Thursday, 5 September 2013

Back to reality - beware medic talk!

So this week was my first week at work. After  15 whole days off (in a row!!) it was time to get back to reality.

I was due to start work as an RMO in the emergency department at 'Charlie's.' An RMO is sort of equivalent to an SHO in the UK, which for all non medicos basically means a junior doctor who slightly less useless than an F1 (newly qualified doc). So I went to my induction, picked up my scrubs and sat through the IT training only to find out that my criminal record check had not come through! Without this I can't practice medicine in Australia! So on my first day I was sent home! Not cool!

So not only was I letting my team down by leaving them a doctor short, I earned a reputation as a secret criminal leading the other doctors to speculate about my previous crimes! Perfect first impression...

Anyways, after another 5 days off I finally got my criminal record through and was allowed to start work. I went in for 1 day, then I was straight into my 5 days off! The shifts here are great. We do 5 shifts on then 5 days off. The days are long at 11 hours (reality more like 12-13) but compared to the UK, this feels great! No more 20 day stretches and no more 24 hour shifts! The other great thing is that there are tonnes of doctors and always a consultant or senior reg on! In my last ED job, I was often the only doctor on through the night. I did have access to a registrar sleeping on site but it was made pretty clear that your weren't to wake them unless something on the scale of a nuclear explosion had occurred!

The job here is much more demanding so I feel I earn my 5 days off! ED in Australia is not just a case of triaging patients then passing them on to the appropriate speciality, we actually diagnose and treat patients ourselves. The A in our ABCDE assessment no longer stands for "call the anaesthetist" but rather "get a scope and secure the airway yourself!" Awesome!! In the UK there are specialists for everything. If you need to plaster a broken bone you call the plaster technicians, if you need an arterial or central line you call the anaesthetists. Here in Australia you are expected to do everything yourself. As a result I can now do a variety of nerve blocks, do all my own plastering and have even drilled an eye. Yes with an actual drill!! I am 100% sure that I was much more nervous than the patient!

The other thing I have noticed about ED in Australia is that there are so many crazies! I think I can recall 3 occasions over the past 2 years where I have had to call security and chemically sedate a patient who had gone crazy (elderly demented patients excluded). Here in ED a "code black" is a daily occurrence, usually several times a day. A code black is called when a crazy comes into the department. Security is called and a doctor is required to do a "chemical take-down." This is where we insert an IV line and give drugs until the patient calms down/falls asleep. Sounds easy but the patient usually has to be held down by about 6 security guards! I think the reason there are so many crazies in Perth is the huge crystal meth problem. This is not a common drug in the UK because it is difficult to make without being noticed (and UK is very crowded compared to Oz). Also, with such a large coast line, drugs are much easier to smuggle into Perth. Seeing these people has been a real eye-opener! The reality of crystal meth to Breaking Bad's Hollywood-isation!

Of course the Aussi doctors say the reason they have so many crazies is the crazy amount of sunshine! But don't worry, we are safe for now as so far we have only seen rain!

So overall I'm loving my new job!

And now onto Chris's new job......something about concrete.....roads.....snake handling....trips to the Pilbara....lots of cups of coffee.....I think I better let him tell you about that! Keep your eyes peeled for his riveting, completely not boring walkthough of his new place of work! (Puns intended....sorry!)

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