Into the swing of things

I have done three shifts now, one at st clares and two at the health sciences centre. I am enjoying it now I have got the hang of things a bit more.

They have all been steady work, but not rushed off my feet, lots of waiting on attendings to present to or waiting on blood work/images to come back. They have a strange system here, whereby there is no medical admissions, so patients just sit in the ED until a bed is found on the ward for them (some patients wait a couple of days!!). This means they then block beds in the ED, so the wait goes up to about 8 hours for non urgent stuff ... its pretty poorly organised as a whole. They all look at me in horror when I explain the 4 hour rule in England.

I have seen loads of cases so far, we get everything and anything and work them up, then decide what to do with them. I was even discharging patients without the attending ever examining or speaking to them on tuesday ... responsibility has jumped up to proper doctor level! A lot of the complaints are routine stuff that perhaps would go to the GP in England, then there seems to be tonnes of abdo pain ...

I did my first ever digital (finger) nerve blocks on tuesday, then pulled a nail out of the guy's fingers (the idiot managed to nail gun his fingers together - accidently) and suture him back up again. Good fun. Today, I got the lovely job of making an incision in a perianal (bum) abscess ...ew. Luckily not too much pus came out. I also plaster casted a broken wrist, that was good. My practical skills should be pretty good by the time I finish!

Unfortunately bit too tired to make the most of our day off yesterday, so just went to Walmart and brought some trainers so my feet don't die quite as much form all the standing. Though at least last night we got to eat dinner like normal people - they don't give us breaks on any of the shifts which is a bit weird. Getting used to the way it all works, their systems are so different to ours and they use the same drugs but with different names, or have completely new protocols for prescribing depending on the problem which is making it interesting.

One patient asked me today if I was anaemic ... her boyfriend then chipped in with "its cos she's from England" ..... I politely informed them that no all english aren't this pale, just me.

xxx

Rich's View 2

What annoys me about canadians:

• They are CONSTANTLY happy (at least in britain if you are happy you keep it to yourself!)
• They are UBER pedestrian friendly (its a bit like if a donkey walks near the road in england, every car stops and waits for it to decide whether it wants to cross or take a dump on a parked car- in canada they stop for us to cross the street even when there isnt a junction. Then they dont even honk at me or sam, when we then take 10mins to work out if its "normal" and then attempt to cross said road in an appropriately appologetic manner.)---------in hindsight we recon this is because the ppl of newfoundland find "people walking" so rare that they are simply baffled into stopping and staring at us in awe/horror.
• They are fearless patients (was given a patient to painfully suture his hand up after he stuck it on an angle grinder and he was happy for me to do this even though he knew i had never sutured in my life! )
• They all know someone from england (who turns out to be a great aunt twice removed from cork in ireland. i think i hear st patrick turning in his grave)
• They dont understand the word "toilet" (apparently they take a dump in their bath??)
• They take the piss out of MY accent!!!!!

Urgh ... tired. Don't think there is life and the ED!

So we started yesterday at 7am with our ED induction at the Health Sciences Centre (bigger hospital), which basically involved the attending showing us the charts and where to put them once we had completed them! Then followed a tedious intro to the hospital in general, an hour walk around it getting highly confused and some IT stuff. Got home at 12, but had to go back for 2pm to get our security ID's, then race over to St Clare's hospital for my 3-11pm shift! They expect much more here than they do in the UK, clerks here do everything and are effectively non paid F1/2's, so we have gone up in the world rather rapidly.

So I am shattered ... my feet are blistered ... they don't believe in giving us breaks during our shifts ... and it's busy!

But it is good, I sutured a guy's thumb back together, which was fun. That is the first time I had done any suturing on a person, and the attending just gave me the kit and told me to get on with it - luckily the patient was an older bloke who wasn't too bothered about scarring! I ordered my first 'consult' for a broken hip and have learnt some of the crazy new drug names.

I was meant to be in the majors section, but that was quiet so I ended up clerking in the 'fasttrack' bit - a glorified GP centre, that the locals all use when they can't see their family doctor or just don't have one. So it was abdo pains, bumps and bruises and cuts etc. Standard GP type stuff, though a nice fairly easy intro into the Canadian system. None of the older patients can understand me at all ... they sound like a combo of irish and cornish so I'm having as much difficulty understanding them too!!

Hips were pretty sore after yesterday leftie worst, but dosed up on the painkillers and carried on. There is a lot of moving, but its sitting, standing, sitting, standing so not too bad. And we get to wear scrubs!! (though this does mean I brought all my smart stuff over for no reason)

Got a 5-midnight shift today at the health sciences in unit 2 (majors) and a day off tomorrow.

xxx

Exploring St John's

On Saturday we walked downtown (about 40 mins over hills) and had a look around, its very strange here because there is no "centre" of town like in all UK cities. Instead people shop at malls which are on the outskirts and therefore there are only posh boutique style shops in town and lots of coffee shops. It's a nice city, though small - 180,000 people in lots of colourful wooden houses - I think they got the dulux colour palette and went a bit wild ... will try to upload photos soon.

Today we had a lie in woohoo, then went to Cora's for brunch, que a big crepe fat filled with raspberries and nutella. We have learnt several things about Canada so far - everything is supersized - Big cars, Big portions and BIG people, in fact NL has the largest number of obese people in the whole of Canada, so chest pain will be the order of the day in the ED me thinks.

