Monday 3 December 2007

Reasons I don't miss Gen Med #1 - The Ward Round Octopus

Before starting deciding to change my career path and become a trainee anaesthetist, I used to be a junior doctor working in General Medicine. This is the same job that Zach Braff’s character in Scrubs does, but I have to say I’m less inclined to have surreal lapses of reality.

I think whenever you decide to change an aspect of your life, you always wonder whether or not the decision is the right one. It’s now been several months since I made the switch and, looking back, I have no regrets.

Here’s the first of the reasons why I don’t miss general medicine.

The ward-round octopus



Ward round days were when the consultant in charge of the overall care of the patients on the ward would go round and see each patient, catch up with what we juniors have been doing and make decisions about their future care.

As a junior, it was my job to know what was going on, and to have all the relevant information to hand that allows decisions to be made. It was also my job to document conversations between the consultant and the patient in the medical notes and write down what the management plan is.

On a practical level, this was often a bit of a headache, especially because I was often the only junior on the ward round. It meant that I had to find the patient’s observation chart and make a note of their most recent blood pressure etc…, get the blood results folder (that I had previously prepared) and open it at the right page to see their most recent lab results, get the patient’s medical notes and find where to write the day’s entry (often not as easy as it sounds), all the while I’d be listening to the conversation between the patient and the consultant and writing down the relevant points as legibly as possible, whilst being ready to interject with any relevant scan/histology results and I’d also be trying to write down any tasks that needed doing over the next day or so… and I’d have to do this ALL AT THE SAME TIME.

Seriously, even with judicious use of all available flat surfaces (the notes trolley/bedside cabinet/patient’s bed/patient’s footstool), I felt like I needed an extra couple of limbs just so I could relay all the available information and write everything down so things didn’t get forgotten about.

This process would have to be repeated for every patient on the ward so I had to be quick with my octopus arms because after deciding on his plan, the consultant would move onto the next patient whether I was ready or not.

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