Conversing with Life

The longest night

Thurs 1415hrs: Post call. Head feeling groggy, limbs wobbly. Still thinks it's Wednesday.

I wonder if there's been any post-call syndrome described.

General: Slow response time, dark eye rings +/- bags, halitosis (i brushed my teeth ok!), wearing the same clothes as yesterday and may smell. Lethargy.

Cardio-resp: As your parasympathetic system kicks in the afternoon, you get bradycardic. Breathing gets deeper and you almost enter a sleep-like mode. Worse on sitting down for long periods of time.

Gastro: Gastric discomfort (from either an empty stomach or recurrence of stress ulcers.) Urge to BO but you decide getting in an half hour's sleep is more important. Doesn't matter what you decide, your urge wins anyway.

Neuro: Mild limb numbness and weakness. May have incoordination, procedural accuracy drops by 10-20%. Poor memory. Inattention.

Renal: Dehydration (especially when you realise you haven't been drinking water the past 5 hrs because you've got 5 more new cases, 10 more plugs and 20 more venepunctures.)

Orthopaedic: Low back pain (especially if you've been bending over the bed the past hour trying to get the plug into a old lady.) May have sprains or fractures if you trip on the stairs (Don't close you eyes when you walk!)

There you have it. Feel free to add on the list if you can think of anymore.

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A summary of the night

Wed 1800hrs: Got my first procedure job from the HO. Set plug for patient in ...
1830hrs: Poked 3 times and failed. Call HO for help. (Bad way to start a call.)
1900hrs: HO saves the day. Got catheterisation at the same ward, he brings me through.
2000hrs: More plugs and blood c/s.
2100hrs: Called to isolation wards to clerk new case. Prescribed bld c/s, catheterisation, and plug.
2220hrs: Hops over to the nearby restaurant to get dinner / supper bites. Wolfs down food, get hydrated.
2250hrs: New cases and urgent bloods to check. I get on with clerking the new cases.
2305hrs: Wakes up the auntie from sleep, takes a history and performs a physical. Slow going as this is my first case, takes a while to fill in the clerking sheet.
Thus 0005hrs: Finally finishes. Staff nurse informs you another new case is admitted. You get started on it right away. Feeling pumped as I get into the rhythm.
0045hrs: Finishing up. MO arrives to vet the clerking and see the case. You feel good when your diagnosis is concurred.
0130hrs: HO arrives. I clerk new case with him, sees how he uses i-soft to aid clerking.
0230hrs: New cases come in. I get sent to see them first. More clerking!
0330hrs: Back pain from taking blood from new case. Starts to feel tired, sits down at computer to write. Feeling thirsty, wished I brought along my bottle.
0400hrs: Starts on another new case. Looks simple. Aims to finish it 'chop-chop'.
0430hrs: Starts to chat up the staff nurse while writing. Staff thinks you are going crazy.
0500hrs: Calls HO up to report progress and present new cases. Says he'll pop in to see the case. 0530hrs: Cases seen and done.
0535hrs: Bloods at psy ward. Difficult veins, ends up doing the leg veins.
0610hrs: HO asks, breakfast or sleep. Not a difficult choice.
0630hrs: Collapses on the on-call bed, gets some shut-eye finally.
0700hrs: Wakes up, freshen up. Rounds starts in half-hour. New day awaits.

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Reached home at 3pm, slept like a log till dinnertime. Planned to run before dinner but much too tired. Weijie asked me to to tell him how it feels to run post-call, sorry dude.

Too tired to do anything. Blogging is easy work. "Word gets around."

Surfing the net, reading up on learning issues. PICC (peripherally inserted central catheter) , peripheral or central line?

Wei Qiang converses @ 21:34