Today (Thursday), I decided to do a full day’s call in Medical Recovery. That means starting at 8am and finishing sometime around 11am the next day. So far its been a quiet day – only 4 new patients so far (as of 1530). Lets hope its a quiet night too…
Well. As soon as it hit 5, the floodgates opened. By 9, the short stay ward was full and patients for observation were beginning to pile up in the medical recovery area. Then to make matters worse, we were visited by a sister who insisted that we had too many people waiting downstairs and that we should admit patients to the wards, where there were at least 20 beds available.
Liza, the intern on call, was unhappy with admitting patients who actually needed observation because they were unlikely to get it on the wards where the nurses are at their station, as oppossed to recovery, where all the nursing and medical staff are 2 metres from the patients. Then we had a visit from the CEO of the hospital, the head of the casualty department and the provincial minister for health (I have no idea why). The decision was to admit stable patients, even if they would normally be observed overnight and discharged the next morning.
The most pressing case we had was a case of severe lactic acidosis (arterial pH 7.1). We consulted with the ICU doc on call, but they were full and unable to free a bed, so we had to manage the patient in recovery
By 11 we had pretty much gotten the situation under control. The Medical Officer on call went home at that stage leaving Liza in charge. At about 2345 we left casualty for the on-call room.
We managed to get a good 40 minutes rest (and at least 20 minutes sleep) before the first phone call. That kept us in A&E until about 0215. We got almost 2 hours sleep before heading back down to A&E at 4 for an acute exarcabation of asthma in severe respiratory distress. Back to bed for about 5, and up at 7 for a quick breakfast to prepare for the post intake round. Liza had to go do anaesthetics stuff so I was the only one who’d been there all night who would be there for the round.
This should have finished at about 10, there were only about 8 patients in recovery. Except, we had to go and see the 8 we’d admitted directly to the wards. I didn’t get out of the hospital until 12. As you can imagine, I was a bit tired. And, this was a quiet night – I’d gotten about 4 hours of sleep in total.
I’m going to do a weekday and a weekend call in Trauma over the next couple of weeks, I wonder how they’ll compare.