A full day in ED

This may shock you, but today I worked a full shift of 8:30 to 5 in ED, without even a lunch break. Are you proud of me? I certainly am! 

 We're still getting to do lots- we even get patients designated as ours by the consultant for who we have to do all the paperwork and referrals etc. which is pretty cool, even if he does sometimes tweak our plans first. 

That's one way to discourage coffee breaks...!


 I'm also starting to see the limitations on healthcare here more too: today we discharged a patient with ?cauda equina, which would NEVER happen in the UK. Here, however, there's no MRI scanners to confirm the diagnosis and no surgeons who would be able to operate, so there's a certain grim acceptance here that patients will just have to go home and lose the function in their legs. I also got laughed at for suggesting taking a baseling HbA1c for a diabetic patient- apparently they rarely do baseline tests here, because of the associated cost. You live and learn, eh?



 There's also a lot of T2DM and HTN that are poorly controlled thanks to non-compliance: today we saw three different patients with the sporting BPs of 181/112, 201/120 and 226/146 (!!!) which according the the nurses are really not that unusual here. I basically just assume every patient I see has hypertension and diabetes at this stage, which probably isn't far off the truth- about 70% of adults here are obese!

 We went out for dinner at a Chinese restaurant this evening, and I managed to pick the others brains to pull together a plan for the next few weeks- hopefully I'll manage to stick to it and cram everything in, and can manage a few more days finishing at lunchtime...!


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