JuniorDr Blog

being woken up is a luxury. However, in psychiatry you DO get long, quiet on-call periods where sleep is possible - that's a fact - I get jealous of the cool scrubs surgeons wear (and those funny necklace-like things with the ear-pieces the medic have).

The blood results, that to remind I was woken up for, were over a week late. And normal. And had been repeated more recently. What it seems had happened was that the SENIOR nurse had found a paper copy in the diary and panicked. This wasn't a newbie support worker getting flustered but the nurse in charge of a ward of 15 adult patients who, when faced with a simple results report, didn't know what to do. With a set of results that were all normal.

This isn't meant to be a rant against nurses - I know my place - but more about the apparent divide between medicine, with its investigations and tests, and mental health, where we hold hands and CARE (until it hurts). It seems that when some people go into mental health work they begin actively avoid anything medical - to extent that common sense also goes out the window. The problem with this is that it creates a situation where trust and respect is lost and, at times, patient safety is compromised. If you can’t trust the person at the other end of the phone then nobody benefits.

The answer, in my sleep-deprived state, is to start small. To try and explain, simply and concisely the medical tests that come through to the whole team so that the knee-jerk reaction of “proper medicine” get the doctor to review begin, albeit slightly, to shift. That way all of us, doctor and patient alike, can sleep soundly through the night.

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now and then to defend him. After a while John directs his anger at me and I take most of it.

Then I call him a wanker and storm off the ward. Actually I don't. I calmly rebuke his antics with polite answers until he gets fed up and goes to see his private patients.

I have clinic in the afternoon and stay late to finish some letters. On the way home I get a call from my ex. He's around this weekend and asks if I'm free. I pause outside the tube station. I need a few seconds to think this one over.

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long and I keep getting interrupted by my house officer with problems that he should have sorted this morning. I refer him to the med reg on call.

The mess is having a night out and I arrive suitably late. Spending time with colleagues out of work is one of the joys of medicine. People are so different outside the building. And the alcohol helps.

I spend most of the night chatting to fellow cardiologists but as the evening wears on things get silly. I end up on the dance floor with my house officer and somehow I end up nearly pulling him.

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little cocky, especially for someone so soon out of medical school. He hasn't sorted out the referrals I asked him about this morning so I try and be firm but I'm not very good on discipline. I agree to do a couple and we part on mutual terms.

I spend the rest of the day taking ward referrals. Most of them are decent but I have a run in with the gastro reg who insists on getting an emergency cath for a ward patient. I tell him that it isn't indicated in this case but he insists on going to the consultant on call. I tell him to go ahead and we stare at each other for a few seconds like a playground game of chicken. He walks away but I don't hear from him again so I guess he was the chicken.

My ex calls me as I'm walking in through the front door. The conversation is short and less than pleasant. He's free tonight and wants to know if we want to meet up. I toss the mobile away and open a bottle of merlot.

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I spend an hour putting in lines and getting his pressures up. On answering the bleep the intensive care registrar tells me that he's busy so I start our man on noradrenaline which is against ward policy. The sister in charge tries to stop me but I tell her that we either start the norad or I give her the crash bleep and let her come running when he arrests. She backs down.

We do the rounds with Dr Edwards, a young and nervous respiratory physician who insists on examining everyone again. I wonder if I'll be like that when I grow up? I grab an Indian takeaway on my home. I eat out of the boxes and when finished pile them up on top of last weeks' ones.

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