Yesterday, I met a nineteen year old with left sided pain. She also had a positive pregnancy test and her period was late. Not unusual in my line of work.
What was unusual, was that she said that she had never had sex. This conversation took place in front of her mother, so I don't know if that was the reason for her answer. I don't know if it was true that she was a virgin. She was extremely distressed and her mother was convinced she had a rare form of ovarian cancer.
I was torn between doubting the patient and my diagnosis - after all, the most common cause of a positive pregnancy test is, well, pregnancy.
A scan showed an intra uterine pregnancy of about 6 weeks. She left the hospital. I think she has gone to have a termination. I am worried about how she'll cope. I don't know what happened here - heavy petting perhaps?
Wednesday, April 16, 2008
Monday, March 31, 2008
I passed!
I passed my Part 1 exam! I'm still pretty shocked as I wasn't expecting to have passed - the first paper was ridiculously difficult.
My main feeling is one of relief, that I will never ever have to revise and sit that awful thing again.
Congratulations to all those others who also made it through.
JD
My main feeling is one of relief, that I will never ever have to revise and sit that awful thing again.
Congratulations to all those others who also made it through.
JD
Monday, March 10, 2008
A Small Update
Things have been a tad busy. I'm learning lots of new skills although I'm worried that I'm not learning fast enough. Time is limited and I feel so inexperienced.
I have mainly not been blogging because I have been revising hard for my MRCOG Part 1 exam. It's all basic sciences and quite removed from my day to day job. I've struggled with it but the exam was last week and it went okay, I suppose. About 25% of people pass, so I'm not particularly hopeful to be honest. The first paper was really hard but the second paper was manageable. Just have to wait for the results...
The job isn't great, which made motivating myself for revision a little harder. It's improving as I get to know people but it is an unhappy department, under a lot of pressure. I have taken over the running of the rota, which is not compliant. Unfortunately, someone in human resources did their sums wrong and nobody noticed until I took over. It means people are not being paid for some of the work they do, but the department cannot afford to either pay the money or release the hours. It doesn't do much for morale.
The house is almost 'finished' and is nearly feeling like home. We have had to sort out a lot more than I expected (naively!) so it has taken six months.
I will try to blog a little more regularly... there are always stories to tell.
I have mainly not been blogging because I have been revising hard for my MRCOG Part 1 exam. It's all basic sciences and quite removed from my day to day job. I've struggled with it but the exam was last week and it went okay, I suppose. About 25% of people pass, so I'm not particularly hopeful to be honest. The first paper was really hard but the second paper was manageable. Just have to wait for the results...
The job isn't great, which made motivating myself for revision a little harder. It's improving as I get to know people but it is an unhappy department, under a lot of pressure. I have taken over the running of the rota, which is not compliant. Unfortunately, someone in human resources did their sums wrong and nobody noticed until I took over. It means people are not being paid for some of the work they do, but the department cannot afford to either pay the money or release the hours. It doesn't do much for morale.
The house is almost 'finished' and is nearly feeling like home. We have had to sort out a lot more than I expected (naively!) so it has taken six months.
I will try to blog a little more regularly... there are always stories to tell.
Saturday, October 27, 2007
Still here
Thank you for the encouragements to return. I haven't had much to say recently. Mainly because the things that I want to talk about are too specific to allow me and my place of work to remain anonymous. Work has been incredibly stressful but I have just had ten days of annual leave, which has improved things.
I have discovered that I am remaining in my current position until next October - fourteen months. This is so that we will be in line with the SpR (registrar) changeover dates. Although I am enjoying the obstetrics and gynaecology part of my job, I am unhappy in my position. I feel unsupported a lot of the time. Some of the Consultants bad mouth other Consultants in front of nursing and junior staff, which adds to the discomfort. There is minimal team feeling and a high sickness rate in nursing staff as well as two of the other junior doctors. The next twelve months stretch ominously in front of me and I am paranoid that my depression is going to return.
In happier news, the house is now starting to resemble a home. We are still carpet, paint and furniture short in one bedroom. The shower does not work and we need a new boiler. However, dramatic progress has been made.
I have discovered that I am remaining in my current position until next October - fourteen months. This is so that we will be in line with the SpR (registrar) changeover dates. Although I am enjoying the obstetrics and gynaecology part of my job, I am unhappy in my position. I feel unsupported a lot of the time. Some of the Consultants bad mouth other Consultants in front of nursing and junior staff, which adds to the discomfort. There is minimal team feeling and a high sickness rate in nursing staff as well as two of the other junior doctors. The next twelve months stretch ominously in front of me and I am paranoid that my depression is going to return.
In happier news, the house is now starting to resemble a home. We are still carpet, paint and furniture short in one bedroom. The shower does not work and we need a new boiler. However, dramatic progress has been made.
Saturday, September 8, 2007
A Short Update
I have now completed a full rota cycle. I'm enjoying myself and I'm feeling that I have made the right career decision. I'm terrified about just how much I have to learn. I see the Registrars dealing with problems and I can't see how that will ever be me. It's a bit like when I was a medical student and could never imagine actually being a doctor.
