WARD ROUND - the team are lovely and I am lulled into a false sense of security...
8.35am: Slept through my alarm but made it in just on time. Luckily the consultant isn't in and nobody has mentioned my tardy arrival. Result!
10.30am: Its been 2 hours and the fact I missed breakfast is starting to reveal itself in loud rumbling noises. I look innocent and pretend its a patient.
10.35am: Everyone is about to move on to see the patient I have clerked - my moment of glory/fear to present the details and suggest a management plan.
Suddenly the patient in the next cubicle starts going downhill at a rate of knots and everything falls into dissaray. The team rush over to see what is happening.
Its rapidly heading towards an emergency situation. Its noisy and smelly and sad. I feel my heart rate go up...
The SHO calmly asks for someone to:
- help hold the patient's sick bowl
- get the ECG machine
- get cannula equipment
- check patient's blood results from the morning
The medical students all look at each other and freeze. Nobody is sure who is supposed to do what...
I rush off to find an ECG machine. I've done an ECG once before. Well, twice but the first time didn't count because it was on my friend and her underwire bra made the trace come out crazy. Plus it took me half an hour... I find a machine with a faded sticker barely legible that says ECG but it looks weird. I cant see the clips that I think should be there. It seems to have lots of plugs. I panic. I stare at the various trolleys. But there's no time so I lug it over and announce meekly that the ECG machine has arrived. Everyone ignores me. Someone has magicked a tiny one from somewhere. Then someone else eventually moves the lumbering hulk of a machine back to the corner I dragged it from. I am so embarassed. I'm still not sure how it works or whether it is a relic that was on the way to the recycling bin.
Somehow everything is done and the SHO is so calm she impresses me. But then I remember that she's seen this before. We are all flustered and trying our best not to get in the way but its our first time. The surgical team is called to assess the patient urgently. They discuss the options but don't seem sure its possible. Meanwhile we think things are stable; there's access with cannulas and the nurses are keeping the patient comfortable.
CRASH CALL...
All of a sudden its a crash call. Last time this happened on my ward it was a false alarm and the patient recovered but this time its different. Suddenly there seem to be hoards of people around the cubicle. Neighbouring patients are gawking while we try to pull all the curtains and one of them loudly complains and asks if the patient is dead yet. I feel sick. A small female doctor is doing CPR. Gusto is the wrong word but she's really going for it. I feel terrified thinking that in the not so distant future that's going to be me trying to bring someone back... As students we just stand there helpless trying to follow what's happening, fetch anything people need and understand what we will be expected to do in future. Machines are beeping importantly. Its not a shockable rhythm. People move in and out at high speed asking calmly but urgently for drugs and charts and delivering kit and generally being efficient and useful.
It goes on for over half an hour. Everyone looks drained. It is unsuccessful and that is sad although its likely that the patient would have been for palliative care at some stage soon. Our patient was lovely and I'm just sorry that's how things ended. This job really is nothing at all like its portrayed on TV. There is no glamour. I have just seen someone vomit faeces. But the team did their best.
Today I discovered what was going on with the machine! When I learnt to do ECGs two years back we had an old machine with leads that attached with things like crocodile clips. In the intervening time it appears they have changed the sticky tabs and clips so you push what look like plug ends into a new sticky tab with a metal loop. So I had correctly found an ECG machine after all - just goes to show how much you have to keep up to date with the kit as well as new management protocols...
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