Dragged myself in for the board round at 0830, shattered after the late film night. Thought today might be a bit of a write off as was so tired, quite how wrong I was! Went on the surgical round, no patients on the CAU so straight onto ward 1. Here the combined assessment unit (CAU) is essentially a place where people come if they come into A&E too sick to go straight away, or are referred in by their GPs for either investigations or routine stuff like venesection and infusions. Ward 1 works as a rehab ward, and ends up being mainly a geriatric ward from what I've seen, with lots of patients there having multiple health problems and awaiting transfer to nursing homes or similar.
Caught up with the exotic wound from yesterday, it was looking much better after the debridement and the consultant was discussing the therapeutic use of maggots... Sounds gross but apparently is very effective in cleaning dead material from wounds, much more so than surgery. The larvae can be bought in tea bag like containers, that are then left in the wounds for a few days to remove the non-viable tissue, leaving a clean healthy healing wound... Fancy it anyone?!
Pippa and Eleanor were leaving today, they were the two Edinburgh students on placement. They'd baked lots of cakes! Sadly they were going back for an exam on Thursday. If either of you are reading this GOOD LUCK! Eleanor's coming back to Fort William for surgery, she'll have an awesome time as the teaching's really good and they get you involved, as I experienced again today...
The theatre list started with a lap chole, a procedure I'd now seen a few times but each one is different. Same threading of the cystic duct, removal of the gallbladder. Then my patience was rewarded by being given the opportunity to suture up the right sided incisions - subcuticular stitches again. After that a chill in the coffee room with soom food to refuel, before another hernia operation = awesome, started to get the hang of these things now! Got to suture up that one with a straight needle and subcuticular stitches - getting better at it now.
Time for lunch after that, so made my way up to the canteen where scotch broth was the soup of the day. Pretty stodgey but tasty. Hollie, on of the GP STs, then 'assigned' (/forced upon) me a patient who had just come into the CAU, so after eating I dutifully made my way onto the ward to clerk them in. The history was slightly tricky to establish, however I examined and then documented everything, including what I thought was going on and a rough plan of action. I discussed it with one of the F2s, they agreed with all of it and added a few extras, before allowing me to just get on with implementing it! Sent off some bloods and arranged the investigations. Really satisfying to got through the process. At least it is when I only have to do one at a time, unlike the juniors who have to juggle many patients at once!
It was nearly time to head off when an emergency patient came in via A&E needing an operation. So I headed back to theatre for the third time of the day, and my persistence was again rewarded with more subcuticular suturing!! I love being in theatre, the people are great and the work is so enjoyable, just being focussed on one task and everyone there sharing the same goal. Had a good chat to the surgeon after, got some tips and good advice.
Finally made it out of the hospital and back home, shattered but content. Baked potato then quick trip to Morrisons to stock up. Skyped folks before the final installment of Lord of the Rings - epic in the best sense of the word! Early morning tutorial tomorrow, gonna be a struggle...
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