The politics within the job are very odd, particularly with all the practitioners. I'm going to save writing about this for another day.
The caesarean section rate is very high and it's slightly disconcerting assisting at sections which would have been delivered vaginally in my previous job. Pre-term breeches being a prime example. A lady who was 27 weeks pregnant was admitted fully dilated and pushing. The baby was breech so they did a crash caesarean section under general anaesthetic. I feel that I am too junior in training to know what's right. I worry that I will never learn how to do a breech delivery though and that I will then have to section these people because I don't have the necessary skills to do otherwise.
Not that that matters yet - I have many other skills and attributes to learn first.
The politics within the job are very odd, particularly with all the practitioners. I'm going to save writing about this for another day.
The caesarean section rate is very high and it's slightly disconcerting assisting at sections which would have been delivered vaginally in my previous job. Pre-term breeches being a prime example. A lady who was 27 weeks pregnant was admitted fully dilated and pushing. The baby was breech so they did a crash caesarean section under general anaesthetic. I feel that I am too junior in training to know what's right. I worry that I will never learn how to do a breech delivery though and that I will then have to section these people because I don't have the necessary skills to do otherwise.
Not that that matters yet - I have many other skills and attributes to learn first.
Monday, August 20, 2007
Day 8 of 12
Last week was on call - evenings all week and then long days through the weekend, which was busy. I'm extremely tired now and am covering theatres all week. My unfit body is crying out from the 10 hours stood in theatre today (surprise, surprise, the list overran but fortunately we didn't have to cancel anybody)
We move into our new house on Friday. I'm so excited. I can't wait for this horrible commute to be over - only four more days until I no longer have to buy petrol every 2.5 days.
Unfortunately, I am too tired to blog. I have replied in the comments below, thanks for all your thoughts, as ever.
JD x
We move into our new house on Friday. I'm so excited. I can't wait for this horrible commute to be over - only four more days until I no longer have to buy petrol every 2.5 days.
Unfortunately, I am too tired to blog. I have replied in the comments below, thanks for all your thoughts, as ever.
JD x
Thursday, August 16, 2007
The New Job
I'm enjoying the new job, although its very different to my previous post in Obstetrics and Gynaecology. The bread and butter work is obviously similar and the staff are lovely so I'm happy.
There are a few issues with the rota and of course, I still have no contract or confirmation of pay and conditions. Nor do I have a parking permit, a full rota or even an end date! They are still unsure whether I am there for a year or six months. Hmmmph.
Educationally, I am slightly concerned. We are not doing enough hours and I am very much a service provider. Bloods, venflons and discharges. I notice that the extended role midwives are being trained to do ventouse deliveries and fetal blood sampling, whilst I sign off blood results.
The Gynaecology Nurse Practitioners are very good at their job but they have no knowledge of medicine and try to coerce me into dangerous practices. One asked me three times why I wasn't given fluids to an unwell patient. She had heart failure and was dangerously fluid overloaded. Later, she patronisingly asked if I had done some medicine "because I seemed to know what I was doing". Quite. I know I am young and inexperienced but I have been trained well in the basics. These people tell me regularly that they are the same as an SHO. Apart from the fact that they can't prescribe, order unnecessary tests and scans and won't make any decisions other than whether or not to bleep the Registrar. They are excellent at the Gynaecology though and a mine of information. It's just that they haven't been trained in anything else.
The other career trainee is also concerned. The GP trainees are happy because the job is ideal in that respect. It doesn't matter if they can't do an instrumental delivery or a caesarean section or interpret a CTG. It does matter for me. We are going to run a rota cycle (six weeks) and then discuss it with the Consultant in charge. I want to work and I want to train. Hopefully, they're going to let me!
There are a few issues with the rota and of course, I still have no contract or confirmation of pay and conditions. Nor do I have a parking permit, a full rota or even an end date! They are still unsure whether I am there for a year or six months. Hmmmph.
Educationally, I am slightly concerned. We are not doing enough hours and I am very much a service provider. Bloods, venflons and discharges. I notice that the extended role midwives are being trained to do ventouse deliveries and fetal blood sampling, whilst I sign off blood results.
The Gynaecology Nurse Practitioners are very good at their job but they have no knowledge of medicine and try to coerce me into dangerous practices. One asked me three times why I wasn't given fluids to an unwell patient. She had heart failure and was dangerously fluid overloaded. Later, she patronisingly asked if I had done some medicine "because I seemed to know what I was doing". Quite. I know I am young and inexperienced but I have been trained well in the basics. These people tell me regularly that they are the same as an SHO. Apart from the fact that they can't prescribe, order unnecessary tests and scans and won't make any decisions other than whether or not to bleep the Registrar. They are excellent at the Gynaecology though and a mine of information. It's just that they haven't been trained in anything else.
The other career trainee is also concerned. The GP trainees are happy because the job is ideal in that respect. It doesn't matter if they can't do an instrumental delivery or a caesarean section or interpret a CTG. It does matter for me. We are going to run a rota cycle (six weeks) and then discuss it with the Consultant in charge. I want to work and I want to train. Hopefully, they're going to let me!
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