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Day 1 Neurology

Posted Dec 05 2011 3:18pm
I have been building up myself towards this new role of mine....you know, from being the Senior House Officer (SHO) to a Specialist Registrar (SPR).

Today marks my first day as a SPR, in neurology, a field which is very much new to me. My knowledge and experience in neurology is pretty limited. I mean, I have a bit of stroke in the past, and also had a month's attachment in neurology. However, those experiences are certainly not enough to prepare me for what is to come!

I am the allocated ward registrar for the month of December. The day started off with a handover between me, the nurses and the SPRs who have been in the dept already. The handover took at least an hour, as they had to tell me important details about every patient (we have 15 patients). I know it is not many, but it took quite awhile for us to get around them.
By the end of the handover, my head was spinning. Alot of questions were running in my mind... What is this about limbic encephalitis? And what is ventriculitis? How do you treat it? What is TBM? (I soon found out that TBM = TB meningitis).

After that, I started my first ward round as a SPR. It was not an easy task, just because most of the patients have been there for a number of weeks. So it took quite awhile for me to grasp what was wrong with them in the first place. By the time I completed the round, it was already 1pm!

We all went for a quick lunch. Upon returning, the nurses were looking for me. They wanted me to review a few patients in the day room, there were 2 difficult lumbar punctures to do, and a few other bits and bobs. It really didnt occur to me that there were so many decision making tasks as a SPR. I also had to attend to a few phone calls from patients who needed some advice.

When I was a SHO, all I had to do was to ensure that the ward runs smoothly, get all the requests done and do as the registrar tells me to. But now, I am on the other end of the stick...it is me who gives advice, it is me who makes some of those decisions that SHOs can't make, it is me who have to take on more responsibility than before....

The only positive thing I found today was that I am starting my new role in a familiar environment. I know the nurses in the ward from my previous attachment. I am working in the same hospital, therefore, I know how to get my way around things. I couldn't imagine starting work in a completely new hospital...it would be even worse.

It was a wee bit overwhelming for me today. Thankfully, my senior registrars have been pretty helpful, in giving me some very much needed support and advice.

I hope for a slightly better day tomorrow.


ps. one last problem is that i need to constantly remind myself to write down my correct grade when i write in the notes. So far, i have been calling myself a "CT2," whereas it should have been "spr."

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