Hola amigos!!! This is Dr Tarun Puli, an IMG from India. I am an aspiring Paediatrician to be, working as a Clinical Fellow in the Academy of Surgery at the Barking, Havering, and Redbridge University Trust, Romford, posted in ENT at the moment.
Yes, you heard it right; that doctor was me and the patient as well. Unfortunately, I had an anaphylactic reaction to something I was not aware of while I was about to start my night shift on 19/03/2023 at 20:00. This is a small, heartfelt article I want to share about my learning during that time.
How did it start?
It was a pretty normal UK day, sunset after 18:30, woke up, had dinner, and started a bit early to job as on Sundays there will be less frequent bus service even in London. Around 19:20, I felt my neck heating up; yes, you heard it right, I felt something was off, and my neck started feeling very hot and itchy.
Got off the bus near the hospital at 19:25 and went to change into scrubs. That's when I observed the hives spreading all over my body. I was almost panicking as I was the only night cover for the department that night, and I had an anaphylactic reaction.
What did I do?
1. I rushed to the on-call room and broke the news to my colleague that I had an anaphylactic reaction.
2. I informed the on-call registrar about the situation, and he advised me to go to A&E immediately to get treated.
3. Time was 19:47, I registered in A&E, and immediately I was given IM Chlorpheniramine and IM Hydrocortisone by 19:54, 6 minutes before my shift.
4. I messaged and apologized to our department group about the situation.
5. I messaged the SHO group requesting if anyone is willing to cover.
6. We informed the site manager that there might not be an ENT cover overnight, given the situation.
Where did this lead me, and what have I learnt?
As an over-enthusiastic doctor, I thought only oral doses would cause drowsiness. I was proven wrong when the drowsiness started hitting me within a few minutes. When that happened, I was talking to my colleague over the phone about a possible takeover of the night shift. Slowly, I was unable to comprehend what he was saying, that's when I realized I was getting drowsier.
Several thoughts ran through my mind, most of them unclear; I could hear patients screaming in pain, losing their patience as they were waiting to be seen by a doctor for more than a couple of hours, and nursing staff liaising with them politely to let them know that there is a delay and they will be seen.
I will quickly summarize what I have learnt in the 3 hours while I was in A&E as a patient :
As a doctor working in NHS, you can't help but apologize to patients for the waiting time in A&E. Nevertheless, there can be a plethora of reasons for it, ranging from being understaffed to a lack of beds/chairs/examination rooms.
For a change, when you are on the flip side of the coin, you understand the range of emotions patients go through by the time they are seen. Most of the patients understand the situation in the hospital and are kind to us. Few patients tell me there's no need to apologize as it is not my mistake; rather, I'm doing my duty, treating them accordingly and compassionately.
The importance of compassion hit me hard all this while when I was waiting in A&E, what it means to patients, and how important it is as doctors for us to have empathy while talking to anyone in a hospital setting. Keeping your clinical knowledge aside, being a benevolent doctor is much valued and needed the most.
Imagine being in a busy setting one day; we might have 10 patients to review. We try to do as much as we can, given the circumstances and the presentation of each patient. But from a patient's perspective, we are the only one (doctor/team) he/she is waiting for, to be seen.
So, it's natural that they expect empathy and sound medical knowledge from us. Regarding knowledge, we keep learning every day, and it is a continuous process, but empathy is something that should come from within as a human. It is a basic trait that we can give to another human who is suffering from any health issue.
This brings in the importance of how you communicate so the patient recognizes that you are not arrogant/ignorant but rather a compassionate/empathetic doctor.
Your body language, the way you speak and present yourself, everything matters as that is what is visible to the outside. If you're completely tired, please take a break to recharge yourself or ask a colleague to cover/help you. In the end, we are humans as well.
No health Organization in the world would give such world-class care and treatment for free to every person. But everything has its own assets and liabilities. I feel the asset of NHS are its health care professionals at every level and the common people who support it.
The liabilities include being short-staffed, less bed availability, improper funding at times to recruit more professionals, and many more. It is not a criticism of any organization, but the fact with which we are carrying forward, unfortunately.
There can be many factors coming into the picture when you want to deliver proper care- availability of medicines, beds, and sometimes health care professionals. We strive to provide the best possible care to patients, with fewer delays possible. Care also represents taking care of yourself and your health- physical, mental, and emotional.
Why is this important?
There is a protocol for almost every situation in your trust; please try to know what it is and act accordingly. My colleague has kindly come in to cover the night shift so the care is not compromised for any patients. I'm glad to have a wonderful team who understood the situation and supported me accordingly.
It is important learning as I myself witnessed the situation succinctly, which led me to learn what the 3C's mean and how to implement them accordingly- Being a COMPASSIONATE doctor who can COMMUNICATE in any situation, conveying the news to patients and attendants with confidence and never compromising on the CARE provided, whilst taking CARE of yourself and seeking help from colleagues/seniors whenever you feel burnout/ overwhelmed.
Need More Help?
Please let me know in the comments about your experience as a doctor in the NHS and any situations you faced. If you have something to speak out, you can reach us on TrewLink Website. You can register using this link: https://trewlink.com/?referrer=tar630001
You can also help your colleagues by sharing the article.
There are articles about Top Tips to Avoid Burnout During PLAB Preparation and How to Make the Most of Your First Job in the UK.
I would love to hear your stories on how it went for you…Do let me know in the comments.
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Dr Tarun Puli