Was on call last weekend. Not horrendous. Usual barrage of patients with a few really sick ones. Usual dictum is hospitals is that the medical registrar's job is the worst in the hospital. You get dumped on by every specialty in the hospital.
You get cardiac arrest calls, 50-60 admissions, referral and reviews from all other specialities and you are responsible for another 300-350 patients already admitted to various medical wards.
Last week end was reasonable. Only couple of very sick patients who ended up in the ITU(intesive treatment unit). Our ITU is very top led. I see the patient if he very sick and I mean very sick, has a good quality of lif previously, then I call the medical consultant on-call who then takes all the details from me and call the ITU consultant on-call. ITU chap then either comes down himself or sends his registrar down. In other hospitals I've worked in it is usually a registrar to registrar affair and we usually let the consultants involved know what happened. Here there is a rigid system. Helps ITU weed out admissions I guess. But it is a pain in the butt to go through the convoluted system.
The worse thing about weekend duty is week afterwards. Because you have done 14hrs every day for 3 days in a row, the next week becomes one long drag. In essence you work continuously for a fortnight. European working time directive means that it is not as bad as it was previously. I still think that if you are a junior doctor you should be working more than 48 hrs. Perhaps not as long as 80 hrs, but 55 hrs seems reasonable. Controversial.
I will rant about about absence of adequate personnel or bodies on the ground during the week end and especially bank holidays, one of these days.
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Wednesday, 4 June 2008
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