Nights On A&E


They actually weren’t that bad. I got through it. I’m out from the other side with all limbs intact. But it wasn’t easy. It wasn’t ideal to have to do nights so early into the placement but I guess I would have had to get it over with at some point.

The first one was really busy. I came on to several patients already waiting plus many waiting in paeds, so I got pushed over to help that side for a while. Having done GP, I knew how to examine kids but when it came to looking at a foot xray, I was lost. Who knew kids have barely any bones in their feet? And the bones they do have are all so far apart from each other.

I finally made it onto majors. Most of my reviews were for patients who had fallen. There seems to be a high proportion of the population who just fall over or collapse in the middle of the night. After the third one, it started to feel like routine. ‘Did you hit your head?’ ‘Did you lose consciousness?’ ‘Was there anyone with you at the time?’

I started to feel a bit more comfortable. I was still nervous, but I just got on with it. There were two registrars on overnight as well, so I badgered them non-stop. All night.

On the last night, I was talking to one of the registrars about one of my patients. She was an elderly patient from a nursing home who’d been brought in by ambulance. After I finished he looked at me, ‘so what do you want to do?’

‘…er… I want to admit her, I don’t think she’s safe to go home.’

He agreed, then told me that this was quite simple, she needed to be admitted. I didn’t need to discuss every patient. Cue crying emoji.

I guess on some level he was right. I just felt better getting a senior opinion. It’s much easier to admit people than it is to send them home. But I’m still mindful that there isn’t an unlimited amount of beds that I can send everyone to. The talking to made me a bit more hesitant to discuss the next couple of patients like I needed to prove that I had a few brain cells. I successfully discharged my next patient after doing all the tests under the sun to make sure she didn’t have an acute abdomen.

I think now I’ve got a better idea of what I’m doing and a better sense of who can go home and who can’t. And I know I can still ask. I just need to be a bit more independent in my decision making.

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