Surgical On-Call

So this week I experienced my first set of surgical on-calls of CT1. What better than to theme this week’s blog post on this quake-in-one’s-boots-worthy activity which invokes much chagrin in surgical trainees across the UK and perhaps even globally.

To explain.. A Senior House Officer (SHO) (normally either a Foundation Year 2 doctor or a Core Surgical Trainee/similar) “on-call” shift involves holding a bleep (a pager), through which other members of staff across the hospital can contact them in order to ask for either a review, to provide advice about, or to accept a patient. So, for General Surgery, you are literally at the beck and call of the hospital for surgical patients.

It is a notoriously stressful affair and my experience was no different. The beginning of the shift was steady, with a few bleeps here and there, mostly community referrals. The odd accident and emergency (A&E) referral also meandered in. However, it then hit mid to late afternoon when the community rush hour commenced. An influx of calls from General Practice (GP) surgeries and the walk-in centre made my bleep sing.

But it was not over yet. Oh no.

The final straw that broke the camel’s back arrived in the form of what I call the witching hour(s). This comprised the final 3 hours of the shift at which point A&E started to refer all the remotely surgical patients to me, sending the bleep into a close-to-self-combusting frenzy.

I was covering both general surgery and urology, which meant I had to keep sifting through the referrals to determine who was being admitted under general surgery in order to hand them over effectively to the general surgical night team without missing any details. The update of the handover list was running late and the calls kept coming in. I ended up handing the bleep over to the night SHO before the formal hand over in order to attend to a severely pauce handover list.

Honestly, it felt like chaos.

I think it’s safe to say that I’m not the biggest fan of this genre of shift. However, upon reflection, it can be useful. Allow me to elaborate: it sucks you up, squeezes you through a kaleidoscope of trials and tribulations before you tumble out of the other end moulded into a slightly more experienced version of your former, pre-on-call self, all within the space of one single 13 hour period.

Like a Darwinian evolutionary process. Just in 13 hours.

I think treating each shift as a learning curve has helped me approach it in a much more positive mindset. Whilst the on-call was tough, I think relishing the presentation of each new challenge as a learning opportunity gives it a fresher feel and alleviates the pressure from all the stressors flying in from all corners.

I mean, it’s easier said than done for sure.

But it’s helped me adjust my mindset to incrementally more positive than negative.

Which helps. Even if a little.

So, this was an interesting experience that will continue to bring douleur to even the best of us, but apparently it gets easier with more experience. Of that, we shall see…