It's the weekend! And thank goodness for that.

The end of another week, and what joy it brings.  I'm so tired out!  And I still can't believe that it's still only been a week and a half of work.  It feels like so much longer, but that's probably just a reflection of how busy I am.  I totally loose track of what day things happened, along the lines of explaining an incident to some one, and no actually being able to say when it happened.  Logic dicates it was yesterday, but every other fibre in my being says no, it was so much longer ago!  Craziness.

This week work has brought:

• three death certificates, waiting for me to fill out on Monday morning.  Three legal documents where I have to officially, legally decide and declare the person's cause of death.  It's quite a responsibility.  And my SHO (i.e. the person who is two years ahead of me and claims to remember what it was like to be in my situation) was very unsupportive.  We were warned on our first day that we shouldn't do the first ones alone.  That we should have someone talk us through it, and help us come to a decision about the cause of death.  He just flatly refused to do this.  And I was having the office bleeping me because the family of one of the deceased was refusing to leave until they had the certificate.  And so I pestered the SHO more to come down, and he suggested that I stay on the ward and he goes and does it.  How am I supposed to learn?  So I said no to that.  You would have thought I was asking him to give up a kidney or something.  Such a battle, then he only helped me with one, and refused to let me stay to do the other two.  Such a battle!  It shouldn't be this way.  Next time, I'll know not to even bother asking for his help on the certificates. 
• Along with death certificates, comes cremation forms.  Again, a legal document to say you have identified the body, that you don't think they died in even a remotely suspicious way (both these things can't be checked once a person is cremated!!) and you also have to declare if they have pacemakers (blow up cremetoriums if left in the body), metal work (e.g. from broken bones) or radioactive implants (can be bad to the health of cremetorium staff).  You can be held liable if something goes wrong with any of these things, so it is a huge responsiblity, which we were again told we should have our SHOs guide us through and help us with.  My SHO flatly refused, so I had to blunder my way through.  One of them had very limited notes, so I couldn't in all honesty say that they didn't have any non-human bits in them.  I was really worried and concerned about this and unsure what to do.  My SHO's advice?  "You're not confident, you have to get some confidence and just get on with it, we don't have time for this".  Not in anyway helpful.  Fortunately, I've adopted several other SHOs to go to for advice and managed to work something out.  But since I had three to do, they did take time.  My SHO's response - bleep me and ask me where I am (despite me having told him) and then ask if they can wait, since we had so much to do.  Well, no, I've already put it off for three days because of trying to get answers and help.  It's not fair on grieving relatives for me to put their funeral plans on hold indefinitely until I found some time.  But on the positive side, I do get paid for my crem forms (in addition to my usual salary) so at least my stress and worry isn't completely unrewarded.  Although, I do feel slightly guilty profiting from someone else's death, even if indirectly.
• Four consultant ward rounds, getting to know people's styles, preferences, way of doing things.  Four consultant ward rounds where my SHO in his attempt to look good in front of the consultants, has excluded me from them so that I can get the next patients notes ready, xrays and scans up and blood test results up.  I there to learn.  This is the only time I'm with the consultants and he excludes me from going to see them.  And then I get moaned at by radiologist and microbiologist, because I do the requests and prescribing, but often I don't really know why, because I wasn't able to hear the conversations had between the consultant and the patient.
• One drunken walk home by myself, after Thursday drinks out with my fellow F1s where I tried drowning my SHO stress out with a little too much wine.  (And for the record, no, no hangover, just not enough to eat, because didn't really have the time).
• One talk with a consultant late Friday night, who had noticed I was upset on the ward round (had been hiding in an office, crying on the ward clerk's shoulder because I had just been sent on a wild goose chase by my SHO and then humiliated by him in front of said consultant, thought I was composed enough to go back, but clearly wasn't).  I wanted to hug this guy.  He was so sweet, and he was talking things through, and telling me that it was a shame that I had to start on this ward, because it is so crazy and doesn't let up.  But he wants me to enjoy it and learn and benefit from it.  And was there anything that he could do to help.  I think just talking was help enough.  And I explained about the death certificates, crem forms, other issues and the ward round that had just made me feel really bad about myself and my abilities and that I just didnt feel I was supported or able to learn.  It's nice to have been able to talk about it, and he's going to have a word with my SHO, and hopefully, things will improve.
• One slice of chocolate cake from a patient's wife, who had brought it in for him, but he didn't want.  And I work so hard and deserved a treat!   People can be so lovely and it's the small things that brighten up life.
• Twice "just in case" boxes prescribed.  Annoying amounts of paper work, and depressing intentions.  It's a set of medications sent home with a palliative patient so that if they get pain, nausea etc, then they have medications that a district nurse can set up and help them with.
• One failed male catheterisation - and then a mini-lecture/discussion from the consultant urologist as to where I was going wrong (in his opinion, as he didn't actually see me try!).  Apparenly not, errmmm, straightening things up and out enough, typical girl being too gentle!  But good tip and learning point.
• One finished sweater and one nearly finished cowl, accidently (on purpose of course!! ;)) twisted.  But three days when I was just simply too exhausted to knit.  Which is sad.
• One dinner out with my flat mate and fellow ward F1.  No one understands what I'm going through more than her.  And when, one night, we were both still there on the ward after 8, she suggested we treat ourselves to an opportunity to unwind.  It was a lovely Italian restuarant, where the waiter flirted outrageously with my engaged flatmate and ended up giving us free lemoncello!  It was just what we needed.
• Three episodes of falling asleep on the sofa whilst watching things on my laptop, despite having always laughed at my parents for doing this (in front of the telly) routinely every night.  How quickly these things change!  I really will have to start thinking about sticking to better hours, and not trying to stay up watching stuff. 
• One trip to see Toy Story 3 in 3D last weekend.  Cute but not as good as I was expecting according to the hype.
• One chance to graffiti a fellow human's body with a permenant marker, outlining a rash to check it doesn't continue to spread.  She was a lovely patient and thought it halirious as I sat an doodled and tried to make sure I was doing an acurate outline, despite bad light.
• One trip to Starbucks for a hot chocolate on this rainy Saturday morning and a chance to check up on blogs and facebook.

