My night

Some may know I am working at one of the NHS hospitals in Yorkshire. From this August, we need to work only 48 hours a week. Previously, it was over 50 hours a week. This post is about my last night experience.

My working time last night was from 20:30 hours to next morning 09:00.


18:30 hours I got up with headache after previous night on-call. Ibuprofen helped.
19:00 hours I did check my emails, Twitter and Gtalk if my sister and mayvelous online or not.
19:55 hours I left for my work place. I popped into a nearby shop to buy sandwich.

20:25 hours I arrived.

20:30 hours Hand-over meeting

21:00 hours I saw a 60 year old lady collapsed while trying to be seated at wedding ceremony. She had breast cancer spreading to liver. Her life span remained less than 1 year (perhaps less than 6 months). This would be her final celebration before her own funeral.

21:33 hours The bride of above weeding came in to see her friend. She was still on wedding gown cleaning hospital MRSA floor while walking at acute medicine department.

22:12 hours Two more patients came in. Both had breathlessness. One of them is my old patient. He is the regular visitor of our ward.

23:03 hours A girl with multiple over dose of medications. I leant that she did so after recently separated with her partner.

23:22 hours A beautiful girl came in. She was the partner of above patient.

00:12 hours Another overdose lady came in. (What’s wrong with England, many want to take their life).

00:30 hours I saw her. She has got multiple self inflicted cutting scar on the arms. Strong alcohol smell +. Nursing staff told me she is hepatitis C positive, very well know to them.

01:00 hour Take-away Pizza arrived. I ordered previously. Hospital provides foods only for the patients. One patient claimed that doctors had been having/stealing tea or coffee supposed to be their quota supplied by tax payer's money. In fact I am also a tax payer as they took nearly £1500 (nearly $3000) a month as a tax. Doctor and patient relationship has been in such a bad condition in some parts of UK.

01:11 hour The nurse bleeped me someone had constipated for 9 days, asking me to do something. She is just a bitch. Doing a bad practice?. Constipated for 9 days. Now they had a big bloody concern about constipation at mid night while I was seeing emergency patients. That is UK NHS.

02:20 hours I felt tired. So I had a cup of tea.

03:00 hours I saw 2 more new patients. One was the elderly came in with kidney failure after his long term catheter was no long working. Another was chest pain after taking alcohol and cocaine.

05:20 hours Someone vomiting all the time. She had lung cancer recently diagnosed. I found out that a big problem with her tummy ?inflammation going on. So I did refer to surgeons.

05:30 hours One of the nurses came back from break time. A strong tobacco smell from her. I asked about where was the smoking place in that NHS smoke free hospital. She told me where she did.

06:00 hours I saw a new patient with breathlessness. He had enlarged multiple lymph glands on the neck suggestive of a serious condition. But his useless GP treated as simple infection.

06:45 hours A new patient asking me to get a urine bottle as an urgent. I did not know where it was kept. Nurses busy with other patients.

07:20 hours. Above patient’s blood result did not come back. I did check with laboratory. They never received it for some reason.

07:30 hours I did repeat blood for above patient. I just leant that it was on his birthday, but he had been on hospital early morning. I just sympathised. I did birthday wish. He said thank you.

08:00 A lady in her 60s told me she was not able to cope with her husband after she looked after him over night with her own will. Normally we don't need any attendants or helps at hospital. she did so herself. In the morning, she had been too tired and got confused. She had been asking to delete her name from next of kin saying that she would not come back to see her husband any more.


08:10 I was bleeped to see an ill patient. I was alone in the room when I examined him. He was over 80. Already dead. But he was still warm. He was my last patient. But a dead body. No family members around.

08:30 I did check some blood results if they were OK

09:00 I had been free man again. No need to see sick people for sometime as I had 3 days off.

An injection appeal in Britain

During the last week, our team had to see outlier patients. Basically I review patients first and I discussed with my consultant if needed. You may don’t know what outlier patient is. For example, if a patient with nerve or brain problem is placed in chest ward for some reason, he or she is the outlier patient of neurology and the neurologist has to go and see that patient as his outlier.

In this hospital, outlier patients are a little bit different. Those who are not medically serious and ready to go home, but still need to be sorted out their social and other issues, are put under the care of outlier team.

Well, on Last Wednesday, 36 year-old-chap who is a known multiple sclerosis came in with some minor recurrent attack. Plan was to give 5 day course of intravenous injection. He is apparently well and no reason to stay in hospital for once a day injection. So I have to organize to get intravenous injection as an out-patient.
I never thought that it was a difficult job. But in the real situation……

In fact, his wife is a sister working in our hospital. But British rules and regulations do not allow doctors and nurses to give medical care to the close relatives and next of kin.

I phoned to his GP who declined to do so. They did only intra-muscular injection in surgery, not intravenous injection.

So I tried the district nurse who normally does home visit for dressing and medication and so on. The same answer was given.

And then I contacted to the Intermediate Care Team whose function is to look after recently hospital discharged patient if needed. They said they don’t have enough capacity to do so.

There is a day treatment centre in our hospital. They said they open only 3 days a week. So not possible for 5 consecutive day injection.

A&E department is out of question. They only deal with emergency patients.

I tried MAU, Medical Assessment Unit. They declined again as they have got a great deal of workload with acute patients all the time. ( I know that fact very well)

Finally CDU in-charge sister agreed to give intravenous injection to my pity patient in her department. CDU is Clinical Decision Unit who takes GP referral. At that department, hospital doctors see patients referred by GP and deicide to admit them or not.

On that evening time, patient went home after waiting for an intravenous injection agreement for nearly the whole day.