Late night musings

What a way to come back to this blog after months, but I really need an outlet.  My flatmates are driving me mad.   I know it's a Friday night and all, and they have a right to a social life, but do they have to be so !*$£"@! inconsiderate.  They arrived back about 2.30am, with a bunch of other people, I'm guessing (from the voices) at least 3 or 4 of them.  And now it's 3:40, they're playing music, chattering away loudly enough to ensure I have no hope of sleep, cooking (which is making me feel hungry!) and sitting in the lounge.  Where I left not one, but two on the go knitting projects, including one I've been working on for months and that the stitches slide easily from the needles.  I am now very paranoid that when I get a chance to see it, half the stitches will have pulled out and unravelled, it'll be scrunched or dumped uncaringly by the drunkards in a corner and it'll have greasy crap spilt over it (my delicate cream coloured laceweight silk/mohair).  If I had known they'd be entertaining all night long, I would have packed away the knitting safely.  And my wheel's there with a gently attached piece of half spun batt, and a predrafted, lightly balled batt next to it.  I wonder what state that's going to be in.

Can you tell that I'm pissed off and frustrated.  And I'm so tired.  Physically tired from a busy week - slept for 2 hours this evening, which I never normally can do.  And tired of my flatmates and their sucky attitude towards me, for example, shutting the kitchen door when I get home and walk past on the way to my room.  And their general lack of respect for my things.  But on the positive side, it's only about 5 weeks before we move out and go our own ways.  Roll on that day!

And yes, I realise that I'm being a little immature and paranoid here and part of that's because it's nearly 4 in the morning, and I'm awake against my will.  But I still want to scream... oh yeah, and now I need to go to the toilet and it's far to awkward to leave my room... let's hope they get tired soon.

On being a surgeon

On Wednesday, I left my hectic, challenging, demanding job in medicine and began my new rotation in surgery.  And wow, what a difference!  Admittedly it all starts an hour earlier, but yesterday, I had done my ward round and all the jobs and was sitting in the mess twiddling my fingers by 9:30!  It almost feels like some sort of perverse torture, after being constantly so busy for about 10 hours a day, this is a strange feeling, and one that feels so wrong.  I have to be there but to do what?  I'm working on a couple of things to keep me occupied, and I know there will be busier days, when I may even regret this post.  Don't get me wrong, I'm not really moaning, I'm merely making some observations on it all.  I'll probably get used to this change of pace and barely notice it after a will.  I definitely am missing my old job, but it's good to get new experiences.

So here is my list of things that I want to achieve in the next four months:

• work on an audit
• catch up on my e-portfolio
• do some e-learning
• work on some presentations
• do some reading and active learning, rather than just picking it up as I bumble along.
• do some form of exercise, am considering swimming
• eat proper meals, rather than half-arsed attempts at sustenance
• do some formal teaching

And there they are, documented for all to see, and I'll try to keep you up dated on progress. :)

And now, I'm off to nap, as I think I need to add something else to my to do list, not over-indulge with alcohol too often!!!

Has it really been that long?

I've been on call today, and for the first time, chatting with various nurses, it dawned on me.  I have just two days left of my current placement.  And who would have ever thought it, but it actually fills me with a great deal of sadness.  In the two and a half months since I last blogged (!) I've come to love my job.  I've found my rhythm and I can actually say I enjoy my job.  There are now only fleeting moments when I'm feeling a little swamped that I slightly begrudge it all.  And I actually feel like I can cope, actually, it feels rather natural too, and dare I say it, at times I actually think I may be rather good at it.  There are moments when clearly I'm not... but still!  I can't believe how far I've come in what is such a short amount of time.  I've just read back at my previous few entries, and I feel like a different person to that overwhelmed and green doctor.  I still can't quite believe that this is where I am now, and that I'm actually here, doing this, that thing that was a pipe dream for so long.  And now, I have to prepare myself for all new adventures in my next rotation.

So, what have I been doing since I last posted?  Well, besides that crazy 10 hour days that I barely notice anymore, and sleeping, I have:
1) been on holiday to Dublin with Lorri, which was fun and exciting, and soooooo grown up - a girls weekend away.  With complimentary champagne courtesy of the hotel apologising for the 5am fire alarm, facials, shopping, getting Lorri to love and stroke the pretty yarns at the local yarn shop, Japanese cocktails over sushi and tasty food, the search for "real" Irish music, sipping Guiness whilst posing for photos, and then ditching the foul tasting stuff, looking in the window of EVERY jewellry shop we past, being gently reminded of the violent and colourful history of the country, crazy traffic lights with awesome robotic sounds, kicking up the leaves on St Stephen's green, admiring the beautiful autumn around us!  It was awesome, thanks Lorri!

2) Buying more stuff for crafting that I could even begin to think I had the time for!  But I have still squeezed in several hats, a couple of cowls, a couple of adult jumpers, a couple of scarfs, two pairs of socks, 100g of spun fibre.

3) Spending Halloween in Bristol with my nearest and dearest, after spending the day at Fibreflurry with Mary (bless her!) then shopping at the Bullring, on a whim!  Playing mini-golf and not coming last!

4) Many meals out, some just because, some to unwind, some to catch up, some for celebrating being paid!

5) Making peace with my SHO long enough to have a lovely photo taken with him and the other two doctors on my ward.

6) Obtaining 2.6kg of alpaca fleece, which I have no idea when I'll ever get round to finish washing, let alone picking, carding and spinning!

7) Enjoying Yeovil and pretty sunsets over the hospital

And that pretty much sums up the last few months for me.  It's not been too bad at all, and boy has it sped past!

