Today was my first evening of ward cover. It's exactly the same as weekend ward cover - being asked to make decisions about patients you don't know and constantly being asked to review patients for no good reason. Here is what I spent my evening doing:
1. Bleeped to go and review a patient with severe abdo pain. Didn't bother trying to get any other details on the phone since the nurse could barely speak english. Arrived to find that the patient had metastatic bowel cancer, she had had the same pain since admission and had been seen by palliative care who had advised PRN tramadol. Looked at the PRN section of the drug chart only to find that no analgesia apart from paracetamol had been give for two days despite the fact that tramadol, diclofenac and morphine had all been prescribed. When I asked the nurse why she hadn't given any of the painkillers that had been prescribed she just looked at me blankly. Wrote tramadol up regularly since the patient just won't get it otherwise. Poor woman.
2. Asked to review a post-op patient with a swollen calf (alarm bells ringing at this point). Arrive to find the patient had knocked her leg on something and has a bit of a bruise on the side of her leg but no swelling, no tenderness, not hot etc. Not in any pain. No action needed. What's more the (lovely) registrar had already seen her a few hours ago and told her that it was just a bruise.
3. Asked to review a patient's regular medication because the doses had been prescribed wrong. Looked for the patient's notes to try to find out the correct doses only to discover they had gone home two days ago.
4. Asked to consider changing several patient's antibiotics from IV to oral despite never having met them and not having a clue why they were even on antibiotics.
5. Asked to prescribe vaccinations for a patient who had a splenectomy and needed them sometime before going home next week.
5. Asked to write TTOs for a patient who might be going home on monday.
6. Asked to rewrite 2 drug charts.
The surprising thing is that this is all within a couple of hours of the normal teams leaving. I'm sure the nurses wait until 5 before looking to see if any fluids need prescribing, drug charts need rewriting etc. I wrote "No - this is a job for the normal team" on a couple of the notes left for me. I was very very close to writing "Fuck off"