So, following a duller Endocrine placement I was looking forward to being thrown right back into the thick of it at a very busy tertiary emergency department at the heart of Manchester. The way we do A&E placements is very different to how other placements are held. For a start, there aren't any outpatient clinics, there aren't any ward rounds etc. Secondly, you are assigned shift patterns for the duration of your four weeks. My four weeks will run like this:
Monday - nothing
Tuesday - 1700-0000
Wednesday - 1200-2200
Thursday - 0800-1600
Not including the teaching that we have every day from 4pm - 5pm and the Friday's usual themed case discussions etc, and clinical debrief and all of that.
We also get the pleasure of wearing big pocketed-scrubs much to my other colleagues' envy. Placement clothes are not fun, a pain in the backside to pick out and for women - have like no pockets on a skirt. You then risk wearing your stethoscope around your neck and being called a moron, or you just wave it around and hope nobody steals it. Anyway.
While these are our shift patterns, there isn't really any accountability. There is nobody to make sure you are there, nobody you sign in with and you are free to come and go as you please. Great! 4 weeks off then right? Wrong. It can be if that's what you want it to be; i'm not going to lie, at least 2 of the 8 members of the group are certainly treating it that way. Without sounding like i'm getting on my high horse too much; I am aware of what great experience A+E provides, I know how envious a lot of my peers are that they don't have a placement here and quite frankly, there are things to do. So yea, forgive me for being keen, but I will stick around.
The way I normally roll is, I check in with one of the doctors, ask if there is anything interesting going on, or if there's anything he suggest I get on with. Normally, you can go ahead and clerk patients in, present them to the doctor and shadow the doctor that then see's and treats them. In majors, there might be some interesting patients to take a full history from, bloods that need doing, or a doctor to shadow. Then in resus, you get all the trauma calls in. Very '24 hours in A+E' esque. It's interesting, you both lose and regain your faith for human kind in a single admission.
There was that guy who went home to find 15 other guys waiting for him and kicked his head in. Then theres that young woman who was just walking down the road when suddenly someone on a bike "punched the back of her head and neck" - newsflash, that kid wasn't punching, he was slicing. But then you see some of the most incredible doctors working their asses off to do everything they can to make them better.
I'm only half way into this placement and i'm sure there is plenty more to see but one thing is for sure: it takes some sort of insane human to want to spend their whole career doing emergency medicine.
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