Weird experiences in the world of medicine and doctors

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Re: Weird experiences in the world of medicine and doctors

Postby Innuendoes » Tue May 27, 2014 10:41 am

Elessar wrote:Turns out there's been a huge amount of discussion, and the verdict seems to be that whatever you say, someone will find a way to criticise you:

http://m.bjsw.oxfordjournals.org/content/39/6/1101.full

*cough*
 
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Tue May 27, 2014 7:43 pm

Forget 4 hours of sleep, somewhere in the UK there's a hospital where if you're a surgical patient, the only doctor you're going to see for the next 12 hours is dosed up on paracetamol and has Vicks VapoRub rubbed into his scrubs top.
 
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Re: Weird experiences in the world of medicine and doctors

Postby JLP » Tue May 27, 2014 8:58 pm

Elessar wrote:Forget 4 hours of sleep, somewhere in the UK there's a hospital where if you're a surgical patient, the only doctor you're going to see for the next 12 hours is dosed up on paracetamol and has Vicks VapoRub rubbed into his scrubs top.


how many wards do you cover on a night Elessar?
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Tue May 27, 2014 9:59 pm

JLP wrote:
Elessar wrote:Forget 4 hours of sleep, somewhere in the UK there's a hospital where if you're a surgical patient, the only doctor you're going to see for the next 12 hours is dosed up on paracetamol and has Vicks VapoRub rubbed into his scrubs top.


how many wards do you cover on a night Elessar?


It's about 9 wards (although there are outliers all over the place at the moment) and SAU. No idea how bad it is because this is night 1/7. Clearly I've been able to have breaks though!
 
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 10:36 am

I've been chatting to the ill doc who I mentioned the other day and whose workload JLP asked about (I answered in the first person for some reason, not sure why; rest assured the following is in no way autobiographical)

"Well Tuesday/Wednesday night was a dream, absolutely awesome. Multiple breaks, and a steady and totally manageable workload.
Wednesday/Thursday was a fucking nightmare. IT system down for 8 hours overnight which was a fiasco. No catastrophes though, so we've dodged a Daily Mail bullet there. I had one very brief break in 12 hours. I need sleep. I don't want to risk upsetting someone tomorrow by not getting enough of it."
 
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Re: Weird experiences in the world of medicine and doctors

Postby JLP » Thu May 29, 2014 11:42 am

It is scary the work load you have on nights. Do you have any thing like senior nurses supporting you, doing some of the prescribing and routine stuff like blood work etc?

We use a system called i bleep. That means medics are not bleeped unless it is an emergency. All the work is co-ordinated by senior nurses and allocated. A medic can check his work load at any PC by logging in.
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 5:33 pm

JLP wrote:It is scary the work load you have on nights. Do you have any thing like senior nurses supporting you, doing some of the prescribing and routine stuff like blood work etc?

We use a system called i bleep. That means medics are not bleeped unless it is an emergency. All the work is co-ordinated by senior nurses and allocated. A medic can check his work load at any PC by logging in.


There's a clinical coordinator who in theory does bloods, cannulas and ABGs but that's all the support we have.
iBleep sounds amazing! Our nurses have guidelines for when to bleep, but many ignore it. We get plenty of "Please prescribe fluids", "Please review, he's MEWSing 0 but just doesn't look right", "She should be prescribed alendronate once a week, can you come and do it?", and a personal favourite which I heard about the other day (sadly I wasn't the recipient), "There's a bat on the ward".
Last edited by Elessar on Thu May 29, 2014 5:37 pm, edited 1 time in total.
 
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 5:35 pm

"A patient is threatening to self-discharge". Let him do it then. Nurses don't like that because unless a doctor has said they have capacity and understand the risks, they have to call security and the police if a patient absconds.
 
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 5:40 pm

Then you get there after 4 hours of doing far more important stuff and there are half a dozen entries in the nursing notes whinging that the HO hasn't arrived yet. Often they lie and say they bleeped several times and ignored (presumably because the patient has been nagging them). I used to ignore it but nowadays I document back - "One bleep received, unable to attend until now did to high workload, advice initially given over phone" etc. Don't get into a documentation war with me!
 
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Re: Weird experiences in the world of medicine and doctors

Postby JLP » Thu May 29, 2014 6:05 pm

Elessar wrote:
JLP wrote:It is scary the work load you have on nights. Do you have any thing like senior nurses supporting you, doing some of the prescribing and routine stuff like blood work etc?

We use a system called i bleep. That means medics are not bleeped unless it is an emergency. All the work is co-ordinated by senior nurses and allocated. A medic can check his work load at any PC by logging in.


There's a clinical coordinator who in theory does bloods, cannulas and ABGs but that's all the support we have.
iBleep sounds amazing! Our nurses have guidelines for when to bleep, but many ignore it. We get plenty of "Please prescribe fluids", "Please review, he's MEWSing 0 but just doesn't look right", "She should be prescribed alendronate once a week, can you come and do it?", and a personal favourite which I heard about the other day (sadly I wasn't the recipient), "There's a bat on the ward".


Obviously I know youare pretty junior but if you have friends in high places, you can do much worse than i bleep. Doctors still do get bleeped but we tend to then speak to the staff to make sure it does not happen again.
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 6:08 pm

JLP wrote:
Obviously I know youare pretty junior but if you have friends in high places, you can do much worse than i bleep. Doctors still do get bleeped but we tend to then speak to the staff to make sure it does not happen again.


Is it wifi based? The hospital trialled a system similar to what you described (apparently at great cost), and it didn't work because of areas of poor wifi signal in the hospital, which made it unsafe.

So now we're trialling iPads for ward rounds. Wifi based. Same wifi system. Absolutely no learning curve whatsoever.
 
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Re: Weird experiences in the world of medicine and doctors

Postby JLP » Thu May 29, 2014 6:24 pm

No what happens is a nurse on the ward puts on a job onto the system. This is on the hospital intranet. A Hospital at Night practitioner then allocates the job to a medic or to a nurse. Said medic or nurse can then log in via any hospital PC to view their jobs. Each job can be classed as red, amber or green depending on what it is so you can then manage your own workload.

So if you are writing notes, you can log in to see your workload. We have practitioners who can prescribe fluids and some meds and that takes a lot of work off the juniors.
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Re: Weird experiences in the world of medicine and doctors

Postby Elessar » Thu May 29, 2014 6:34 pm

You have paperless notes?
We're introducing that. Eventually it'll be great but the teething problems will be dire.
 
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Re: Weird experiences in the world of medicine and doctors

Postby JLP » Fri May 30, 2014 11:17 am

Elessar wrote:You have paperless notes?
We're introducing that. Eventually it'll be great but the teething problems will be dire.


we are on the verge of introducing them I think. I am off work at present so a bit out of the loop.
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