The Graveyard Shift

Well I just finished my first week of night shifts.

It was a very long week. But that was quite an experience.

Middlemore hospital gets extremely busy over winter. More so than usual.

On medicine overnight, there are 2 house officers to run the entire medicine department of the hospital. This week, we had 3.

Usually 1 person stays downstairs and admits patients to hospital with the registrars, and 2 people stay upstairs managing ward calls from the 12 medical wards.

But this week, there were so many people waiting to be admitted at the start of the night shift, that 2 house officers needed to be downstairs, and 1 house officer managing 12 wards.

Take a wild guess which one I was.

Me and my 12 wards all 4 nights this week.

People having pain, fevers, sepsis, bleeding, crashing, and passing away. And little me being the first to deal with all of them.

My hospital has an online job posting system where nurses post up alerts/jobs about patients who are unwell and need to be reviewed.

On a good shift, this is limited to around 10-15 jobs.

Every night this week, I started on a shift where there were 40+ jobs across 12 wards, with constant phone calls about acutely unwell patients too.

I had a friend of mine (a 2nd year house officer) at a different hospital also rostered on nights this week. He was my cheerleader and support. Which really helped.

But my God was it tiring. The night house officer job is nice in some ways. Such that your main goal is to get people alive through the night before their primary medical team is able to see them.

But the difficult thing is that there are zero resources through the nights and it’s just you and a very busy registrar downstairs making all the decisions.

Meaning if there’s a patient who has been having nose bleeds for 6 hours straight despite several nose packs, your options are to continue trying the nose packs or call the ENT registrar on call at a different hospital who can barely offer any useful advice at all.

But I’ve got to say, I got all my patients through the week.

Last night in particular, I started off the shift with 51 jobs across 12 wards with several acutely unwell patients that the previous on call house officers were unable to clear.

Oh and there were 15 people downstairs waiting to be seen, meaning the registrars and both other house officers were stuck downstairs and no one was available to help me clear said 51 tasks.

I was running the entire medical hospital.

Quite proud to say that by 630am, I had cleared all 51 tasks, put in 8 IV lines,  successfully carried out 2 Abgs and kept all my patients alive.

My first night I couldn’t clear 46 tasks and hadn’t eaten or drank anything for the full 10 hour shift. I was close to tears from the exhaustion.

I also didn’t eat or drink anything on my last shift, but I cleared all my tasks.

Sleeping and reflecting afterwards, I felt strangely good.

The feeling was one of actually having accomplished something. And feeling that hey maybe I can handle some things on my own!

Night shifts are weird. I can see why they’re commonly called the graveyard shift.

But honestly, sleep is VERY important for life, people!

What Do I Know?

Sorry for my absence.

But between Taylor Swift releasing new music and the new Avengers movie coming out, and Adele getting divorced and little old me struggling through working Easter weekend at the hospital,

Things have been kind of hectic.

ME! is amazing though by the way.

I haven’t seen the avengers movie yet.

And I’m very sad for Adele

But damn I have busy. And I know I asked to be busy. I’m not complaining about that at all. But this week is the longest time junior doctors are going on strike for safer hours. 1 whole week! I am Not on strike. I gave up on my union. While I support the cause, I do not support the methods. So this has been the longest, slowest week I’ve had so far. 

And today I want to complain about some of the things I hear around me.

My registrar referring to a patient everyday as “she’s still fat” 

My consultant telling me to do jobs that aren’t mine then walking away without helping me understand them. 

Doctors of different specialties cherry picking their patients – Eg. Rehabilitation wards cannot take obese patients as they have an experience of obese patients previously falling and breaking equipment. Regardless of how much rehabilitation potential they have, they will not be taken over.

People flipping out when they’re stressed and taking it out on the world.

People valuing those  who have so-called “people skills” and giving them awards while those who actually work hard and are deserving are left in the dark. 

Nurses not listening to what I’m saying after I’ve tracked them down and asked nicely to do a job more than once.

