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 haemorrhage. He
was sitting upright in the bed, he look reasonably alert and even had a bit
of colour in his cheeks. It was reassuring to see that the
observation chart at the foot of the bed showed that blood pressure and
pulse were entirely stable. I relaxed a little. Sister Ashbrook was at the bedside with one
of the staff nurses. She looked displeased.
“Why you junior doctors can’t anchor drips securely I
will never know,” she exclaimed in a voice loud enough to be heard by every patient on the ward. “Does
no one ever teach you that the cannula should be secured with adhesive
tape, the forearm should be splinted and the splint should be held in place
with at least two rolls of three-inch crepe bandage? When my nurses do the job it’s done once and done properly; the drips never come adrift.”
It was clear that the
remark was aimed at me! It was on the tip of my tongue to point out that the consultant anaesthetist in theatre had
inserted this particular drip, not me, but with the relationship between us
already strained, I thought better of it.
“The nasogastric tube seems to have come adrift as well,” I
said,
knowing that inserting these tubes was usually a nursing task and hinting
that perhaps the nurses were not quite as perfect as she would wish to
believe. Too late, I realised that this played straight into her hands, for
Sister remembered when the tube had been inserted.
“Yes,” she replied pointedly, “but the nurses didn’t put
this particular tube in place, did they? The anaesthetist did that in theatre”.
“Probably at the same time that he inserted the cannula in
the arm, Sister,” I said, innocently.
My remark was greeted by a long cold stare but there was no
verbal response. At least it was comforting to know that senior anaesthetists,
as well as house officers, could be held responsible for mishaps.
Sister barked out her instructions.
“Well Doctor, set up a new drip, pass a clean nasogastric
tube and rewrite the intravenous infusion regime. Mr Quigley needs to catch
up with the fluid that he should have received in the last couple of hours.”
She turned on her
heels and marched off, snatching the screens shut behind her. We were back with
the ‘I am the senior sister, and you are
a junior doctor’ routine that I had encountered when I first arrived on the
ward. Mr Quigley looked at me, sympathy
written large on his face.
“She can be quite a
tartar when she wants to be, can’t she, Doctor?”
“She certainly can!”
------------------------------
I am pleased to say that the overwhelming majority of the nurses it has been my pleasure to work with have been exceedingly helpful colleagues!
------------------------------
Thought for
the day
Advice is seldom welcome, and those who need it most, always
like it least.
Lord Chesterfield 1694 –
1773 (In letters to his son)
This story is adapted from The First Cut which tells the story of an introspective young man
who is thrown, bewildered and unprepared, onto a busy surgical unit as a newly
qualified doctor.Through his eyes numerous ‘patient episodes’ are told, many
amusing, some serious, others poignant, but all very ‘human’.
It is available from Amazon as a paperback or ebook.
Extract from doctor’s letter: Patient is alive - but without my permission!!
To comment on any of these tales, use the comment box below,
clicking ‘anonymous’ if your system asks you to ‘select a profile’.
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