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24 hours as a paramedic: “Saving lives in understaffed wards deserves more than a pay cut”

Shivam Sharma, a geriatrics resident in Birmingham, keeps a diary to show what it’s like to work on a day when less than half the required number of doctors are on duty. A 26-year-old man in his fourth year as a doctor must make life and death decisions as an endless to-do list grows. As Connie Dimmesdale said.

8:15 o’clock My shift does not start until 8:30 in the morning, but I get up early to visit two patients who were very ill yesterday. I worried about her condition all night.

Patients often die in the geriatric ward. The prospect never gets easier to accept.

08:30 “A lot happened overnight. I have to solve problems by prescribing new drugs or liquids for patients who are running out of supplies and reviewing incorrect prescriptions.

9:00 am – The transfer starts when the team members meet to discuss all the patients in the department. I listen to the news and share my thoughts and recommendations.

9:30 am – I begin the round by reviewing each patient’s progress, updating the treatment plan, and answering any open questions.

Today will be especially crowded, because we do not have enough staff due to illness and holidays. Three doctors are trained, usually six or seven.

I write notes for each patient, and when I have all the information I need, it’s time to review them with a full head-to-toe examination.

10:00 hours – There are a number of patients whom I have to refer to cardiology because of suspected heart failure.
Then my attention switches to one of the two patients yesterday. He has been in the hospital for several weeks now and has developed shortness of breath and I suspect nosocomial pneumonia, but he is getting better.

Patients who stay in the hospital for longer periods are more susceptible to such infections, highlighting the importance of releasing medically healthy patients as quickly as possible. However, the ongoing crisis in social services has meant that many have to wait a long time.

10:20 – When I observe the condition of the second patient, my heart stops. Despite four days of strong antibiotics, oxygen and nebulizers, the patient’s condition worsened.

His oxygen saturation is still alarmingly low and he is unable to communicate properly due to progressive dementia. It’s heartbreaking.

Understandably, the patient’s family is alarmed. I must be honest. I explain that the patient’s condition is very serious and the prognosis is unfavorable. This is a difficult conversation, but we must decide whether to continue treatment or to calm the patient at the end of his life.

At times like this, I doubt my ability as a doctor to balance the desire to save lives with the reality of what is best for the patient. I understand the family’s desire to continue treatment and maintain hope of a cure. But when I discuss the situation with my consultant, we both know that prolonging treatment will only cause more suffering.

11 o’clock As I continue my rounds, I can feel the load of the day’s tasks pile up. Every patient needs a certain level of attention and care, whether it be a simple adjustment of medication or a more complex consultation with a specialist from another hospital. The constant need for follow-up and tracking of test results is a never-ending cycle that can be tiring. I can already feel my energy levels drop.

12:30 pm While I’m going through my to-do list for the rest of the day, I’m interrupted by the nurse on duty, who has to relay all the patient’s conditions and treatment plans.

1:00 p.m. I need to take a blood sample from a dementia patient who is being treated for MRSA (a type of antibiotic-resistant bacteria). Working with people with dementia can be difficult as they are often confused and often unable to remain calm.

I put on personal protective equipment and wash my hands before entering the patient’s room. She is alone in a side room due to an MRSA infection and is understandably terrified. I do my best to calm her down and distract her with small talk. Luckily, my spell seems to be working and I’m the first to taste the blood.

13:30 – Half an hour lunch break and meeting with colleagues. Our union just announced strike dates, so there’s a lot of talk about it. We can all agree that we are worth more than the 26% cut in real wages since 2008.

2:00 As I return to the department, the growing to-do list reminds me of all the tasks I still have to complete.
I start by changing the patient’s catheter. This is always time consuming as finding all the necessary equipment can be a challenge. Nothing is labeled, which only adds to the disappointment.
Then I need to make a few phone calls to track down important research and recommendations. This is always inconvenient as the phone lines are often busy or the doctor on call I am trying to reach is stuck.

03:00 The nurse warns me about a patient whose condition seems to be deteriorating. There are several warning signs: an increased heart rate, low blood pressure, and a need for new oxygen. I rushed to the patient’s room.
I suspect they are septic due to a possible infection. The chest X-ray confirms the infection, so I’m changing the treatment plan and instructing the nurses to keep a close eye on her.

4:00 p.m. “It is always difficult to tell a family that their loved one is still ill, and despite our best efforts, we cannot provide further treatment.

17:10 – Time to go home.

18:00 “I have lunch and then spend time on my application for special education. It’s a very competitive process and I’ve spent a lot of free time studying for exams and preparing for job interviews.

8:30 p.m. – I feel pretty tired, but I have some urgent emails to take care of.

21:30 – I’m going to the fitness center. Yes, I’m tired, and yes, it’s late, but I don’t know how I would function without the gym. It helps me clear my head and relieve tension.

23:00 – time to sleep. I watch 20 minute TV shows. I am glad that I have days off, because next weekend I will work from 9:00 to 21:30.

Source: I News

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