And here I am, yawning but cozy and content that I don't HAVE to do anything for another day and a half.  Life is crazy busy, but as I said to the consultant, I really am passionate about being here and doing this, and it will take time to settle, I keep on forgetting that it's been less than two weeks.  I still have times when I'm really enjoying myself, which makes up for the times of extreme stress.

Hope you all have a good week!  And until next week, bye-bye!

On being required to be Superwoman

I have now completed three days of "independent" work, and have come to the conclusion that I am expected to have about five clones, working in sync with me, all communicating from a single brain to co-ordinate it all.  I was warned this was coming, so I'm not entirely surprised, but I didn't think it would be quite to this extreme.  I knew I'd be busy, and out of my depth and feel overwhelmed.  But I feel very busy, very out of my depth and very very very VERY overwhelmed. 

It's been a hectic three days, where I've barely had time to stop.  And by and large, I've been by myself about half the time.  My middle grade doctors have been having their various induction days and the consultants have been off doing, well, whatever mysterious things that consultants do, leaving me, very green to it all, by myself.  Which can be fine.  I'm a glorified secretary, I mainly sit and push a lot of paper around and play on the computer.  But when there's a genuine problem with a REAL person, it becomes scary.  I've spent longer than I care to admit at medical school and apparently I have so much knowledge floating around in my head, but it's true what they say, you don't really learn the practical things at uni.  And I suppose the hardest thing that you can't really get taught at uni is how to prioritise things.  I have issues with patients that I'm not sure how to deal with, paperwork being shoved in my face, requests to go and see this person, results of tests been handed to me, telephone calls from GPs about patients who came and went from the ward before I started, and my middle grade doctors giving me an ever growing list (well, orders, that I sit and list, and try not to loose said list).  And my brain tells me that the priority is to hide and flush my bleep down the toilet so no one can find me (apparently, like cockroaches, they would be able to survive nuclear armagedon) and cover my head with my arms.  But a small voice of reason somewhere reminds me that this actually won't be helpful.  So I do what I can, going by the moto of I'll try spread the disappointment of those relying on me around, so that my incompetence is not wholy apparent to anyone but me.  And I just hope that I'll improve quickly and eventually feel like I'm on top of it.  I definitely feel like I'm in a leaking boat, just bailing out the water with a teaspoon.  My spoon needs to grow and then eventually, I'll be in the position to plug the leak and all will be plain sailing.  And for those worrying about how this all sounds, yes, it is dangerous, and tettering on a knife's edge.  I am aware about this as are the powers that be, and I've just got to improve as quick as I can, because that's what I've signed on for.

And most of all, I'm saddened by how quickly I've become jaded by it all.  Reading this back, one would think I've been working for three months, not three days.

But it's not all bad.  Here are the good points:

• I still get a buzz from answering the phone/introducing myself as Dr van Tonder.  Every little time, my heart beats that little faster and I get a little smile.  It's becoming gradually less surreal, but that little moment of happiness reminds me that I'm still here by choice, and it's something I've wanted so hard for so long.  And it reminds me that no matter how bad it is, there's really no place I'd rather be.
• I'm meeting some fantastic people.  The nurses have been brilliant and I have even had a cup of tea and biscuits brought to me whilst I was sitting in front of the computer, when at 3pm I mentioned in passing that I hadn't had lunch yet (and I didn't!  Went home at 8.30(!!!) and was too exhausted to think about food for a good half hour of sitting staring into space and then calling my mom!)
• There really is no better place than a hosptial to people watch and see such a fantastic cross section of society and really find out about them.  People are truely fascinating, and so utterly capable of surprising you with the most unexpected things.  Patients are more honest, more open and to some extent, more vulnerable - you tend to see the "real"(ish) them.
• My fellow F1s are a great bunch of people.  Supportive (my ward/job is notoriously the worst in the hospital, so I get a lot of sympathy) of my stress, and very social.  We went out to dinner this week with them and some of the F2s and we had a bbq with crazy no-rule, no-score volleyball over a hedge.  It's nice to have a life outside the hospital and they are the best way of doing that in this strange unknown little town.
• Knitting - yup, where would I be without this?  I have found a shop that has a reasonable range of wool, and I have finally found a suitable yarn for the sweater that my friend Mary picked a pattern out for back in March.  She found a lovely quick pattern.  So much so that I am most likely to finish it later today, despite the busy week and having only started it last Saturday evening.
• I had a letter yesterday from the hospital (I stay in hospital accommodation) saying they are sorry for the poor state of the housing and that they have initiated an improvement scheme.  I'm hoping this means they'll install internet, so I don't have to drag my laptop to starbucks everytime I want to surf decently (the 3G is a bit hit and miss in my flat for my iPhone not to be frustrating to surf on).  And further to this, to help restore our confidence in them, they have decided to give us a month free of rent.

Yup, it's been a funny old week.  It's more or less what I expected but at the same time, nothing like what I was expecting.  I'm a bit like a zombie at the moment, but I'm sure this will improve and this is just mainly due to adjusting to the new things in my life. I'm so glad for my weekend off to recuperate and think of an action plan and how I'm going to improve next week.