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17 Sep 2019

I’m balancing the work phone in one hand and swapping between toast and coffee in the other. 

It starts, the first call of many! A patient with a large right inguinal hernia. An incidental finding, not painful nor obstructed, I make plans for an outpatient referral. Just after, the phone rings again. There is a trauma patient inbound.

Twenty minutes later, the helicopter lands. By now I have received three more calls in quick succession. One patient with possible appendicitis, one man in clot retention and another with left lower quadrant pain. I juggle the phone and plan my attack as I’m on my way down to the ED. 

The next hour is spent in resus bay. It becomes clear that the trauma patient has significant injuries and needs to go to the ICU. There doesn’t appear to be an intra-abdominal injury necessitating a laparotomy, but it takes some time to determine this, first a secondary trauma survey, then intubation and a chest drain and pan scan.

A call comes in from the ED, the team have been unsuccessful in passing a 3-way catheter to relieve the patients clot retention and are requesting my help, so I head over to catheterise. I get two more phone calls in the process. One from a nearby clinic about a paediatric burn, and another patient in the ED for me to see.

I review some imaging of one of the earlier referrals, the patient suffering left lower quadrant pain. I notice he has Meckel’s diverticulitis and move him up the list to see. It’s the afternoon and the phone is running hot. It’s time to fall back on my strategy for keeping up. I quickly take stock of who is waiting and triage who to see next. Working my way down the list leads me from task to task until 8pm.

The on-call phone of any hospital service is treated with a degree of weighty responsibility and respect. It usually comes in the form of a battered old, over-sized phone with a near flat battery and a broken pocket clip. Days holding the on-call phone can be busy and unpredictable, but always interesting.

I handover to the night registrar and I think I’ve managed to keep on top of the day - it’s been stressful but it’s time to head home to decompress.

I eat dinner and reflect on everything. Despite the day I think back to the gentleman with retention. He recognised me from an evening a few weeks prior where I admitted him in similar circumstances. He recognised me by name as soon as I walked into the cubicle emphatically saying “Dr Kate! I’m so glad you are here.”. It made me smile.

 

Dr Kate Engelke

Principal House Officer in General Surgery
The Townsville Hospital
Company Secretary and Board Director
Queensland Doctors’ Health Programme Pty Ltd

The Queensland Doctors’ Health Programme is an organisation established to assist Doctors and medical students who may be in difficulty. The health of doctors can be affected by a variety of things; stress, burnout, the complexities of professional practice, or even natural disasters. Our work aims to help and support doctors through their careers to maximise their health and wellbeing. If you are a doctor or medical student in need of assistance you can contact your health advisory service in your state or territory.  https://www.drs4drs.com.au/

Read other articles in this edition


Published: 17 Sep 2019