The Best Laid Plans...

Another weekend, another crappy night shift. I meant to write this as I went last night, but the Department went bananas, and I didn't get a chance.

Normally we do single weeknights, and three at the weekend. Last night I was covering for one of the other Middle Grades. Friday night always holds the promise of being a bit more exciting than a regular night. Especially when it falls just after payday. Last night, however, the weather was truly dreadful - at least by English standards. Clearly it wouldn't have raised much on a tropical storm scale, but I still thought I saw a man with a long beard working on a huge boat. (What about the evil fish, tho'. Still unexplained...) Bad weather sometimes works in our favour.

Things were actually pretty good when I came on. A couple of patients in Resus, but both stable. Only a few in the racks, waiting. Then - something went wrong. I'm sure my halving of my nicotine dose didn't help, but even so...
Suddenly, I found myself with no doctors; they were all on a break, or with someone, or something. Then all the doctors came back, but I think they'd been out collecting patients. I wouldn't put it past them.

It actually started well. We had to improvise some kit, to get a difficult NG tube down, and then visible on CXR. Very Heath Robinson; reminded me of when I first started out. But, then the onslaught began...

So - I had to move 'small bowel obstruction' out, and off to theatre, hope that 'stridor' would hold her own for a bit. That gave me the chance to see 'dislocated ankle' (with bonus 'altered conscious level') and pull the offending limb; once that was done, we whipped in 'dislocated hip' - lots of pain, very anxious - albeit with no real success.

This calm procession was interrupted by 'acute lower GI bleed (?perf)' man, and his party trick, "the vaso-vagal". Once MY pulse normalised, I was able to attend to 'young fractured wrist' , 'large scalp lac kid' and the re-do ankle manip. In the background was a poor unfortunate lady with a broken hip. To add insult to her, already substantial, injury, her heart kept trying to give out on her.

Time for a deep breath:

Then: 'suicidal overdose', and 'accidental (booze) overdose'. I punctuated this with a young lad who'd dislocated his elbow. To add insult to his injury, I had reassured him, prior to x-ray, that it wasn't dislocated. That's me taught, then.
(It went back, no trouble)
At some point, 3 giggling buffoons pitched up having stabbed themselves with a Stanley knife. Not having sustained life, or limb, threatening injuries, they were advised of our substantial waiting time. They promptly discharged themselves. Still, at least they got a nice ride in the 'Dorset Big White Taxi Service'.

I have an idea that there was more, but I can't remember.
No-one died, and almost everyone got treated in reasonable time. But I can't remember a night so consistently busy at this hospital.

The fallout to this happy clinical ballet was that I was still at work at half six this morning; this blew plans for a quick jaunt up to London right out of the water. Ah well.

I'm still not married, in case you were wondering.
I also didn't smoke any cigarettes. My final weaning programme is under way, and I've a feeling it's going to take a while for me to get used to the reduced dose...