I still appear to be as fascinating here as I was in the far east ... I'm not that pale!

Also, we think some very strange bloke found NL (probably a gynaecologist), as they seem to have the dodgiest names for places - DIldo, Placentia bay, Conception bay, Pippy Park and Quidi Vidi lake (pronounced so it sounds like kiddy fiddly ... ) ....
xxx

Rich's view (a bit like in the "real live story" from love it)

Blogs are gay, however, as im not the manliest man in britain (or indeed in canada) and more importantly sam is making me write something, I shall be adding my own 2 cents to some of the bloggy things

St Johns is a bit like going to a cornwall, most of the ppl have two heads, but they are a friendly bunch so it doesnt seem to bother you too much. I recall having a cheery conversation with a till worker in the local supermarket, it went something like this:

rich: good day kind sir, i would like to purchase this six pack of lager beer if you dont mind
till worker: yooouh'v a tilloncaaard(?)
rich: pardon
till worker: yooooooooooouh'v A tillon caaaaaaard
rich:................ um....
fellow shopper in queue: ooooooo ay a got one!
rich:........i would like some beer pls?!


You see the ppl of newfoundland have a unique blend of accent encompassing irish, cornish and american, with a zing of french.... i think.... Which making conversing both interesting and challenging.

I cant wait for monday when we start taking histories!

Rainy Toronto, Hooters and the middle of nowhere!

Hey

So we made it to Toronto on wednesday, 3 hours late. We were taxi-ing towards the runway when we had to come back to the stand because a woman was ill, her whole family (all 7 of them) were then taken off and it took over 2 and a half hours to find their numerous bags... So we just found food and crashed after arriving.

Thursday, it decided to rain on us lots, so the plans to do the CN tower (couldn't even see it most of the day as the fog was so low) and other sights of Toronto failed. Instead we found a shopping mall and traipsed around that for a while, then chinatown and the harbourfront. I'm sure Toronto is quite nice in the sun, but its a bit dismal in the pouring rain.

For dinner, I managed to spot a brightly coloured place called 'Hooters', which looked quite busy and therefore promising... we got inside and it slowly dawned that there weren't exactly many other women in there, and those that were, were wearing not very much consisting of hot pants and a see through top ... OOPS. Ah well, Britishness dictacted we couldn't really leave and the food was actually ok! Though the service was a bit full on in more ways than one lol, despite me saying no thanks 4 times to another coke refil, my half full glass got removed and replaced with a full one anyway! (it was free luckily)

Then today we flew over to St John's, on our way over we could see how baron it is in Newfoundland, literally nothing but lake after lake surrounded by completely empty land. St John's itself seems nice so far, we are staying in a student house with 5 German students all on placement in different areas of the hospital. They seem lovely and have already given us good tips on what to do/see etc. We have found the supermarket is ridiculously expensive, apparently because they can't grow anything here, so its all flown or shipped ... £60 for not even half a normal food shop we would pay no more than £20 for at home - so the budget is going to need to be increased I think!

We are probably out to the pub later in downtown St John's with the new housemates, if I can still walk by then, hips not too happy as did quite a lot of walking yesterday. Also going to venture to try and find the Walmart tomorrow to see if that is a bit cheaper, as otherwise we are going to get scurvy (£6 for 4 red peppers!!).

xxx

Packed and Checked in! T - 14 hours ..

I am all packed and have checked us in already... complete with a snazzy new blue wheeley suitcase as the rucksack was a bit too small and was hurting my hips to carry so que a dash to tesco's this afternoon. But it is packed now and I haven't even used the expandy bit so I can bring extra stuff back ... hehehe! Just got to sort all the admin forms for immigration because we are on temporary resident visas and have to prove we have funds/ticket home etc. So much stuff to do ... T-14 hours until my bus and counting.

We got our shifts for A and E for the next four weeks, not great but a lot of variety. We are also going to two different hospitals which wasn't what it said before! It does seem that whenever I have time off Rich is working and vice versa, so thats not too brill, but we get 2 sat/sun's off in the 4 weeks. There are a lot of later evening shifts so I'm guessing thats when they have the biggest patient load, so should be more interesting! I also wonder if our shift patterns match one of their doctor's, so we are assigned to someone at all times, who knows?! We shall find out at our 7am orientation on monday!!

Will check in again on Friday when we hit St John's and had a day to explore Toronto a bit,
xxx

not so good with the technology ...

Hey, so I thought I would have a go at the blogging thing to let everyone know what we are doing in Canada instead of emailing ... but I'm not overly good at using technology so it may not work so well.

We fly on wednesday to Toronto then onto St John's on friday to start the actual elective on the 27th july. I am doing four weeks Emergency Medicine and four weeks Paeds Ortho at the children's hospital next door, Rich is doing the first four weeks with me, then four weeks Critical Care at a hospital run by nuns - hehehe! Then we have three weeks travelling, but haven't decided exactly what to do then yet, decided Montreal, Quebec, Mont tremblant and parc algonquin should be visited though kinda depends on my hips.

Just attempting to pack at the mo, though the stuff to go in the bag is growing rapidly ... Also trying to sort out all the admin forms etc to take and hoping not to get swine flu in the next 3 days!
xx