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1st night
5:24 pm
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Sweating palms, check; palpitations, check; dry mouth, check

I did my best to prepare for my first night. Slept right through the afternoon (thank you blackout curtains!), ate as much as I could and packed as much food as I could.
Even read a bit about common emergencies just in case I get called to a crash.

The moment I stepped into the room where handover happened, I never really stopped working.
Jobs was already accumulating when I took over. It was the run-of-the-mill jobs: prescribing fluids, putting in venflons, taking blood, writing discharge letters. My first patient to review was this old lady who was palliative.

"Doctor, her urine output has dropped"

A quick look at the obs chart showed that she always had low urine output. But it was complicated by the fact that she had kidney injury and palliative care was still not discussed with the family. Thank god the registrar was still there so she gave me solid advice to just leave the lady alone. Right after that...

"Doctor, this patient has low BP"

Shit! Another quick look at the chart showed that her BP is hovering just at the cut-off point. Everything else was normal. I looked at the notes but nothing really was clicking. I went to her cubicle and she asked me to draw the curtains around. Then she started sobbing about how the nurses were not paying attention to her and how she was in pain (she had an epidural in!). I had no clue what to do. Basic common sense escaped me. The nurse rescued me by suggesting I call the anaesthetist to check the epidural. Duh!

It's amazing how 5 years of medical school is non existent in my mind. Application skill= 0
The 12 hours went so quick. By the time I was done, I was back in my bed ready to sleep.

And I realise how much uncertainties there are. I came back home just wondering if I actually did the right thing. Was the lady with tachycardia really just dehydrated? Was the lady with the epidural in being a drama queen (apparently her block was still fine) or was she really in pain? Was it right not to push for the transfusion for the lady who dropped her haemoglobin? Is the lady with hypocalcemia alright? Was that really the endocrinologist's instructions?

I really should check up on these patients.

I just followed the nurses' instructions mostly since I'm still not comfortable making clinical decisions for patients.

2nd night and I wasn't bleeped at all to see any sick patients. Maybe the nurses realise I'm such a useless person they might as well just do what they think is necessary or call the registrar directly.

hopefully things will be better