Saturday, 11 February 2012


by Dr Goon up early,dress neat,shave.
2.finish your rounds before your consultant.(and arrive before your MO/Reg/Consultant)
practice correct examination technique and REALLY examine the patient not just copy the previous BHT update.
(always practice examinining in a systematic manner and in your spare time-watch how the MRCPians do it with style and clarity)
3.if the nurses chart monitor seems suspicious/made up-check the vitals yourself.
(carry a handbook-e.g Oxford handbook of clinical medicine to check dosages/terms/clinical conditions etc you are unsure).Trace all the results and more importantly INTERPRATE them and act on them accordingly.
4.If dressings are not done by the nurses- check it and do it yourself.Do it for your patient.You will learn how to do dressings effectively and watch wounds heal before your eyes.
5.Do not dissapear from wards and go for long lunches.This isn’t an office job.A patient may collapse or may need medical attention right away.Take turns with fellow HOs to take short breaks(obviuosly only with ones you can trust).
6.If you have referred a case,ordered blood products,arranged for scans/X-rays but it is still not done-please follow up and do not wait to be asked to do that.
A HO is the ” ward producer” and this is an important responsibility.
7.Do not argue over whose patient is this or that- if the work isn’t complete-the patient suffers.Whilst some HOs couldn’t care less-you should be different and care.After all that’s why you chose MEDICINE in the first place.Help your colleagues with their work.
8.If some nurses do not do their jobs,there is no need to argue with them-just a gentle reminder-better yet, do it yourself.Nurses are not trained to understand the urgency of certain medical conditions and the complex pathophysiology and pharmacological interactions.You chose MEDICINE-so be a doctor.If the patient needs to be wheeled down for an investigation and the MAs or nurses are delaying time-offer to wheel the patient down with them.Remember-its not beneath you to do that.Lead by example.
9.When you are on call-know the problematic patients or critically ill patients.Keep a tight watch and review the patient yourself periodically.DO NOT RELY on nurses’ reports which may be inconsistent and inaccurate.(One patient i treated was recorded as BP 120/80 by a certain nurse-he was having hematemesis-when i checked myself -BP was 85/40)
10.Don’t be a hero-inform your MO/Reg/Consultant when a patient deteriorates or when you get referrals that need urgent attention.But obviously-you will need a strong background of medical knowledge to convey information in a legible/intelligent manner.Institute emergent attention yourself whilst waiting for MO/Reg/Consultant.
11.STUDY STUDY STUDY- If you get depressed thinking all you do is scut duties-you should be even more depressed knowing that you do not know enough.Study
-get good materials for the MRCP/MRCOG/MRCPaed/FRCS-. learn how to read CTs/MRIs/X-rays- you can use the chance when you request for investigations from the Radiologists to teach you a thing or two.Study,memorize and examine patients.Think of differentials and don;t just accept what the casualty officer’s diagnosis is.If your MO/Reg is not knowledgable-use that to funnel your own efforts to be a better clinician so as to guide your future HOs.
12.Come on the weekends and do your rounds-know your patients inside out.
Remember,one day you may be a Specialist and if your HO does all these like you do-you can rest well at home.

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