Answer for yourself

I came across this quote today which I want to share with you, one which I thought was worth remembering…

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As you probably know by now,  I work on the stroke ward. I’m one of TWO doctors on the ward, and this ward has 25 patients. 25 patients who’ve all had strokes. 25 patients who just like that, can become seriously unwell. In addition to these, we have our outliers (patients who are under our care but are on another ward, due to a lack of beds), and we review them also. We have no senior doctor to turn to, other than our consultant who comes on certain days to do ward rounds.Today wasn’t one of those days.

My counterpart colleague was looking after the outliers, and I was looking after this ward. Each patient has jobs that need doing for them, such as doing blood tests, chasing blood tests, putting blood forms out for the next day, doing cannulas, requesting investigations, referring to specialties, speaking to micro, radiology, psychiatry, families, physiotherapists, occupational therapists, speech and language therapists, dietitians, the list is endless. In addition we have meetings with the therapy teams (exactly the same people I’ve just spoken with…no I don’t ask for these meetings, they are organised at a time most convenient for others, unfortunately not for us).

We also need to have our lunch. Today I finished at 5pm. I had lunch at 3.30pm.

Earlier today I was roped into a ‘not-so-nice’ discussion with a dietitian, regarding a patient who had an unsafe swallow because of his stroke. Unfortunately, the nurses were unsuccessful in getting a nasogastric tube in for his feed (a narrow tube which is passed into the stomach through the nose), and the only way we could get a tube in was with an x-ray. The radiology department only does this on certain days. My consultant knew we were trying to get a tube in, and we were adequately replacing the salts in his body with intravenous fluids.

Dietitian: You know this patient’s potassium is low, don’t you?

Me: Yes I do, it was low yesterday and he’s been getting fluids. I’ve just written up another bag for him.

Dietician: You know he’s at risk of refeeding syndrome.

Me: Yep, he’s still getting the fluids.

Dietician: And we don’t want him to have a cardiac arrest.

Me: Yes I know, we’re checking his bloods.

Dietician: He needs bloods everyday now.

Me: Yes I know, we’re checking his bloods.

Notice how I said the same thing twice. Was I a tad bit annoyed at what I thought was a pointless conversation? Well I’m human, so yes. I have a billion other things to do, I’m still doing my ward round, and I’m now being told stuff which I am fully aware off. In my mind, I knew the patient was getting the right treatment until his tube could be fitted, and we were still keeping any eye on him.

Despite my feelings though, I was acknowledging everything she said. Note I’m saying acknowledging them. I’m not trying to please her, I’m not trying to convince her that what I am doing is correct, and I’m not doing it for her.

I’ve noticed that in the work environment, there will be people who will try and take over, who will want to be the big bosses. Maybe they’re older than you (I think she was), and maybe they’ve had more experience in their field than you have in yours (I think she did), but regardless you don’t change what you already know. You don’t have to do things to please them and you don’t have to answer to them.Don’t lose your focus for who you do things for. Do the best job you can do, be authentic, and answer for yourself only.

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