Just got used to it

After 8 weeks I think I have gotten the crux of Emergency medicine. Basically when you first see the patient and talk to them, you just have to decide in your mind: are they going to be admitted or not? That is the basic question.

Once you decide, this patient is not going to go home today/tonight then things are so much easier. When presenting the case to the consultant, I am sure this patient is going to be admitted but just letting the consultant know about it and let him suggest anything else that I should do for the patient.

Previously it was a matter of me presenting to the consultant on the phone and letting him decide whether the patient should be admitted or not. Consultants and registrars alike whinge and complain when the ED doctors admit a patient. They do it so much that I feel almost guilty to admit a patient. That's why when speaking over the phone I used to tell them the whole story and let them decide to admit the patient.

But now, instead of telling them the whole story I just say “Dr Polan, I've got a patient with hyponatremia and acute renal failure which requires admission.” Then I pause. The consultant then just usually says “Oh yes, certainly” then interrogates me with questions (which I can answer because it's just a matter of relaying info rather than trying to convince him to accept the patient.)

Things also have significantly improved for us since they introduced a new role for the medical registrars called “admissions registrar”. So instead of us calling the consultant and going through abuse or the anxiety of potentially receiving abuse over the phone, we just discuss with the medical registrar and he will see the patient and HE will be the one talking to the consultant (and he's also the one copping the abuse).

Since this change, my morale has improved dramatically. It also helps that the medical registrars (new ones) are just awesome. They even teach on the side. Very nice arrangement.

I also now know which consultants are nice or not. I wish someone had told me this information when I started. Now there's only 2 weeks left; not much use so much now since I had to learn it the hard way anyway ie. Kene marah at work then nangis bila balik rumah.

PLUS the nurse which was the pain in the arse has been on annual leave (6 weeks) which also is a delightful experience for me.

ALHAMDULILLAH ala kulli haal.
2 more weeks of this rotation yehooooooooooooooooo
Some of the nurses have been telling me that they're gonna miss me.
I felt guilty not reciprocating the sentiment.