Christmas Weekend With Supriya​

Second in our Series "Diary Of An IMG"

The weekend shift usually has two foundation year 1 doctors covering the wards. Unfortunately, my colleague could not make it so I would be covering 4 wards. I thought I would ask my sister to help me out as she had worked in Southampton before and did the same job in her FY1. After some convincing she agreed to come down to help me out and I was very excited to work with her. We both jokingly said it goes either well or bad where we will never want to work together.

Saturday morning we both came in at 7.30am and received the handover from the night team. It was a Christmas weekend and luckily for us, there were only 3 admissions. We managed to finish the ward round in 20 minutes as they were all scheduled for theatres hence why it was quick. Then the consultant took us for a coffee to costa for coffee where we chilled for an hour. We both returned on the ward and went to our respective wards to get our work-list for the day. I had 3 patients to review (ankle swelling, Elbow pain and distended abdomen). Supriya and I decided we will do the jobs together. She led it and it took 20 minutes to review all my patients. I was so impressed on how efficiently she worked through her jobs and it was definitely a big learning point for me. Each job that would have taken me 10-20 mins, took her 3-5mins. Supriya reassured me that this will come in time and experience.

Towards the end of our shift, I got bleeped for a patient with a distended abdomen who seemed to have desaturated. He was admitted with a distended abdomen which he has had for more than 4 years. When we got to the ward, he was saturating 80% on 15L however he was not cyanosed, nor did he have a drop in his GCS score. His abdomen was more distended than his baseline and was also tender on examination. He was shouting, ‘take the mask out my face!’. I was getting anxious as I felt like he was getting more and more agitated. At this point, Supriya asked him “If he had any pain in his abdomen to which he replied ‘No’. I was getting worried about him as I felt like he was getting distressed, and I wanted to escalate this. Supriya managed to stay calm and told me to stay calm too as she managed the patient. We got his ABG which came back normal and requested an urgent abdominal x-ray then called the general surgeons for any further advice. The general surgeons wanted to insert rectal flatus tube for decompress him as he has had a history of volvulus in the past. However the issue resolved itself as he opened his bowels so they asked us to continue monitoring the patient.

This experience was a massive learning point as sometimes when the observation numbers do not match the clinical condition of the patient, you must trust your judgement and always stay calm. Go through your A-E assessment, get the appropriate investigation and then call for help once you have done everything. This was a great experience I shared with Supriya and I felt like I learnt a lot from the weekend shift with her.

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