I am an A+E doctor, kind of. I’m a GP trainee who is rotating through A+E and I am a mere one week into the job. So for now I am an A+E doctor. As luck would have it (or not depending on your work ethic) it is one of the busiest and biggest A+E departments in the UK. I found this out at induction but it would have been useful to know before-hand. Judging by the expression on everyone’s face when I told them where I was going to work I probably should have guessed. But I didn’t.
Day 1, induction: “We see 100 000 people through these doors every year, that’s 100 000 times we need to get it right. 275 people a day, 275 times we need to get it right. We need to meet the 240 minute target for every patient, but let us worry about that not you”. And so our pep talk began, it lasted 12 hours in total with the odd gem thrown in like “1 000 base-balls bats have been bought in the last year, but not one base-ball”, “x-ray the C-spine of anyone over the age of 65 years who falls as they have a fracture until proven otherwise”.
It was exhausting and frightening in equal measures.
Day 2, A+E majors: Holey moley, this place is going like a fair. And there in the midst of it is me and 3 other newbies wearing our new green scrubs, our faces a clashing puce in colour. Before catching breath a card is thrust at each of us by a harassed looking nurse. “Bed 15, 6, 9, 11” she says in our general direction before heading off with a sick bowl. We stand in the middle of majors, the beds in a large circle around us. Minutes later, having figured out the numbering system, we go to our assigned patient.
Mine a sleeping elderly lady, her daughter worried sick by her side. I listen to the story, a wonderfully fit octogenarian who simply felt more tired than normal. She looks ghastly, she’s of the generation who don’t want to bother the doctor. She’s not very well at all. I bring out my new stethoscope (my last one got nicked lost in psychiatry) as I feel certain listening to her heart will reveal the answer.
Lub-dub, lub dub, goes her aging heart at a very respectable 67 beats per minute, 62, 58, 53, 47, 40, 35…..lub-dub……….lub-dub……. 32 beats per minute. Holy crap my first patient’s going to arrest on me whilst I’m left standing in a pool of my own perspiration. Just as I’m simultaneously reaching for the emergency buzzer and defibrillator her pulse quickens back to normal. Funnily enough mine is far from this.
And so that was how I came to meet the registrars and consultant in the department that day. My lady was fine, she needed a pacemaker, her heart couldn’t keep up with her without one, but with one she is easily one of the fittest ladies of her time.
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The shift went quickly, in fact the whole weekend passed in a bit of a blur. The lack of windows makes the department a bit of a time warp, days will be lost to that place. The main problem with being an A+E doctor is that you never see anyone for more than the opening stages of the game, and the difficulty lies in working out if they’re ill, lame or just pretending. I’ve seen all three in the last few days.
A+E will be a good job, it will push me to the limits of my ability, patience, and self-resolve, but I will come out a better doctor for the experience.
Of that I have no doubt.