I have completed a full week at work and have got a much better feel for it all. The shock of it has lessened somewhat and I feel I am actually making some impact, which is great. I will try and give you all a little flavour for my working week. The day starts at 8 o’clock (or shortly thereafter) and I do a ward round with the team and see half of the ward’s patients. After the round is the time for jobs, there are bloods to be taken and lumbar punctures on a daily basis, the results of which are often available the following morning. I try and take this opportunity to familiarise myself with the other half of the ward. They are looked after by another consultant who does his ward rounds at 7am before anyone else is at work. It is not really an ideal situation, but hey!
The ward is a female general medical ward with the patients broadly grouped into either those suffering from the complications of HIV infection or those with the consequences of high blood pressure and diabetes. On average they are much younger than patients on the wards in the UK, most of them in their 20s-40s. A lot of them are really ill and deaths are unfortunately a common occurrence. Tests and treatment options are limited but despite this diagnoses can be made and a reasonable number patients do get better and go home. There is, however a steady stream of patients who when they first arrive on the ward it looks apparent that I’m going to struggle to have any impact on the outcome. This was the case back in the UK, but there the patients were different. Here they are often younger and are suffering from conditions which could be either cured or if not managed in an ideal set up. I’m having to accept that this is the case and not beat myself up about it. I wouldn’t be any good to anyone if I did. Hopefully as the year goes on I’ll be able to contribute to some improvements.
Anyway, after the jobs, I am able to get home for lunch, which is fantastic. I really don’t miss the long commutes to work and am very much getting used to my 3 minute amble round the corner!! I don’t know what I’m going to do when we’re back in the UK and if I get a post in north Wales!!
The afternoons are quite short and mainly for trouble shooting and seeing any new admissions to the ward. There are 3 clinics which we share with the team which covers the male ward, meaning that each week we either do 2 or 3 clinics. There is high blood pressure clinic on Tuesday, Diabetic clinic on Wednesday and a general clinic on a Thursday. Clinics are amazing! The main focus is efficiency which given the huge numbers of patients has to take precedence over holistic patient care. I plan to keep track of exactly how many patients I see next week, but I estimate that in last Tuesdays clinic I saw 40-50 patients. Thursday’s clinic was a little better, I probably only saw 30 and therefore had some time to actually talk to the patients! Somewhat of a change from the 10 I’d see in the average clinic back in the UK!! On clinic days we have to fit the ward round in around the clinics, which usually involves splitting the work load.
On Fridays we do a grand round, with the doctors from the male ward and see all the patients. I have found this the best part of the week. There is a lot of chat between us all both about work and other things! The team is made up of myself, Dr Cooper (the consultant - who is presently away until the end of the month), and junior doctors of varying experience: one from Tanzania, one from Cuba, one from India, one from west Africa (I believe) and two from Zimbabwe. They are a great crowd! On Friday afternoons there is an educational presentation. Probably not the best time to do this but it is a good way of making sure nobody takes an early weekend.
Well that is my average working week. At the moment I have declined the offer of any out-of-hours work to give Kit and I an opportunity to relax and explore. I will review that when Dr Cooper returns, as I do want to do my bit, but don’t want to have to sit around in Maseru every other weekend when there is so much of this beautiful country to see!!
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