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@primary-survey
Still alive. But only barely. We’ve gone through covid, came out on the other side, waiting for covid again. I’ve been on ITU since forever, on the rota that I wouldn’t wish upon anyone and everything hurts all the time.
It will be fun being a reg they said. All lies. I’m definitely too old for 80+h work weeks and this just needs to stop.
Life
Went from exam stress directly into covid disaster. So now i’m back on itu, washing my hands about a million times a day (bleeding knuckles ftw) and floating through endless variations of the (very similar) picture and slowly filling up our spaces. So there is a lot of PEEP in my life. And nobody’s peeing. And mostly people get better and then worse and then better and worse again. It truly is a disaster and I think my adrenals are probably going to be very confused when/if I will ever be less stressed.
Things I want to do when I get my life back
Take long walks and wander aimlessly.
Big sick
You know when you have a young and previously healthy patient coming in really sick. And ITU, medical, A&E and radiology consultants all completely perplex as to what is happening. And when you have no sats, BP of 60 and lactate of 20. Cardiac arrest at some point. And you still have no idea what the hell is wrong with them. So you’re just trying to put out fires. But there are so many of them.
Well, this.
Fun stuff
It’s been months. And I’m talking about a random coffee with a friend, yoga on a Sunday morning, dinner and a glass of wine too much. I haven’t done any of these in a loooong time. Even a quick supermarket visit would do.
Instead I’m working/sleeping/revising. And repeat. I’m so tired all the time and I don’t really sleep well. I get anxious about ridiculous things. Yes patient might have a difficult airway and help is far away but this is literally the nature of the job. No need to stress about it the night before. What good would that do.
I don’t even want to do anything fun anymore.
Oh i’ve missed normality*.
*When normality is spending days working/revising with my person.
But still, even after few days off work (with intense revision but still) I feel so much better. Maybe this job really is killing me. Or the commute. Or long hours.
How do people cope i wonder.
As per previous post
I recently attended one of the resus courses (as mandated by someone clever who decided we can only retain the knowledge for 4 years even though we do these things literally every week). And most of the scenarios ended with”seek expert help”. Kinda scary to realise I am the expert help.
And in related news, it is a scary/big thing to give sedation to non starved critically ill people, ok! So please don’t just say “oh can he have a little something so we can pace him”? Because if it was just a little something then really anyone should be able to do it.
You Are The Attending
Source: https://thetraumapro.com/?p=5096
Word!
Hostility
I really wish we all would rise above it. There is so much hostility in the hospital I used to work in. Between patients and doctors (why have I been waiting for so long?), doctors and doctors (please gynae can you just take this clearly gynae pathology and stop requesting surgeons to review every day vs please ED can you do some investigations), nurses and doctors (please come now the patient is in pain literally while I’m intubating someone) and between all levels of HCP.
I wasn’t used to this when I first started here. I guess it’s a combination of burnout, overworking, moral injury and sheer frustration due to the divide between the standard of care we should be providing and the reality of what can be done. It’s also not really getting to know the coworkers, constantly rotating and just generally low key giving up.
I do it too occasionally. When I get a ridiculous referral, when I get called for an emergency and everyone walks away, when I’m tired. And of course, when I get a cannula call where people blatantly lie about their grade (we have an agreement of only taking reg to reg referrals) or reason for difficulty and attempts. I’m trying to be better, to verbalise calmly what bothers me but sometimes it’s truly like hitting a brick wall.
I guess what I’m trying to say is yes, we need to be better. But the government needs to be better too. Because it’s similar to that bullshit of resilience talk where really the working environment is just so grim that everything is mostly a result of that.
worklife
ICU nights in small hospitals can be pretty variable. Sometimes you can do a reasonably quick wardround because you know everyone, drink tea, chat with the nurses, read a book and go to sleep (sorry medics everywhere) and sometimes you get the sickest of them all and an upper airway obstruction on the top and the nearest help is about 30 min away. And somehow I’ve become (?)the most qualified person for these disasters.
But what nights have left me is a brain that doesn’t stop when I lie down to rest. At work and long after I finish nights. Although with this rota next set is just around the corner. I keep on going through possible things that can go wrong with my patients, stupid things I have said years ago, endless things to do and exam anxiety, general dread and often full blown existential crisis ensues. I try a bit of mindfulness, deep breathing and relaxation, lose focus, get a migraine and then the morning comes. And the cycle repeats itself.
Let’s see what tonight brings.
Exams
I swear it gets more difficult every year. I’m quite resentful that I’m again in the eat-sleep-revise-repeat pattern but I’m also to tired to fight it. Allegedly it should be the last one. If I don’t go mad and apply for ficm as well. Or maybe finish mrcp. Ultimate masochism this is.
What makes my day
Consultant repeatedly referring a patient to my F1 because only men are doctors.
Work
There is only a certain amount of end of life discussions and generally everyone dying on ITU one can handle. I’m cutting it pretty close these days.
I never thought I will say this but it used to be somehow easier when I was an SHO getting through the endless job lists. Now it’s all about trying the hardest to not make a wrong decision about admitting/not admitting someone to ICU. ICU that has not had a “bed” since September.
ShareTweetNever touch your hair. It cannot be down, and it cannot look fancy. Optional styles include bun, ponytail, or braid. ...
yep. the sad thing is half of these things are pretty much routine occurrences.
Don’t want two patients
HA actually though…
UK healthcare: FAQ of why many people miss the point.
I don’t expect most people to know what it’s like to be a junior doctor; the most clued up tend to have close friends or family in the job. I see a lot of the same arguments floating around in comments on just about any article on UK healthcare, and it gets a bit frustrating when you realise some people have a deep misunderstanding of something that is a huge part of your life. Here, I’m summarising such concepts as:
why doctors probably don’t earn as much as you think.
why concern about a significant pay cut is not greedy.
why many of us are against privatisation.
why you shouldn’t try to force doctors to stay in the country, work for the NHS or be doctors against their will.
why the fact that although there are plenty of wannabe med students, this does not fix things.
why someone else being paid less is not a reason to devalue doctors, and is probably a reason to pay low paid workers more fairly.
This is a lengthy post, so you can find the rest of it under the cut.
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friend: ...