Oh Bristol, how I've missed you.

Bristol was everything I was hoping for, my solace and my calm.  How is it that a place, a simple city can just inject me with life and make me feel so... so... so. . . renewed.   How I've missed it.  And the people and the shops and all those other familiar things that I hold so dear about it.  As soon as I started seeing some of the old familiar places on the train, I couldn't hide my grin.  It's reminded me like never before, I will most likely end up in Bristol, I gravitate towards that place and no where else makes me feel so at home and so complete.

And what did I do in Bristol?  I saw Mary, but unfortunately no one else, since people were working or away.   And I went shopping.  Lots of shopping... dangerous shopping.  Mostly things I've been putting off for a while, like some new clothes for work.  And then some purely special treats.  Like a new camera, an idea that I've been toying with for about a year.  And something truely indulgent, to symbolise my achievements.  I wanted something special and enduring.  And hey, just because I don't have someone in my life to buy it for me, why can't I buy my own little bit of very special jewellry:

I love my little bit of bling.  Perhaps a bit silly and dreadfully materialistic of me to be buying diamonds and saphires, but I don't care.  I love it, and it really is a special symbol of what I've acheived to get here and how long and hard I've been working to get to this point in my life. (the truely indulgent part is when I go back next month or whenever I get round to it and buy the matching earings!!)

But most imporantly, this weekend was all about relaxing and unwinding after a really hectic two weeks, and I've certainly managed to do that.

On being blessed

On being blessed! 

I'm composing this on the train to bristol, in a desperate need to escape all things yeovil and work. I had this overwhelming need to escape, there's no two ways about it, I've been exhausted this week and it's been rather crappy at times. Working 12 days in a row, and such long intense hours where I frequently go 12 hours without eating or drinking (turns out being a junior doctor isn't exactly healthy!) is incredibly draining. And that's before you even add in the stress of really sick patients, stupid workload and tense working relationships. So I needed badly to unwind and be cheered up.   It's really felt like too much at times this week. And we've had medical students around this week (and oh, how I remember being them, it really wasn't that long ago!) and several of them have asked if I'm enjoying the job. What do I honestly say? I can't destroy their hope in their first week of the year! But I don't want to exactly be sugar coating it either. And it's also given me pause to think about what I really do think the answer is. Do I enjoy my job? I enjoy the patients, who I faithfully say goodnight to every night when I go home and who so brightly greet me the next morning. They care about me, and when they see me looking stressed or upset, they mother me or take great concern and always ask later if my day has improved. I love the man who had a stroke and cant find his words, but he deliberately catches my attention then winks at me and wanted my attention for no other reason than to put a smile on my face.  I love how I get to touch their lives in such a positive way. However, I don't like it when I'm been pressured from all corners to do this and that. Everyone has their own agenda, and of course, their's take priority over all the others! It gets tiresome and the stressful and then sends me running to the toilet knowing full well I don't actually need to pee because I've not drunk anything in hours, but it's a quiet place where I can spend five minutes, gazing out of the window in silence!  I don't enjoy the stressful working relationship I have with my SHO which has finally come to a head and we've talked and things are better, but probably still fragile.  I love the fact that I'm learning even when I don't think I am.  I get asked something or do something and suddenly I realise that I actually have picked up a lot in the chaos. And I've always said that it's one of the things that really attracted me to the job, constant learning.  So, do I enjoy my job? I don't think I can honestly say that I can, but I don't hate it either, so maybe that's okay for now.

But on my crazy attempt to escape Yeovil, I've also come to realise that I am incredibly blessed. Several things have reminded me if this fact.  Firstly the gift bag waiting for me on the ward, from my favourite patient (don't care if it's incorrect to have favourites, I really couldn't help it with this woman!) who I had finally been able to discharge earlier this week. It was addressed to me and no one else, and contained a box of chocs and a thank you card, sent with love. I came so close to crying. I was so incredibly touched and it made me think that I must be doing something right somewhere along the line.  

Secondly, my amazing friends who are always thinking of me and supporting me even when I haven't specifically asked for it and at times I don't even realise it. Is there a greater blessing in one's life than wonderful friends who just accept you and love you? So thanks to them.

Thirdly, at the train station this morning, I was drawn to the little cafe window on the platform by the smell of bacon cooking (oh why oh why is that smell so irrisitable!) and I asked if they take cards, no. Where was the nearest cash machine? Too far if I was going to catch my train.  Random stranger who clearly overheard this conversation fished out her purse and insisted on buying me a coffee, saying that sometimes a girls just gotta have her coffee.  I was so touched and speechless, although I didn't have the heart to tell her it was actually a bacon roll that i was after. I just stood there luxuriating in that cup of coffee, which has so totally made my day.

And then there's this train journey. There's a certain symmetry to it, following on from that journey I made, what was it, six weeks ago, when I was filled with anticipation, curiosity and a fair dose of anxiety.  I've survived! I've had some amazing experiences, meet some lovely people, made new friends, seen new things and I'm so incredibly blessed to be doing that which I've wanted to do for so long.  How lucky am I? I have an amazing job, which makes a difference. I'm fairly secure in my employment. I'm quite well payed. I'm healthy (there's really no place that makes the fact more apparent or makes you more grateful for your health than a hospital).  I get to go out for dinner and enjoy good company with the people who understand what I'm going through.  The high levels of stress at work aside, I'm so incredibly blessed and lucky.  Life is really tough at the moment if I look at the individual instance, but when I step back and look at the whole, well it's not too shabby at all!

(p.s. Sorry for the typos, joys of iPhone technology on a train I'm afraid!)

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.