Bleep-Bleep-Bleep (Part 2)

My recent relationship with the on-call bleep these past few days has been, to say the least, bitter. Having thought about all the calls I received, I've managed to categorise them:

Trash-bleep: "Hi doc, just called to let you know...." . This sentence infuriates me as 80% of the time I'm told some pointless drivel, and mostly it is to shift any responsibility away from the ward staff to a doctor who may know nothing at all about the patient. If you're going to call me, have a legitimate question you need me to answer.

Ghost-Bleep: How many times have you called back immediately and then no one answers? What is the acceptable number of rings before you give up? If you're going to bleep someone, please wait by the phone or be within an immediate 5 second radius! I haven't got time to be waiting for you.

Prank-bleep: "Hi, you're the surgeon, do you cover [insert alternate specialty here]". Just because I'm a surgeon, it does not mean I cover all the surgical specialties! If you don't know who to call, ask a colleague or switchboard first.

Ping-pong-bleep: If you're going to call me to refer a patient, please have all the information to hand, including basic demographics, relevant history and obs. It's just courtesy. If you have to put down the phone to run back and forth somewhere else to answer every question I ask, I will hang up.

Repeat-bleep; Please don't bleep me to ask a question that someone else on your ward/department has already bleeped to ask me. It is a waste of both yours and my time with constant repetition.

The Echo-bleep - Some people feel it necessary to bleep multiple times successively within a space of 30 seconds. Why? If anything, I'm less likely to respond to your rudeness.

I admit, I don't see any feasible solution to overcome these categories. Common sense and lack of team communication will continue to render pointless bleeps. Perhaps we still need to consider a smartphone messaging system as in my Part 1 post.

Code Black

That time of year has once again snowed upon us where the A+E department admission increases exponentially. As the elderly chill in their unheated homes, fall victim to the flu virus, asthmatics have increased attacks and the young continue slipping over in the ice sustaining nasty lacerations - we fight on, ploughing through the cards in the "to be seen" box.

In my hospital, this month has such overuse of capacity that every surgical ward is now littered with acute medical patients - it is what they denote as "Code Black status". Most of November was a "Code Red". Following from my previous post, now the medical teams have to leave their comfort bubble of their home ward and embark unto various surgical wards - but which medical team is responsible for medical patients on the orthopedic or general surgery ward?

Even more interesting is that the medical director feels it is necessary that the surgical SHOs assist the medical take during "Code Black." This is absurd! It is understandable that suddenly, their teams are stretched and now end up with Safari ward rounds. I argue, surgeons have always been doing this. However, asking me to review and manage a medical patient admitted with IECOPD on a background of CCF and CKD is out of my depth. If I prescribe something for a medical patient, what is my medicolegal stance - will the medical consultant support my error? I doubt it. Instead, it'll go back to the GMC and state I'm incompetant and risk losing my license.

Would you want to be seen by a surgeon if you came to the A+E with acute chest pain? Imagine the conversation:

Me: "Hi I'm the surgeon on call today, Mr Steth. I understand you have some chest pain..."
Patient: *horror face- at the thought of needed an operation for his suspected heart attack*

What purpose do I fill seeing such patient in A+E when I have no role in the medical post-take? Surgeons chose surgery for a reason - not to be demoted back to acute medicine. 

Interestingly, I haven't found any regulations regarding the cross-covering of medical-surgical specialties. This is a gray area that will need clarity. I don't deny that managing medical take is a challenging task - but there is a reason I chose to be a surgeon. Being involved in the medical take is not one of them.