People being angry and rude one minute, then turning around and being oddly nice the next. Please give me 1 days notice as to what face you’ll be wearing today.

Sigh.

But I shouldn’t complain too much. I still have things that make me really happy (though they probably shouldn’t) and I’ve still got people who understand when I complain. And I have been learning a lot this week. My registrar is on strike which means my consultant expects me to do his job. Which I’ve been learning to do. So that’s good! 

And so I keep chugging. Hoping for a brand new day every day and trying to be kind of Awesome.

Because you can’t spell awesome without ME! 

More Aussie Trails

Greetings from Sydney!!

*insert opera music from Finding Nemo here*

So after my 10 days stretch and having days where I was talked at by 10 different people at once and being asked questions like “does this patient really need an enema considering he’s at the end of life” even though said patient is extremely impacted with a dilated rectum of 10cm, making me want to walk out or drop everything and scream…

I was perfectly ready for a break.

I had a week of annual leave that I decided to spend in Sydney!

Picture perfect, no? 

There stands proudly the Sydney harbour bridge (which is massive and makes the one in Auckland look like a joke) and the Sydney opera house.

Sydney is so bright and warm! I came to Sydney briefly 3 years ago but it was at a time where my brain was definitely not up to processing anything.

So I have returned to Sydney to properly explore. Hitting the tourist spots like the opera house

And Bondi beach

Really touristy stuff! And I’m absolutely ecstatic at being able to get my camera out for these places! Major photography spree.

So far Sydney seems pretty cool. But oh my goodness is it big.

It takes a minimum of an hour to get anywhere in this city with public transport. The public transport system is pretty good! But it still takes a very long time to get from A to B. And living in Auckland, where everything is practically 10 minutes away, this city is very bizarre for me.

Still. The scene is pretty great. 

More pics to come! 

My Life Is Average 

So today I was mulling around thinking about the current state of my life. Basically kind of bored.

I just finished a 10 day working stretch including weekend and then slept for 11 hours straight.

I woke up and it was hard to get into a mode where I don’t think about work.

You know people bang on and on about “work-life balance” like it’s some magical equation that’ll make your life perfect. I bet all of them would agree that I don’t have such a “balance”

Mostly because people think that this “balance” is either being able to have babies and being a working mom (if you’re a woman), or being involved in some kind of group activity like sports or tree planting club or something.

I basically stay home and browse the internet and talk to my friends. I’m not part of any club and I’m not particularly athletically inclined. I’m sure most of these balance people will say that’s not good enough.

I kind of disagree. I think work-life balance is more about being able to give your best at work and outside of it. And let me tell you, I am giving 100% to being lazy right now.

But also it’s that point in my life where there are no big goals and nothing much to work towards.

Like I spent a lot of effort and time working towards becoming a doctor and it’s like, well now what?

So that’s what work-life balance is kind of a question mark for me. Now what do I do with my life?

A friend of mine said it may seem a bit messy but if you sum it up, it doesn’t sound that bad. He proceeded to say “I’ve got a good job I’m about to be promoted in, I’m engaged and planning a trip to Japan this year”

I had to laugh.

Mostly because that actually sounded great and my summary wouldn’t sound as good.

“I’m a doctor, working in Middlemore hospital… and uhh….”

Yeah I don’t know. It required much more thought after that initial sentence. Like yes I’m a doctor, and that’s pretty good I suppose. I’ve just started, I’ve got my whole career ahead of me, working towards becoming a gastro consultant etc.

What else do I do? I’ve got my blog. I’ve got my writing. I like taking photos, I like playing the guitar.

But I’m not exactly fantastic at any of these things. I’m basically average.

I’d like to be someone who does a lot of things. But I don’t know what.

Oh well. Today I at least made a point to play guitar, write, and take photos.

Macro shot of my bamboo plant/tree thing!

I’m going to get back into taking photos I think. Macro today. But hopefully will get back into going places and taking landscape photos. After all, the season is perfect for some soft, pastel photography.

