take and send off the bloods of patients who have just entered as well as attending to any acute issues.

On that day, I had to assist with the front and back cubicles as well and in the afternoon, the juniors left for their Operating Theatre (OT) orientation.

My phone literally rang non-stop that day and the nurses kept haunting me down for everything. If only, I had the ability to clone myself…

Suddenly my phone rang and I had to assist a registrar to help tend to a visiting outpatient, attend the female surgical ward acute issues because the medical officer on-call called me as well as attend a virtual meeting.

Time flew by rather quickly, one minute I was escorting a patient, next was being called upon by this and that medical officer or registrar or nurses. To the point, my post-call registrar stayed back to assist me.

As the evening progressed, most of my patients desaturated. The annoying thing about Surgery, we had to update the whole story properly in the oncall WhatsApp Group for the day.

If only it were as easy as that.

We couldn’t just take a picture of our entry and update. Instead, we had to properly type the whole summary or stay.

I finally completed my task for the day at 10pm. It was an extremely exhausting and tiring day. One which I have no interest in relieving again.

That was probably the worst morning shift I’ve ever experienced.

However, looking back at what I’ve written, it doesn’t do justice to what I actually felt that day.

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #bloggingAsADoctor #dailyprompt #dailyprompt1826 #dailyprompt1828 #dailyprompt1829 #dailyprompt1833 #dailyprompt1834 #dailyprompt1836 #dailyprompt1897 #dailyprompt1914 #dailyprompt1920 #dailyprompt1982 #dailyprompt1995 #dailyprompt2003 #doctor #generalHospital #generalSurgery #healthcare #hospital #houseOfficer #housemanship #Malaysia #medicalOfficer #morningShift #surgery #surgical #worstShift #write #writing

My First Night Shift In Surgery | Housemanship Diaries

Related Posts:

My first “ON” or “On-night” or night shift in General Surgery was in the Female Surgical Ward with a friend whom I’ve known since around my first posting but have yet to be in the same posting together till our fourth posting in General Surgery.

We were blessed enough to have at least 2 people per ward for the night shift.

Our shift as “on-night” in Surgery began from 7pm and will usually last till all the discharges are done the following morning.

Upon my arrival to the ward, I was informed that one patient in particular had no urine in her CBD (urinary catheter) bag and that she felt like urinating but was unable to void. Considering that she had a urinary catheter in-situ, voiding should not have been an issue.

I attended STAT and assessed her. She had a mass over her abdomen which was hard, non-mobile but had smooth edges, around 15cm by 10cm, a rather large one which I assumed was a tumour, probably pressing onto her urinary bladder as well.

It did not occur to me to check if the patient was previously passing urine, it also did not occur to me to check her intake and output chart. All I could think of at that time was, she felt like voiding, she is in pain, there is no urine flowing into her urine bag.

Thus, I prepped the trolley to reinsert a new CBD. I donned my plastic apron and prepped my materials needed and proceeded to clean the patient’s vagina and reinsert a new urinary catheter in as probably as sterile as I could, bedside.

Upon insertion of the new urinary catheter, there was no urine outflow. Thinking that I may have blocked it or inserted not all the way in, totally abandoning my theoretical principles learnt, I proceeded to reinsert about 3 times and each time was met with no urinary outflow but there were bloodstains from the urethra.

I called my partner for help and he proceeded to help me in informing in the oncall group and referred to Urology medical officer oncall who was rather grumpy.

It was during his referral that I realised that the patient had been anuric (not passing any urine) for sometime now. Clearly, she would not have any urine output and although she felt the need to void, it would not have been an issue considering there is a urinary catheter in-situ.

I had unnecessarily caused trauma and I felt foolish for acting prior performing a thorough examination and understanding her case.

The Urology medical officer came and reinserted a CBD to which she asked us not to remove and to request for an ultrasound the following day for assessment as she suspected that the tumour over her abdomen had infiltrated into her urinary bladder or urinary system.

That was settled but definitely ate up a huge amount of our time because of my mistake.

Subsequently I was rather slow and there were a few post-operative patients and new patients admitted into the ward. Hence, I proceeded to do the needful. By the time I was done, my partner had completed taking the blood for the whole ward and at that time, it was around 3am. I could sense the back-to-back disappointment I have caused him and at that point, I have given up on apologising.

We then proceeded to complete our planned discharges of the patients and by 6am, started tracing the blood results of the patients before retiring into the house officer’s room for a break.

In the morning, as usual as in other postings, we would be “summoned” in the group to take any bloods or to start our discharges.

We returned home around 11am and our post-night shift was followed by an off day.

Personally, I felt that I could’ve done a lot better as I was rather slow that night. However, for a first night shift in Surgical, it was not as bad as it seems.

