The First Day

First day on A&E was intense, which I expected. Starting any placement was always going to be uncomfortable, and I’d been to the department enough times to know what I was getting myself into.

I was on an early shift, which meant I started work 4 hours before any proper induction to the department. Luckily, I had a mini introduction by one of the consultants, given a small tour and then started seeing patients straight away.

Switching placements so often is genuinely like leaving one job and starting another a few streets away. You need to quickly immerse yourself into the team and learn a whole new way of doing things, all the while trying not to step on anyone’s toes.

My first patient was a simple case of back pain (flank pain). I saw so much of this in the community I was happy to send him home. I’d taken a history and examined him thoroughly. To me, it was an open and shut case. Is there such a thing in A&E? The department seems to run on paranoia, the chance that something could be missed. I was told to start some investigations, which came back normal and then I was able to discharge him. Whilst I was waiting for this patient’s results to come back, I started seeing the next one. It got to a point where I was just juggling it all.

Another patient I saw had vomiting and diarrhoea for several months. I tried to take bloods and put a line in to give some intravenous fluids. And I failed to do either. 4 months of not laying an eye on a needle has made me soft. And my skills were not great to begin with in the first place. Plenty of time to practice though.

I managed to get to the end of my shift having consumed 200 ml of water. Luckily, I’m used to being in a state of sublevel dehydration so I wasn’t affected too badly. I know that it’s unhealthy and I’ll try to drink more water.

So overall an average start. It was never going to be a case of flying into A&E and clerking patients with my eyes shut. It’s going to take time before I become a bit more comfortable. It’s going to take a lot of asking too many questions, being embarrassed, learning form mistakes but most of all being kind to myself and not piling on unwarranted amounts of pressure. It would be too easy to become overwhelmed and overworked.

But we’ll try to avoid all that.

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