Anonymous #1
#1
Report Thread starter 1 month ago
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Hi, I am currently a surgical intern in Ireland (equivalent of FY1 in the UK) and yesterday I was on call in the ED.

I found myself in a situation where I was admitting and pretty much making management plans for all the patients who came into the hospital with a surgical issue on my own as my surgical registrar who was supposed to be in house also went home. To be fair to him he did come in and see 4-5 patients but the rest of the time he was at home sleeping and just agreed with my assessment of the patients without seeing them himself as well.

There was one case of a patient who came in with a wet gangrene and necrotic toe which I admitted and started IV abx for with a view of the day team contacting vascular in the morning as our small hospital has no vascular service and it will need to be an out-of-hospital consult. My day team got upset with me because I didn’t contact vascular immediately, even though he had the issue the past 2 weeks.

I was overall pretty upset by the experience and still thinking about it. Am I right to be upset over something like this?
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It really depends how normal this is for this centre and what this SpR is paid to do. If he's paid to be resident, then not being resident is of course a huge professionalism issue! But surely someone would have noticed in the morning?!

If they're supposed to be non-resident but you felt unsupported, then it kind of comes down the nuance of the cases and what was said and whether this level of support is ok for the case load coming in in this centre.

The reason to phone vascular for such a case is so that the patient gets discussed in their morning meeting and management (e.g. scans or transfer) can get organised, not necessarily because you want them to operate immediately. If you SpR told you not to phone but you got the 'blame' (constructive feedback hopefully) that is of course unfair.
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