Why working with doctors can induce hypertension.

Whenever my Manager at work asks me to go to the ward to set up a patient with overnight ventilation treatment, I internally groan. This reluctance is the direct result of a combination of three things:

1. The patient is too ill to comprehend, hear or understand what I'm saying. In a role where communication is key, having difficulty channelling information seriously sets me back, normally on time (and sometimes on patience). I don't have anything against ill patients, most of them are lovely people, but when you've already been rushing around all morning and stressed all afternoon; facing challenging patients is the last thing you want.
2. The doctor is annoying. This has been the case usually. I have worked with only a small range of doctors, but in each one I found something to get annoyed at. If it wasn't egotism, or mismanagement, or even ignorance, then it was definitely the doctor's negligence towards the patient's mere presence, if not mine. I remember one actually talked about how I was going to do my job without even introducing me to the patient or the patient's translator. Actually there was one that I found tolerable, and that was because he didn't say much but actually asked questions as opposed to acting like he knew it all. 
3. The patient has run away smoking and no one in the entire hospital can track him down, even after several hours of absence. 

My ward work this week had to spread over 3 days. The first day I was told by my Manager that a patient at a different hospital needed an emergency sleep study done. Normally we don't do such things as the studys need to be booked in advance as the sleep centre only have a limited number of ambulatory recording devices used to study the patient while asleep. However the patient was moved to our hospital and I was sent to wire him up. A consultant had demanded it be done, so it was done, and done it was. So I went, and did it, but I felt sorry for the patient because he had to be wired up 6 hours before he actually went to sleep. The patient, thankfully, did not complain.

The next morning I removed the wires and immediately analysed the data. What I saw was one of the most severest forms of obstrucive sleep apnoea I had ever found, it was right up there in the top 3 most severe OSA cases I had ever analysed (Oxygen saturation level would drop into the 50% range occasionally). Poor man, I couldn't even imagine how he lived! I talked it over with the consultant a few hours later during which he spoke to the registrar on the ward, five minutes later a request form was placed into my hands to set the patient up on treatment. I told the doctor in the same instant that I would be at the ward before four pm. This was at 14.30.

I get to the ward in a rush because I had so little time and so much to do, but I reached the ward at 3.35. I went to the patient' bed to find... a bed. No patient either ontop, beside or under it. I searched the room thoroughly.

I ask the doctor 'Where is the patient?'
She replies, very nonchalantly 'Oh he's at the eye clinic' and proceeds to call the eye clinic immediately. 'How long can you stay?'
'5 minutes.' I say, not being annoyed yet as I'm thinking of getting home in time for my driving lesson (which got cancelled due to drained petrol stations).
'The patient's on his way up.' said the doctor when she finished talking to whoever was on the line.

So I wait for the patient, 5 minutes later and I remember that I told the very same doctor that I would be down before four... so why did she send him away???? 10 minutes into the waiting game and I tell another doctor (the registrar) that I am  leaving and that I had warned the doctor previously of when I would be arriving. I don't normally like the registrar (he explained a patient was dying to me right in hearing range of the same patient) but he was sympathetic and asked if there was anything he could do.. maybe he could set up the patient on a ward CPAP? I declined politely as I honestly did appreciate his sentiment; saying the patient wasn't going to die without one night of treatment.

Guess what the registrar did?

The next day I called the ward in the morning, saying to God knows whoever I was talking to, that I wouldn't be able to come in the morning as I working two people's shifts (understaffed should sooo be the NHS middle name), I would be there in the afternoon.

I manage to get there in the afternoon. I knock on the patient's room door, to get no reply, I knock a little louder calling out a subtle 'Hello?'. Getting nothing, I walk in warily to find the patient snoring, fast asleep; a clear sign of symptomatic OSA. When I woke him up, the first this I hear is a complaint about the ward CPAP, how it was uncomfortable and how it was at such a high pressure he felt like he was choking. I restrain myself from shaking my head. There is no point saying 'No' to a doctor.

I set the patient up on long term CPAP and I quickly understand the patient has not been given any details about his sleep study results. So I give him a brief overview; warning him that he might not want to hear the figures. But bless, he was as excited as a golden retriever and even fetched a pen and paper; enabling him to write down what I said. I spent nearly an hour with him, he told me of what appeared to be the doctors emotionally blackmailing him into using CPAP and about how he was at risk of stroke... bla bla bla.

You must understand that the main complaint of this patient was severe headaches... Considering that a sign of OSA is headaches, even when the O2 saturation level only drops by 7%, that a pretty bad headache might appear when the sats drop by 20% for most of the night and 40% for the rest. But no, further investigations were carried out during the course of the day and the patient had to have three (possibly unneccessary) lumbar punctures to analyse CSF. Oh how I felt for this poor man.

