F1doc 6th November 2017
I have exactly 1 month left of my first FY1 rotation. The switch from medicine to surgery feels almost as daunting as the switch from med student to FY1. A whole new team of people to get used to, fast ward rounds as opposed to the lengthy medical rounds and 8am starts instead of a far more acceptable 9am.
Before I leave medicine I wanted to share a few of my experiences from the past few weeks.
A couple of weeks ago I was the FY1 on evening medical ward cover and I got bleeped about a patient who was becoming unresponsive and spiking temperatures. Immediately my heart started beating faster and my brain became a bit fuzzy, I asked for a few more details on the phone and immediately headed to the ward.
My first thought was to bleep the SHO on call and ask them to come with me to assess the patient. But I decided to visit the patient first.
When I got there the nurse was trying to get an ECG and put a cannula in, the patient was writhing around on the bed in a confused state and it was clear that neither an ECG or cannulation were going to happen quickly.
My first few minutes there were chaotic, my head was spinning and I know that I must have seemed flustered but I eventually managed to remember basics and perform an A-E assessment.
The patient triggered QSOFA (new criteria for triggering sepsis bundle) and 02 sats dropped.
I managed to get an ABG, order a CXR and send an MSU and the lovely nurse got cultures and a cannula in. The next hour went by really quickly and before I knew it I was writing in the notes and the patient was happily sleeping having had the first dose of IV Abx.
I managed the whole thing without calling the SHO, but that doesn't mean I managed without help. The ward nurse was amazing and I called the critical care outreach nurse who was equally fab. Just having them there made me feel so much calmer and more supported.
It may seem like a small triumph, but I was thrilled to have managed a sepsis patient. The patient recovered well and went home later that week.
The next day I got an unexpected email from the sepsis lead telling me that she had reviewed the notes and that we had managed the case really well. Receiving that positive feedback gave me such a boost and made me feel valued. It is so important to provide positive feedback to colleagues and I hope that I remember to use opportunities to do the same in the future.
