"Hello... Its Sunshine the Surgical F1 On Call..."

You have no idea how many times I have uttered that phrase this weekend. In fact I said it so much that when I answered my mobile phone halfway through Sunday afternoon I said exactly the same thing. What a pleb.

If you're reading this you're probably at least vaguely interested in what it is I do all day, especially on call, so in honor of my last ever surgical weekend on call I shall tell you all about my weekend.

Our on call weekends as juniors at my hospital are Friday, Saturday and Sunday. Friday is much like an ordinary day at the start. We just do our own team ward round and do our own jobs. As the F1 on call I do have to help clerking surgical patients in A&E if the SHO gets busy though. This Friday was insane. Not only was the surgical SHO scrubbed in for most of the afternoon we were insanely busy. I single handedly clerked at least 6 patients and saw some others with the SHO and reg as well as doing all my ward jobs. Although I was so exhausted I pathetically crawled into bed when I got home at 10pm, it was actually awesome. My day to day ward jobs mostly involve paperwork and taking bloods, so it's fantastic to clerk and examine patients and get to use my brain a little to work out a management plan.

Saturday mornings on call are generally a struggle. It's hard to face getting up when you know that you're not even half way. It's made infinitely harder when your car is as crap as mine. The internal lights don't work, first gear is a bit dodgy, the heater doesn't work and neither do the washer bits on my windscreen. This meant stopping 3 times on the way to work to scrape the ice that had refrozen off my windscreen. My feet were numb. Thankfully our surgical team are quite laid back so our handover is in the mess which means a chance to have 2 coffees and warm up.

Weekend ward rounds are epic. We have to see EVERY surgical patient in the hospital.  This means becoming a writing ninja, and being able to write in all the notes at lightening speed. Thankfully most entries are along the lines of "pt afebrile and stable, bowels open, eating + drinking, continue weekend plan". Because the ward rounds are sooooooooo long they don't finish until lunchtime. In fact lunchtime is a misnomer as it's unusual to get lunch before 5pm.

After epic ward round is jobs time. We don't have phlebotomists (blood takers) on the weekend and most of our nurses haven't been trained to do bloods.This means my own little phlebotomy round. The bad thing is that it's really boring, the good thing is that I'm now really quick at bloods. I tend to try and make it more bearable by having nice chats with the patients, this has the added benefit of earning me sweeties from all the grannies as I take their bloods. This partially makes up for the lack of lunch and is the only thing that keeps me from keeling over.

After bloods I usually have a couple of scans to argue with the radiologist for. I quite enjoy this, it's a real challenge to get the radiologists to agree to anything. I get really worried once they agree though as they clearly think the patient is quite sick too.

Then it's discharge time where I get the joyous task of writing discharges for all the patients going home. Another boring but necessary task. On weekends it's beyond frustrating when complex patients who have been in for months get discharged and the team looking after them haven't started the discharge letter. I can usually be found hunched over a computer muttering about how I'm going to kill someone on the team. I never do. If I was crueler I'd note down who it was and make sure I hadn't prepared discharge letters for their weekends, as it is I'm simply too soft for that.

All the while I'm doing this I get bleeped for various tasks.

Some bleeps are downright stupid...

Nurse "I know you said this patient can have anything that is a fluid... is tea OK?"
Me "yes"
Nurse "How about tea with milk?"
Me "yes"
Nurse "What about fruit juice"
Me "Juice is also a fluid..."

Some bleeps are necessary but demoralising...

"Please can you come to this ward and write the 3 discharge notifications, rewrite 2 drug charts and that manual evacuation is back from xray if you want to do it now..."

Some bleeps are downright scary...

Nurse "Can you please come to see Mrs Smith on ward X, she's collapsed but is now concious..."
Me *thinks shhiiittt Mrs Smith is the woman who I've just seen has an hb of 7.2 post op*
       "eep! Does she have venous access? What are her obs? Start some fluids and I'm on my way..."

But the best bleeps are like this...

SpR "What are you doing? I need you urgently now!"
Me "Eep, nothing! Where? Why?"
Spr "In the mess, the cup of tea I made you is getting cold and it's 5pm and you haven't stopped for lunch"

My favourite moments of on calls are the evening handovers though. For some reason the exhaustion sends everyone a little bit loopy and they turn into the funniest randomest moments, mostly taking the mickey out of each other for stupid things we have said or done. I'm lucky enough to do my on calls with different teams than my own team so it gives me a great opportunity to get to know the others really well. There is nothing quite as bonding as an on call shift.

Dr Sunshine xXx