Saturday, December 02, 2006

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...


scalpel said...

I'm rather fond of these myself. I've no intention to wean, though.

A Bohemian Road Nurse said...

Glad you're going to stop smoking. (And I'm wondering what you meant by the "evil fish"?)

DrShroom said...

Scalpel - I use very similar lozenges... but I want to try and get nicotine free. I'm not sure it'll work, mind.

BRN - "evil fish" is my own eccentric take on the Bible's flood story. If God flooded the world to destroy evil, what about all the fish and ducks, for example, that would be unpeturbed by flooding... Just a thought

A Bohemian Road Nurse said...

That's funny--you crack me up! (And now that you mention it, I wonder what DID happen to those "evil fish"...)

HospitalPhoenix said...

I love relocating hips, ankles and especially elbows. So satisfying! Maybe I should go back to A&E.