That’s Gen Med 

First week of gen med done! And it was very refreshing.

Good news is that my team still exists as we have a consultant covering the missing one. And my registrar is quite nice, and I’m the only house officer on my team. So yay that worked out.

And it’s wonderfully busy! I barely have any time to think or worry about anything else! Going on a ward round takes up half the day, then doing jobs takes up the other half! With a couple of late finishes too! 

Needless to say, I’m enjoying myself so far.

But this was a short week. I only worked Monday, Thursday and Friday. Because incase you didn’t know, (and you’re not likely to because this isn’t big news like Lady Gaga and Bradley Cooper possibly being in love or Taylor Swift hinting at new music) the junior doctors of New Zealand are on strike! 

We are on strike for safer hours. Basically we work 12 day stretches (including weekends) without breaks and are demanding that we should not work any more than 10 days continuously at a time. Which I am totally behind. A lot of the other house officers are strong advocates and unionists so I hear a lot of noise from them.

I’m not a big unionist. I do support the cause, but I feel like sometimes people take it overboard in a “Us vs them” concept. And people complain about a lot of things that I don’t think ought to be complained about. There’s a lot of “they don’t care about us!!” Talk from a lot of the other house officers but I think I can atleast be grateful that I have a job. 

But anyway. I am part of the union and so I have been going on strike!

In the midst of that however, yay gen med is good so far. It’s been an interesting week. I got shot down by the radiologist when trying to discuss my first case (he basically said your patient is 90. She’s done with life, what’s this investigation going to change), ordered a blood test for the wrong patient (I’m sure I’ll be screwing up a lot of these little things) did atleast 10 discharge summaries in 2 days, and worked late. Not too bad for the first week

Hopefully things stay manageable.

First Quarter Done 

And with that, psychiatry is over!!!!

Will I lament it’s loss? Naaaah

Well I will miss the people. The other house officers and my team, and having my own desk.

But I will NOT miss the department, the nurses, the fact that I have to look after geriatric patients I know nothing about, after hours. Just a big NO. 

Did I learn a lot? I’m not entirely sure to be very honest. I can’t say what skills I’ve gained in psychiatry other than developing an absolute “I don’t give a sh*t” attitude to certain things that aren’t even “problems” but someone else decides to make it a problem and they decide to make it YOUR problem. Which I will no longer stand for.

Having not much to do is really not my thing, I realised. Well I sort of knew that already, but now I’m certain. I need to stay busy. It just makes the day go so much faster.

I’m off to general medicine next! I am very excited. It should be very busy in comparison. 

But as usual, when I least expect it, my bad luck streak reared its ugly head. 

I was supposed to be on a team with another House officer. It was supposed to be a very busy team. On Friday, the last day of psych and the Friday before I start on gen med, I find out that the other house officer has been moved to another team and I heard that my team is going to be dissolved due to a lack of consultants.

Oh, and no one told me this.

I found out because the other house officer approached his new team and asked for a handover, meanwhile I was thinking we were still on the same team. Admin had called him about this, and not me.

Why?

Because that’s admin.

I freaked out and went to them and asked what would happen to me. They said the team is not going to be dissolved “yet”, and I am still on that team. But it is true that there are no available consultants for that team currently and this is likely to create several “changes” to the team structure. None of which I have been informed of yet. 

The lady I spoke to said “don’t stress. The other house officer has been moved but you’re still with this team. If there are any changes, we will let you know”. 

“Don’t stress” she says, even though had to approach her myself and ask about this or else would have shown up on Monday and been utterly lost as to why the other house officer on my team is no longer on my team and why my team has no consultants.

Thanks a lot, lady.

So I kind of don’t know what’s happening on Monday. The house officer currently on this team I will be going to said he would give me a good handover and there are patients on the team currently and there is a registrar. This is good.

But he also said he heard the team might be dissolved. This means I could be moved to another team sometime during this rotation.

Blech. 

I really must find out why I’m suddenly having these bizarre things happening to me.

