The Great Stethoscope Debate

There is an unwritten, but vastly vocalised rule in medical school. It goes something like this....

DO NOT WEAR YOUR STETHOSCOPE AROUND YOUR NECK WHEN YOU DO NOT KNOW HOW TO USE IT!

...and by this, I mean unless you can do more than listen to a heartbeat, you shouldn't be proudly displaying it like a badge, or oversized piece of jewellery. Because, let's face it, that's what it is.

Medical students in the lower years often have a day or two at the hospital every year, and every year you see them waltzing around the canteen with stethoscopes around their necks. Even the fifth years don't do this. This is why God invented pockets or small handbags.

Wearing it on a ward round, when walking around the hospital generally is fine, when you know how to use it, but the canteen is just wrong. It would be like wearing it while on public transport. It's not big, it's not cool and it's not clever.

Rant over

Bullet bitten

The shift went ok. Obviously Frank wasn't there but some of the staff were who I worked with last time. It was nice to actually catch up with them.
Everything went by without a hitch and now I'm back on placement for one more arduous week before Easter holidays.
Now if only I could get over my obsession with wearing gloves to do everything at work then I'd be happy. I guess it's to be expected for a while.
More Occupational Health coming soon....

Getting back on the horse

Since my blood exposure I've only done one shift at work. I did a sedate morning in elderly care and spent the entire time running to the toilet to retch.

Today I'm getting back on the horse. The nurse office called me up yesterday; there's a long day shift available on Medical Assessment for Sunday, would you be willing to work it. I said yes before I really even thought about it.

So in 10 minutes I will be getting on my bike and seeing if I can get my feet through the door of the ward and back to where it happened.



As far as I'm aware, Frank still hasn't consented.

So….

Occupational health appointment today.

I don't know whether I've been lucky to be under the head of Occ Health at the hospital or not.

On the one hand he's written a cracking letter to the medical school explaining everything rather eloquently - and far more so than I was able to do when I went in and jibbered at them the day after exposure. He has rightly told me to refrain from exposure prone procedures* for the next 3 months until I've been given the all clear.

On the other hand, I suspect he thinks I know too much. A little knowledge is a dangerous thing.

For example, I know that the fact that I'm covered in tiny pinpoint bruises and any small cut bleeds rather madly means that my haematological values may have gone a bit astray. He knows that I know this. He knows that I know that I will have to stop PEP.

Unfortunately this is where I stop being a rational medic and a rather emotional member of Joe Public. It means that I'm convinced that if I stop PEP that I will immediately seroconvert. I've decided now that it's all down to fate.

Now I just have to wait for a phone call telling me what my bloods are doing and when my next occupational health appointment is going to be. If all is normal-ish, then it's back in 2 weeks, and if all is bonkers, it's back in a week and stop PEP immediately.

Anyway, I did get some more news on the 'source patient'. A brief word about that term – source patient. I hate it. It's such a vague hospital way of getting round the issue of confidentiality and trying to desensitise it. They know I know who the patient is, and they know I know. As if I would forget. I think I'm more offended by the fact that they aren't referring to Frank as 'Frank' and more as a 'Source'.

Anyhow, the medical school knows, but the students don't know. I think they might think I'm pregnant due to the amount of times I chuck myself out of the room at high speed and in the direction of the toilet. I've also had to avoid any patients with coughs, colds and minor infections because I'm probably immunosuppressed at the moment. I can understand why everyone thinks I'm up the duff, but it amuses me that no-one has actually asked me yet. I guess I'll be more offended if anyone thinks I'm starting to 'show'.



*For the non-medics out there, an Exposure Prone Procedure is one whereby you risk exposing the patient to any blood borne viruses you have. This means that you can't put your hands into any blind cavities or do anything where you can't see your fingertips. As a clinical medical student this means I can't do the following:

• Vaginal examinations or smears
  
• PR examinations
  
• 
  
  Scrub into surgery for anything other than the most minor surface procedures. I've been advised not to scrub at all.
  
  
  

I am still allowed to take bloods and put in cannulas and catheters though. I did some bloods this week and shook like a leaf, convinced that I would somehow manage to stick myself and then inoculate the patient (very hard to do), but oddly enough I did it perfectly and got first blood.

PEP – the worst name in the world

Post Exposure Prophylaxis is the best thing I could be taking at the moment. But calling it 'PEP' is a slight misnomer. I have never felt less 'peppy' in my entire life.

My dreams are weird, I have what my other half has coined 'death breath', I feel like something metallic has rusted in my mouth and taken some bread in there to go mouldy at the same time.

And these are the more annoying and less worrying things…

• My stomach can't decide whether it's hungry, full, upset or what.
  
• I can't stop bruising – everywhere
  
• My face and scalp has erupted into spots and pustules
  
• I'm permanently exhausted
  
• And I seem to have gotten a nasty ganky cough to go with all of this.
  

But sometimes you just have to Keep Calm and Carry On

When work places life on hold...

Over at doc2doc is a summary of what's going on at the moment.

Click here for linkness etc

Some point soon

Some point soon I will blog properly. It might not be here, but it may be over at Doc2Doc.

I'd just started to dig myself out of a mental hole when a physical one occurred. Even so, I'm being philosophical and working on a 'shit happens' mantra at present.

Meanwhile, you'll just have to hang on until I stop barfing....