Emergency call

"One of your patients has deteriorated suddenly! Can u come here now? It's urgent!!!" said the nurse.

I rushed down immediately to find my Registrar, other colleagues and numerous nurses around the patient. There was my patient being breathless, and looking poorly.

"Look for M. She has the information about what to do." said my Registrar. Off I went to look for M in the Treatment room, finding her on the phone with the microbiologist.

The moment M saw me, she was planning her escape. "I can't handle this microbiologist. I don't understand the antibiotic regimes he's giving me. Can u do it?" she said. And before I could even reply, she said "I have never done these before. I don't even know what tests he's talking about. Do u know?" I quickly glanced through the list. I knew there was no delay, since things have to be done NOW before the patient gets transferred urgently to the High Dependency Unit.

"Ok. Tell me all about this patient and what info u have been given so far." I said.

Briefly she told me about the patient, and hastily, she threw me a sheet of paper with all the urgent investigations instructed by the Consultant and the Consultant microbiologist.

I grabbed all the medical supplies I needed, including all the forms and labels, and hurried to the patient's bedside, with my panicky colleague behind me.

Another fellow colleague of mine was there too. "R u alright?" I asked. "Errr...I have done one blood culture. But there is a list of things to do and I don't know what some of them are." said the other colleague.

In my mind, I had a clear idea of what I needed, and without any delay, I did all the investigations which was required to be sent off urgently. I knew my colleague was in a fluster because she started messing up the bottles despite me labelling them. And before I knew it, both of them silently sneaked out, leaving me all alone to handle the patient. I didn't realise it until the nurses said, "Your colleagues have left u to fight the war yourself." when I went "Can someone pass me a gauze?"

I guess the situation during then was too intense for me to feel pissed. I am surprised by the calmness I had while handling the entire situation myself. I carefully put labels onto the bottles, organised my forms nicely, placed the appropriate bottles together with the forms, and then sent them off urgently. I also gave the nurses instructions about what else they needed to do, before I contacted the microbiologist.

He gave me advice on which antibiotics to administer, all of which I wrote clearly on a piece of paper. My Consultant then turned up, "Hey Mich! What's the situation like now?"

"Under control. I have done all the investigations wanted by Dr H. And he gave me the antibiotics regime. If you're comfortable with it, we can start the treatment." I said.

"Ok. No problem." he said.

Just when the problems are solved, then came my colleague..."How? How? U spoke to Dr H?"

"Yes. It's all done." I said.

Knowing how panicky a person I am, I was quite amazed by how calm I was throughout the emergency situation. Today's experience has boosted my confidence a little. But I definitely don't feel pleased abt my colleagues who just ran off. I can accept the fact that there are some things which they may not know (I dont think I know everything either), but at least I would expect them to stay and watch, instead of saying "Oh, I don't know how to do this. U do it." and then shoo off. For all u know, the same situation might happen tomorrow! And I can understand that Dr H can be super long winded, and sometimes he gives too much info that u will find problems concentrating, but that doesn't mean that u just throw it to a colleague halfway and wash your hands off. If u don't understand, ASK!

Honestly, the things instructed by the Consultants weren't over the top. They weren't invasive things like urgent lumbar puncture or pleural taps. They were very simple things, and I don't think I would have saved the patient's life immediately by carrying all those urgent investigations, but as junior doctors, it is our responsibility to carry out the simplest procedures and it's also the least we can do for ill patients. In fact, I felt quite bad about myself when my Consultant helped put in a venflon into the patient when I was prescribing medications. He was smiling when he looked at me, but still, I do feel bad.

Anyway, today's situation taught me the importance of being calm. I have been thrown in tense situations before, and I do admit that I did panic, and I was full of admiration of the Registrar when he so calmly approached the situation.

I remember once when I came out of the ward, feeling lousy about myself because I was in quite a bit of panic while the medical Registrars and surgical Registrars were resuscitating a patient who was basically vomiting copious amount of fresh blood continously. As I was walking down the hospital corridor with my Registrar...

Me: I feel lousy about myself. How do u maintain your calmness?

Him: U do know what to do. Remember ABC. If u make sure each of them is done, then u have done all u can for the patient. Whether he survives or not, it's not within your control anymore. Keep telling yourself that, and u will be calm."

I do aspire to be like that one day. And I'll work towards it.