On the bright side, ironically, every one I told this story to, basically said “well hey think of it as a blessing. You won’t need to deal with the other house officer anymore!” 

This is true I suppose. I will either have a team of my own which will be great.

But it could also be not great in that the team is slowly dissolved and I have to be moved to a different team. 

Which may not be terrible depending on the team. But with the way things are going for me currently, I would not be surprised if things go terribly.

What do I do? 

Gotta just keep swimming I suppose. 

We’ll see what happens Monday. 

Summertime Feels 

Summertime is really the best time to go out and reflect in places. 

Chances of coming by a view that is absolutely stunning, while on a walk, are much higher in summer than in winter. 

Unless you live somewhere where it snows and you like going on mid winter walks in a winter wonderland of course!

But anyway. Today I was due some reflection and mindfulness, as I’m 2 weeks off from finishing my first rotation as a house officer. 

I haven’t talked much about what my job actually entails. I deal with all the medicine for psychiatry patients. Often, most of them are perfectly healthy. But occasionally I get someone who is very comorbid so I have to order tests, make sure they happen, talk to a bunch of different departments, trying to piece together their management. And because of where the psych unit is placed at my hospital, people are very reluctant to come over there and do things for patients. And getting potentially aggressive and high AWOL risk patients to different parts of the hospital is also challenging. So getting things done is hard.

On my long days I also cover geriatric wards. Where every patient is liable to crash, the nurses are super nervous and the house officers during the day dump whatever they are unable to do while they’re there, on the psych house officers. 

But I’ve made it this far. And I’m going on to general medicine next. Which is going to be a massive change in pace which I would welcome, but also will be a huge challenge as I feel I haven’t done much medicine in these three months to prepare me for what general medicine will bring.

Lots of emotional highs and lows this rotation. Being told by someone that I lack motivation, that I lack common sense, that nobody would take me seriously, that I’m not trying hard enough to be involved, coupled together with my own insecurities, fears, the feeling of being frustrated that I can’t do more with my life, and the sickening realisation everyday that I know that I will never get what I want….

It brings me down.

But I’ve been chugging along. 

All of the stuff above is just noise I hear in my head everyday. 

But when I’m on a walk and see the omnipresent sea, the gentle lull of waves going back and forth on the shore, sounds of people and birds and boats going about doing their thing, the sun setting and creating the most beautiful set of colours as a backdrop to the city line and the ocean, my eyes and the rest of my senses are pleased. A wonderful stillness and peace comes upon me and drowns the noise out. Just for a little while. Making me feel that I’m part of something much bigger in the universe.

Of course those moments pass and reality and the noise comes back, but I’ll try holding onto that feeling of peace just like in the photo. 

My Oath

My first week of orientation to hospital ended. It was a long week let me tell you. Full of as many ups and downs as I can remember every year being. And more joyous times with people. 

I found that I can be extremely introverted when I’m not comfortable with the people I am around. But because now I’m an adult, I need to suck it up and do my job. Why must I be the only person who can’t be fake nice to their co-workers? It’s an important skill. 

Anyway it got me thinking. At my graduation, I took the medical oath. It was a lot of generic stuff about caring for patients and making sure I make good decisions, etc. 

But I need to take an oath of my own. Something relevant to me. Something I must strive to follow no matter what happens this first year of my being a doctor. And so I will write it on here so I may revisit it to make sure I’m keeping to my oath.

I promise to work hard and give my best without expecting rewards

I promise to hold myself high and trust that I am capable of doing what needs to be done.

I will not let anyone intimidate me into doubting my abilities or knowledge.

I promise to be self aware of my strengths and weaknesses and work on them accordingly. 

I will always take full responsibility for my actions and decisions. I will never blame anyone else for my choices.

I promise to realise when I need help and make sure I seek the right help.

I promise to remember that nothing and no one is worth stressing about, to the point where my mental health and happiness is affected.

I promise to remember that I am here because medicine is my passion and I am good enough to be here.

