Night Time Duties​​

First in our series "Diary Of An IMG"

I just finished my 9 day annual leave and I was starting for my 4 night shifts. My last nights were on when I started my FY1 role and this time around I felt more composed and settled therefore I was not as worried going into it.

At 8pm I went to my handover which lasted about 15 mins, I did a mini ward round to let the nurse in charge know I will be around for the night. I asked them if there are any urgent jobs then they can bleep me but for the ward jobs like prescribe laxatives, fluid prescription etc, I asked them to make a job list which I will attend too later on the night.

While I was walking past a ward to complete one of my handover jobs, the crash call went off. The ANP, nurse in charge, HCA and even myself running towards to the room of the alarm. The ANP was there already with the patient and leading the crash call. The patient had vomited, unconscious and choking in her vomit. This was my first crash call and though I know my A-E assessment, there is a moment initially where things were a bit overwhelming. The ANP was in the room helped me manage this patient.

I took a deep breath and started managing the patient from by checking their airway. I asked for suction then gave the patient 15L oxygen. The patient was unresponsive and I was worried their airway would be obstructed so I asked the for a guedle. The ANP inserted the guedle and finished my assessment. Very soon after the patient was responsive with the GCS of 15/15 and her observation was back to its baseline.

We carried out some urgent bloods, ABG and portable X-ray. Bloods and ABG showed no abnormality and we treated her for aspiration pneumonia as per trust guidelines. We kept an eye out for her the whole night and fortunately she was stable till the handover in the morning.

Key Learnings

This experience has boosted my confidence on managing unwell patient and reinforced the value of an A-E assessment. It is important to stick to your basics as it prevents you from missing critical steps which can be life saving. It also highlights the importance of being a leader in such situations as clear instruction and efficient organisation is essential as you will have other health professionals assisting you.

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