Survival Of The First Week 

Let me just turn down the drama a bit and tell you about my first week of actually being a house officer.

It was overall, an interesting experience.

Monday: day 1. And long day. As in 8:30am to 10:30pm. I was new to the psychiatry unit and was new on the job but I was expected to go on ward calls until 10:30pm. Lots of new things on this day. I have my own desk in the office, I was referred to as “Doctor”, and I had to chart my first medication. All important milestones. It started off kinda shaky because it seemed like I had very little workload on psychiatry. But as my long day went on, I was called to every end of the hospital to see a patient or sort out something for them. I felt I was actually capable of doing house officer type things. Quite exciting. Down side was that I was all alone on my first ward call day. As new house officers, we were supposed to have a 2nd year house officer buddy to offer advice. Mine never showed up. Which meant for any advice, I had to call the registrar. Which was a major power clash. And I felt the registrar who picked up the phone every time, was less than enthused to hear from a day 1 house officer.

But it’s okay. It had to happen sometime. Better on my first day than later on. So I did survive that.

I even had a pager message at 10:30pm exactly as I was walking out of the hospital about a patient who was short of breath. I had an internal discussion with myself where I asked myself if I would be able to sleep tonight if I ignored this page. The answer was No. So I went all the way back to the other end of the hospital to see the patient who in fact, did not have shortness of breath. I prescribed some paracetamol for this patient who had some MSK pain and went home. Oh well, conscious cleared!

Tuesday: I found things don’t usually go according to plan. And lots of stress. But I felt I actually had learnt enough in the last few years of medical school to do house officer type things! Which is a relief.

Wednesday and Thursday: Kept busy with jobs. I actually had the time to learn enough about all my patients and go around doing things for them that addressed their health. More stress of course, but I think I was getting the hang of it.

Friday: My 2nd long day in one week. Thankfully, it was a quiet day with not too many stressful calls. Actually I had rather strange calls. A nurse called me about a patient who was prescribed fluids but was refusing to take the fluids intravenously, but agreed to drink it. What should she do?! My answer was, let her drink it. She called again asking if it was okay to document that the patient had refused the fluids. I reassured the nurse that she would not kill the patient by not forcing IV fluids on her and by documenting that she had refused it. A few other medication prescribing errors through the night as well. But mostly I was able to sit and reflect on the week.

Overall, I had survived without killing anyone.

I probably do not have the work load intensity of the surgical house officers who turn up to hospital at 6:30am and don’t leave until 8:30pm, only to know that they’ll be back in 10 hours to do it all over again.

Yeah I don’t have that. But I find I do stress and overthink a lot about the decisions I made during each day. I need to work on that.

But let’s just focus on the fact that one week was reasonably well completed. Hopefully the weeks to come are easier as I become more efficient and confident in my practice.

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