Post 32. If you get stuck and don't know what to do - ASK FOR HELP.

I had been asked to pass the nasogastric tube, a task I hadn’t previously undertaken.    It was a procedure that the nurses normally performed.However, I didn’t anticipate any difficulties.At any one time on the surgical ward, there were at least half a dozen patients being treated with these tubes and I wasn’t aware that the nurses had any difficulty in putting them into place.

The tube is passed through the nose into the back of the mouth then down the gullet such that it’s tip comes to rest in the stomach.    It is made of plastic, is transparent, about 50 centimetres long, with a diameter about that of a drinking straw.The tube allows gastric juices to be aspirated, keeping the stomach empty in the early days after an operation.  Taking the tube out of its plastic bag, I fed it gently into Mr Quigley’s left nostril.It went in about half an inch and then hit a blockage.I withdrew it and tried again, this time pushing a little more firmly but again it came to a full stop, suggesting t…

Post 31. Battling with the Nursing Sister- an uneasy truce

It promised to be a busy day – there were three new patients to be seen and it seemed unlikely that I should have time to examine them all before the boss arrived for his ward round. But I got off
to a bad start for no sooner had I introduced myself to the first patient when I was ‘bleeped’ and told that there was a problem with Mr Quigley.Apparently Sister Ashbrook, my nemesis, was already in attendance. I had already crossed this fierce nursing sister twice in the two days since I took up this, my first job since I qualified as a doctor ( see previous two posts).
My heart sank. Mr Quigley had already bled once after his gastric operation, the most likely explanation was he was bleeding again.   Did all newly qualified doctors have doubts about their ability to cope or was it just me? Arriving on the ward, the screens were indeed drawn around Mr Quigley’s bed and there was considerable activity within. Fortunately it  quickly became apparent that the patient had not suffered any major …

Post 30 My Battle with the Nursing Sister. Round Two

Standing in the corridor outside the office door, angry and frustrated, I wondered what I should do until the nursing hand over was finished?I had been publicly humiliated when I walked onto the ward on my first morning as a doctor.Sister Ashbrook, damn her, had inferred that I was still a medical student, despite my name badge stating that I was now Doctor Lambert. 
 She had denied me access, claiming that it was her office when clearly it was the ward office for use by the doctors as well as the nurses.Worse, she had done it in front of the entire ward nursing staff. I still wanted to review some patients before my consultant arrived but I was dammed if I was going to stand outside the door like a naughty schoolboy outside the headmaster’s room.Reluctantly I decided to return to the residency.
But had I taken the right decision?
I was in no doubt that everything that I’d said and done had been entirely appropriate. I had every right to enter the office to collect the notes that I requ…

Post 29 My battle with the nursing sister. Round One

I have the greatest admiration for nurses.They are wonderful, caring, hard working people who do a great job, often in difficult circumstances. So I wasn't surprised  when I started my first job as a resident doctor, that I was advised by my consultant to heed the immense experience and wisdom of the ward
sisters and to seek their guidanceat every opportunity.Sound advice indeed; and advice that later, as a consultant, I had no hesitation in passing on to others.
It was therefore, my grave misfortunate that the very first ward sister I encountered was the exception that proves the rule; an exception that provides the basis of this next story.
With hesitant steps, sweat on my brow and fear in my heart, I approached the surgical ward.I had walked this way many times before, but only as a student.    Now I approached for my first day as a newly qualified doctor. Although proud that I had managed to fool my medical examiners and qualify, I was nervous…

Post 28 A Bizarre Medical Interview

It was 1966 and 70 newly qualified doctors were applying for their first medical job as house officers at Manchester Royal Infirmary. Frederick Swindles, the secretary to the Medical Board, appeared holding a clipboard.He called for attention, then detailed the arrangements for the interviews. Eight posts were available.
“You will be called into the interview room in two groups,” he said.“The first group will be doctors with surnames from A to M.The second group will be doctors whose names range from N to Z.
I will lead each group into the committee room. Inside, you will find the consultants sitting on the right hand side. You will line up opposite the consultants with Dr Abbott at the far end and Dr McDonald, as the last one to enter the room, by the door. When you are all in place, I shall call out your names one by one.You will answer to your name in turn.At the completion of this exercise there may be a pause and some conversation between the consultants - but when you get a signa…