Monday, 8 October 2007

The (under)Graduate

My partnership with the Mountain Goat has been put on hiatus: I've joined a different firm. I now accompany The Big Cheese for his ward rounds. In management circles, this is known as "being headhunted". Or "constructive dismissal".

The Big Cheese runs a tight ship, which means that the ward round's conducted at the speed of light. There's barely enough time to collect the registrar and the students before it starts, let alone find the nurse taking care of each patient.

The one-minute-medicine approach works well for the consultant, who's then free to play golf and eat small junior doctors for the rest of the day. Consultant Surgeons see everything in black and white: you're either ready for surgery or ready to go home. Convalescence is for wimps. This speeds up the discharge process.

It's less efficient from my perspective: I spend the rest of my day answering phone calls from nurses. They get concerned when their patients disappear home, especially if it happens during their bre
aks, which take up approximately 65% of their working day. I've seen a nurse arrive at work, take off her coat, and be told by her supervisor that it's time for her break.

When a nurse is "on her break" she is not to be disturbed. I've never seen it myself - I'm not allowed in the staff room, which is for reg
istered nurses only - but I'm told that they put themselves into a Zen-like state, into which no earthly problem can intrude. I imagine they write haikus, play the mandolin, and discuss the philosophical issues of the day, before dusting themselves down and doing the drug round.

To add to the general chaos, the Big Cheese has taken on an assortment of new medical students. They're so fresh to the wards that one of them - with no sense of irony whatsoever - declared "I love patients".

Even the nurse on her break cracked a smile at that one.


PhD scientist said...

Mrs PhD has a story about breaks from her medical SHO yrs in the late 90s.

As she tells it, junior doctors in those days never got a break because if they did try to take one (or at least sit down with a cup of coffee) the nurses would unfaillingly come and find them to insist they attend to something, talk to grumpy relative, sign off on something, write up orders etc etc - to the point where the SHOs in particular gave up bothering to try to take breaks at all.

The sole exception to this was if the doctor was "taking five" standing outside the doors, or on the fire escape, SMOKING. The general understanding was that since most of the nurses were 20+ a day smokers, they understood that a smoking doctor was not to be disturbed.

Mrs PhD swears blind that more than one SHO actually took up smoking in order to be allowed the occasional five minutes respite.

Maple Leaf Medic said...

"I love patients" had me laughing in hysterical (some might say maniacal) laughter for a good five minutes.

At least this attitute is better than one of my fellow students had when revising for OSCEs and we were deciding between whether to practice examinations on patients or on each other.

"Nah" he said, in his West-London rude boy accent "Let's practice on each other. Real patients slow you down, innit"!

Medical students today, eh :-p