I will also remember that I have other interests and talents outside of medicine that I must strive to maintain those interests.

I promise to always think of the bigger picture. Not just parts of it. It includes everyone and all their perspectives. 

I promise to uphold my dignity and the dignity of patients and people I deal with.

I will ensure I remain happy. 

And I will strive to ensure my reputation is one I create. 



Here’s to being a functioning doctor and adult in my first year and beyond.

An Irritating First Day

Well it was my first day as a house officer. Orientation day 1. This whole week is orientation. Should be good. Should be exciting.

Today was a total bust.

And I need to vent on here.

So how did my morning start?

Early.

7:30am start was written on the timetable. I’ve been on break for the past 2 weeks so I was already having trouble waking up early. I planned to leave 45 minutes early to get to Middlemore hospital which is a 20 minute drive from my house. I had given myself twice the amount of time I would need. 

And it was useless. I’m not sure what it was as I have travelled on this motorway for a whole year the last time I was at Middlemore. But in 2 years, the development of traffic has been shocking. It took me and my friend who takes the same route, 1 hour to get there. Meaning, I left at 6:45am and got to the hospital at 7:45am. MEANING, I was late. On my first day of a new house officer year. 

Miracle of miracles atleast I didn’t miss much. Actually, I showed up and the introductory talk lasted all of 7 minutes before we were given a 1hr break. 

So what did I rush for? Nothing really. 

The 1hr break was for everyone to go get their access cards and parking cards sorted. I had done this a week ago because a lack of a parking card meant that I had to park in public parking for 10$ until I got the card. So I came in early to avoid that. While I was there, they also gave me my access card. So yay I was organised beforehand. 

But when everyone else got their access cards today, they were also given their meal cards. House officers get free food at the hospital with their meal card. Mine was missing. Why? Because I got my access card early and nobody told the department that issues meal cards this. Or some admin screw up to that effect.

The lady running the session said to me, when I approached her asking for my meal card: ” Oh so you thought you’d be so organised beforehand, but see now they didn’t give you your meal card. Which is the best part really” 

………

Why the heck would anyone think that’s funny? I don’t know you like that. Why would you rub it in?? 

So I was given vouchers for the week instead and told that “hopefully” I would get the card by the end of the week.

The rest of the day was quite slow. So many breaks interspersed with irrelevant talks and a walk around a hospital I was already familiar with.

It was nice to see my friends again, but there were also 54 other house officers in the room that I had to socialise with as they’re the people I’ll be spending a year with. And truth be told, that notion made me quite tired. I need to try be a more sociable person. I feel like I’ve lost that about me. I’m basically only comfortable around very very few people. And that’s not a useful way to be. 

Sigh.

Oh well. I guess in a way it’s a good thing that all these annoying things happened on the first day. Like a good omen for the rest of this year maybe. We’ll see. 

4 days left. I’ll need luck. 

Finally Graduated

Here hangs proudly my graduation regalia.

Looks a bit like a dementor does it not? 

Well it looked okay on me. Apparently in New Zealand, the colour of the Medicine degree is Hot pink!…. I’ll never understand fashion.

Anyway! My graduation ceremony was yesterday! After 6 years I sat in a 2 hour ceremony where my name was called and I was awarded my degree to say I am now a Doctor. 

It was a super long day. But it was great. Friends and family showed up. My friend from Wellington even flew up just for my ceremony! It was a great day. 

Lots of people to be grateful for. It’s been a long ride. But I got there in the end. And from Monday onwards, it’s on to work! Officially a house officer. 

I can’t wait! Hopefully I will be a good doctor. 

We all had to take an oath yesterday. One of the lines were “I promise to uphold the reputation of my profession”. Now other than the immediate Taylor Swift reference in my head, I realised I don’t really know what that promise means. What is the reputation of my profession? Have I been holding it up so far? I don’t actually know. Hopefully it becomes apparent when I start working. On to Monday!

My friend got me this cute graduation Kiwi doll! Yay for finally being done!