Thursday, 3 May 2007

End of an era

I'm writing this on the eve of my last day on the wards as a medical student! Man, it's been a long time coming. I don't think bricking it is the term really any more, I've reached a whole new level of stress, which is manifesting itself on the ward in a variety of embarassing ways...

Firstly, I have developed a fear of the blood book. Each day on the ward round, one of the juniors has the folder with all the blood results in it and, if asked, tells The Boss what the bloods are doing. Now, the old Joey would actually quite like holding the blood book because it gave her something to do, but the scared new one is terrified that when asked she will either say the wrong value, not be paying attention, or, most likely, forget the normal parameters for the results (which are not written on the sheet) and read out something plum normal when asked for the abnormal values. Much potential for mistakes, especially with Terrifying Registrar around.

[I had to bleep her the other day, I was shaking, but she was nice, so that was good, and I live to see another day!]

Secondly, I have started to miss bloods. Especially when I go to see a patient, blood tray in hand, thinking I will be fine (as I always used to be), and the patient says, 'oh, well, you can try, but Dr X tried 10 times yesterday and couldn't get a drop', at which point I almost immediately adopt a defeatist attitude and think, 'oh well, I'll never get this' and give up after the third attempt rather than carrying on till I get something. I bet if there are more senior people reading this, they will think I am a moron, but please remember the days when to you this was a big deal too, I'm not a total fool, I just want to get it right!

Then there's the slightly panicky going back to patients after I have taken the bloods (especially ABGs, man, especially those) and checking the puncture site to make sure that they are not bleeding all over the place or I have not knackered their arteries so their hands go blue and then black and then fall off and I get sued.

Now you are thinking, 'call the shrinks, this girl's a nutter!' but it gets better!

What if, when I start work, I prescribe paracetamol for someone's pain, and they have actually already had some and they get liver failure and it's my fault? Or what if, when I start work, I prescribe ibuprofen and someone gets a peptic ulcer and bleeds out and dies and it's my fault? Or what if I miss their crazy arrhythmia on the ECG and they die and it's my fault?!?!?!

See a pattern here?!

I'm getting a bit sleep deprived because I stay awake thinking about all the things that can go wrong, so my bedtime reading has, for the last week, consisted of frantic cramming of medical knowledge in a vain, petrified attempt to avoid such disasters.

I said once in this post that fear was a good thing, but at this magnitude, and so early? Am I going to be like this in worsening degrees until the dreaded 1st August?! I really hope not because I need more sleep than this!

Right, I have to go write up a case for my assessment tomorrow, but to end this on a totally un-medical more positive note, I have recently started to do some boxing again - I used to go to Muay Thai kickboxing training on a wednesday night for a few years, and I absolutely loved it, but then I had a few shoulder injuries (that looked like this) and had to call it a day for a bit, but I have started again very gingerly and am getting huge endorphin rushes from it, it feels amazing!

But now to the case, no more procrastination...

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