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #bloggingAsADoctor #dailyBlogging #dailyprompt #dailyprompt1834 #dailyprompt1955 #dailyprompt1959 #dailyprompt1962 #dailyprompt1963 #dailyprompt1971 #dailyprompt1977 #dailyprompt1978 #dailyprompt1981 #dailyprompt1982 #dailyprompt1983 #dailyprompt1985 #dailyprompt1986 #dailyprompt1987 #dailyprompt1988 #dailyprompt1995 #dailyprompt2003 #doctor #healthcare #hospital #houseOfficer #housemanship #Malaysia #medical #medicalOfficer #Medicine #nightShift #surgery #surgical #write #writing

My First Day Back At Work After A 6-Week-Break | Housemanship Diaries

Related Posts:

I officially returned to work on the 2nd of October 2024.

Initially, I was stationed to work the morning shift at ward. However, a colleague of mine decided to take a sick leave on that day when she was initially stationed as the House Officer in the Emergency Department, ETD HO.

Being the Allocation Leader in this department, it is my duty to immediately look for a replacement and to update in the group with the medical officers. Not one person came to mind and I felt bad since it was a friend of mine who took a sick leave or did I feel comfortable dragging another person to cover this shift since it is a shift most people avoided.

Thus, I offered to be the ETD HO myself. It was during an anaemic House Officer period and there were only one House Officer stationed at the Emergency Department.

Hence, I went to work and stocked up my necessary supplies before meeting the post night House Officer in the Emergency Department to receive my handover.

Of all days, it had to be one whereby no coming mornings (bloods) were taken for the patients and there were a lot of active job-lists not being carried out. Not to mention scans to be requested the following morning.

Basically, there were a ton of “shits” being thrown to me and if I do not settle it myself or to push my post night colleague to help me, I would be in a mess for the day.

Imagine having just returned to work to this. Without thinking much, I started identifying the patients who had bloods to be taken and proceeded to take all of them and sent it off. After sending them off, I started preparing for scans and called the radiology medical officer oncall to present my case.

Finally, after I thought I was done, I decided to review the stranded patients.

Normally, the stranded patients should be reviewed around 7am as we would begin our morning rounds around 7:30am till 8am. Thankfully, it was the weekend and rounds began much later.

I went through my list of stranded patients and there were almost 20. 20 stranded patients at various locations.

Would I have the time to review all of them? What about the active joblists or scans? Can I rely on my post night colleague? What if there is a new case?

I remembered it being a rainy day and the referrals were initially from wards and not from the Emergency Department (ETD).

Perhaps it would be a slow day. I thought to myself.

But, I thought too soon.

Soon, referrals started piling up. My medical officer’s phone (MO) was blowing up with calls. Other sub-specialities kept reaching out for me to help them out and at one point, me and my medical officer had to split to ensure we got everything done to the best that we could.

I wished that I could literally divide myself but I couldn’t. On top of that, my right foot started to ache. I just came back from a 6-week-break. I can’t afford to go on anther few weeks. If I do, just when am I going to end this posting?

I recalled it being a terribly hectic day and I felt bad as I was mostly away, having been dragged away by other sub-specialities, escorting patients or carrying out the active job-lists. I could not really be by my medical officer’s (MO) side to see the cases.

Finally, the end of my shift approached. 7pm and my night colleague came for handover.

Despite it being the evening already, the fire was still burning strong, referrals did not stop coming in and I still had tasks to complete or I would be handing over “shits” to my night colleague.

Finally, it was around 8-9pm, I can’t really remember as I was following night rounds with the OT call medical officer and registrar. My medical officer told me to return home since the following day, I would be morning shift.

I remembered returning home that day, somewhat unsatisfied with myself. No doubt that it was a tough day, but I could definitely do better. If only my leg did not slow me. The pain seems to increase with every step I took and with every exertion I made.

However, as I remembered, I was blessed to have an angel as my medical officer oncall for that day. Instead of shaming me or being sarcastic or mentioning that I could do better, she simply thanked me for putting my best effort on the first day back and welcomed me back.

It’s angels like this who makes me want to try to be better the following day.

About Me | Privacy Policy | Contact Me

#article #Blog #blogging #dailyprompt #dailyprompt1804 #dailyprompt1834 #dailyprompt1897 #dailyprompt1905 #dailyprompt1910 #dailyprompt1911 #dailyprompt1971 #dailyprompt1977 #dailyprompt1981 #dailyprompt1982 #dailyprompt1983 #dailyprompt1984 #dailyprompt1985 #dailyprompt1986 #dailyprompt1993 #doctor #emergencyDepartment #hospital #hospitalUmumSarawak #houseOfficer #housemanship #Malaysia #medical #medicalOfficer #Medicine #sarawakGeneralHospital #surgery #surgical #work #write #writing

#dailyprompt1982

Client Info