He was to be moved back to the former hospital by the neurologist's command for extra tests. Maybe I'm being too blase, maybe this man has an intracranial tumour, I don't know and neither do the doctors. But shouldn't a painless investigation be considered and done before more invasive ones like lumbar punctures If the evidence suggest so? I don't mean to sound arrogant, but I'm pretty certain his severe OSA is what is causing his headaches, so shouldn't the patient be left to try out the treatment in peace????

Arrrgh... the pain... the wasted money... the politics of it all. So silly.

A series of Unfortunate events

After being rejected from yet another career open day this afternoon I thought I was in the mood to write about some unfortunate events that has happened to me lately.

1. It was a good morning, I woke up early and left the house with plenty of time to spare, I get to Wood Lane station and walk to the bus stop, despite the rain, I was okay. Then some idiot car driver drove quickly over this ultimately huge puddle and a wave of dirty rain water cascaded over this poor young woman, she just carried on walking looking drenched and thoroughly miffed. I on the other hand was proud of myself for getting to the bus stop 25 minutes earlier than usual, the annoying thing was that I had to wait 25 minutes for the bus to talk me to the hospital, for a rout that would only require 10 minutes to walk. Anyway, I get to the hospital and remember that I forgot which room I would be in, so I open my diary in a hurry as I'm already 5 minutes late, and in my diary, in red writing, it says: Charing's Cross Hospital. Oh dear.... so I call my friend. and yes she gives me directions for the computer room at the Charings Cross library, so I turn on my heel and go. I got there and hour late.

2. I bought my travel card on Monday morning, well I thought I did, and somehow got onto the bus, the driver let me pass through (nice chap). Then half way to my local station I remember that I did not finalise buying my travel card by touching my oyster card on the receiver again. So I thought i had lost about 44 pounds, this is entirely against my nature and in a frenzy I enquired about the money at the ticket office at my local station, and alhamdulillah, she confirmed I didn't lose anything.

3. I've had some of the most boring monotonous lecturers for the most harrowing diseases known to man, all of which are 3 hours long, it's been such a long time since I've had 6 hours of lectures in a day.

URGH applications!

The only time you will ever feel like you can't speak English is when you're trying to write down answers in an application form. I don't know how, but the power of this patronising form has the ability to make you sit down for hours trying to write down what you need to say in the shortest most succinct way.

that's all I'll say for now.

Want to hear a secret?

I have recently been spending some of my time today to look for jobs, something I've tried to postpone for as long as possible, because I know I'll get depressed by my lack of experience, brains and confidence. But I finaly got myself to those search options when I came across a manga where the main character watched anime 2 days straight because she was heart broken. Then I thought to myslef... omg I'm acting like some pitiful heartbroken girl and I'm still single, moreover; I've been treating job rejections as though they were some form of lost romantic love?!!!?

Once I had made this horrid self realisation about the way I've been spending my days, I thought I should face the music and look for some form of employment. But omg it's so hard to make myself look and face the music!!! I can't find anything I like even if I could find something I could do! I simply lack the motivation and drive to look for jobs.

Then I made another self-realisation, or rather re-discovery as I think I've always known this thing about me but didn't really want to own up to it; I always focus my total concentratiuon when ever I draw or write. It's the only thing that manga can't get in the way of. I could draw for days and weeks and years. And I'd love doing it. I'd get stressed out if there was a paticular deadline, but I would still love it. So I know a huge part of myself wants to just draw and write, and I would feel so honoured for it if I got paid while doing it. Because it's something I love.

But lets look at the practical aspects here. A girl with a science degree, from a science family, with an incredibly overly-logical father simply won't be able to even express her desire of drawing/writing professionally let alone actually draw/write proffessionally.

So here comes the typical filmic dilemma: get a job that you'll be bored an stuck with for the rest of your life to make money and carry on living the same boring life. Or 'live the dream' and draw forever and ever!? Make a name for yourself in history and make sure you can somehow change the world with your writing!?

This is simply a case of practically vs passion.

Passion never wins. But why don't I take a gamble?

Because I don't gamble, or take risks, I've always played it safe, always stuck by the rules, never been spontaneous.

But I don't like being tied down to an organisation either and being another face amoungst the crowd. I seriously want to make an impact to society, I want to be the person talking to the crowd. I don't like being restrained to a set schedual everyday. I want to plan my own days and make my own rules.

So what do I do? Play it safe, or face a hell of a lot of drama to do what I want to do?