Gillian Lever ❄️
@gillybean712
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Yorkshire-based Anaesthetic Registrar, long-suffering cannulation servant & jazzy crocs enthusiast ♻️🌍 Proud member of @GHASProject ! She/Her
Somewhere near the M62
Joined April 2009
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Pinned Tweet
The Great British Laparotomy, an Anaesthetic Night Shift Tale 🧵
#MedTwitter
#AnaestheticTwitter
#SurgicalTwitter
1. Shift begins and Novice is doing their best to motivate SR on night 4/4
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Me taking my only friend, the ultrasound scanner, round the wards providing the cannulation service I always dreamt of when I chose anaesthetics.
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The Trust: “You can’t take your bag into the anaesthetic room”
Me: “Ok, then I will need a locker please”
The Trust: “Well…erm…well…no”
Meanwhile signs all over staff fridges reminding people not to steal food but the Trust think that my bag will be safe lying around
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A new week, a new thread…
Hyacinth Bucket* as the Intensive Care Consultant, a 🧵
*IT’S BOUQUET!
#MedTwitter
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Today in A&E I asked my heart failure patient if he had been gaining weight...
Patient whips out exercise book containing his OWN FLUID BALANCE DIARY that his wife has completed EVERY DAY SINCE 2017.
I apologised for admitting him - fluid balance book will be ruined instantly!
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ICU reg when people ring to “make them aware” of a patient
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The novice anaesthetist I was working with today introduced himself to the patient as Dr X and then introduced me to the patient as Gillian 😒 lovely.
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On call this week and ordered myself a cheeky Nando’s lunch today…of course my bleep went off just as I bit into my chicken burger but my SHO colleague was like “Nope!”, took the bleep off me and let me take my sweet time over my glorious lunch 🥰
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I’m starting ST4 in the same hospital where I started as an FY1 (in fact I haven’t worked there since FY1). I remember my first day vividly - didn’t eat, stayed late & cried when I got home BUT all the registrars I called for advice were incredibly kind and patient 1/3
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My non-medical friend asked about how I become a registrar and I showed her the points grid for ST4 recruitment.
The horror on her face
“But you already work full time!”
“How are you supposed to have the time to do all these extra things?”
“D of E expedition leader?!!!”
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I am a little bit in shock! After 7 years (!) of being an SHO I am going back to my original Yorkshire home to be an Anaesthetic Registrar ☺️
Took a village - I am so grateful to everyone who helped me with portfolio evidence, interview prep and emotional support 💛
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Put in a cannula recently that I wasn’t sure was in properly. Flushed it to see and a second later the patient smacked their lips and I knew it was fine 😂 does anyone know why some people can taste the saline flush?
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This week I had my first trache emergency - a bit scary but I managed ok. I realised a lot of the stress I feel during sim is actually embarrassment & in this real life situation I felt surprisingly calm. Sim is helpful but I’m not sure it fully reflects who copes under pressure
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As I start this next chapter where (terrifyingly) people will now be ringing *me* for advice, I will be trying to channel the lovely regs I spoke to that first day. They welcomed me to the club and I felt like I belonged.
Good luck to all the new FY1s!
We’ve got you 🫶 3/3
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I present
“It’s not called a Water’s Circuit Actually” - Tales from the theatre corridor ❤️🧵
1. Trauma Theatre is empty! Turns out no one wants to come in for an operation before Christmas. Trauma Anaesthetist decides winding up Orthopod is the best use of their time
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Today was a big day for me - did my first case start to finish with my registrar in the anaesthetic room ☺️ best moment was when he (and another SpR) couldn’t hold back and came in and cheered with the ODP when the patient was safely asleep and intubated 🥳 yay ☺️
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Currently on A&E block, resus pt needs airway support.
Anaesthetist knows I’m ACCS (An) & without me asking...
“Come do bag-mask ventilation”
“Gill’s doing the tube”
“Take your time, no rush, I’m right here, you’re ok”
Successful intubation and I love my chosen specialty 😭💙
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Anaesthetic consultant was discussing pros and cons of anaesthetics as a career…
Cons: “Most of the general public don’t think anaesthetists are doctors”
Me: “Well I’m a woman so…🤷♀️”
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One of the anaesthetic SpRs who rotated today declined consultant offer of coffee and I don’t even know what is going on here 😱
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Bit concerned about human factors implication of having a red strip on a saline flush especially in intubation situation. Would be so easy to mistake this for NMB.
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Went with two female doctor pals to register at the hospital library. Male librarian gave us forms for nurses. We told him we were doctors & he said “I don’t know why I thought you were nurses!”
We were all in scrubs, stethoscopes, ID badges stating “doctor”
But we are women.
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Finding Novice, a tale of the hospital’s most junior anaesthetist 🧵
#MedTwitter
#AnaestheticTwitter
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Pleased to report that having a whole Terry’s chocolate orange as an exam “snack” was a great decision and I passed the Primary MCQ 😅
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RESPECT form of the week:
“For ward based care unless patient requires HDU”
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Talking to a more senior colleague about finding balance with work & telling her I found it hard to say “no” so took on too many projects. She nodded sympathetically then at 10pm that night texted to ask if I would make a presentation on hyponatraemia for the next day 🙃
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Another middle of the night transfer to Tertiary Towers and this time the Paramedic offered us snacks from her amazing snack box before starting the return trip!! 😁
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Ward team called me for cannulation service today… when I went to meet the patient she said, “Doctor, you wouldn’t believe how many pricks I have had today!”
I promptly burst out laughing then the patient realised what she had said and absolutely howled 😂
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@Manoj_Wickram
Flushed with my salty tears caused by being the cannulation service all night
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Ward referral fees today:
🩸Bloods = 3 Quality Street
🩸Cannulation = 5 Quality Street
🩸Cannulation where I have to go and get the ultrasound from the other side of the hospital = Please open the Celebrations now…😂🍫
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Senior trainee recently made the astonishing suggestion that it would take 30 minutes to create a 30 minute teaching session for other trainees 🤯
My dude you are DREAMING
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14. Anaesthetic consultant gets chatting to Novice. Turns out Novice doesn’t like coffee, isn’t into cycling, and doesn’t have a burning desire to do a triathlon.
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So relieved to report I passed the Primary OSCE/Viva! Just want to say thank you so much to everyone who helped me prepare - I am so grateful to you all for giving up your time 🥰
I am on call today so celebrating with a lemon Fanta and a magnum 😂
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Today I put in an epidural and had an interpreter on the phone whilst I did it. When we told the pt that it was finished (<5min) the interpreter was so lovely and said “Well done Doctor!”
I have never been congratulated by an interpreter before. This may be a career high 😁
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Labour ward handover is acronym salad
“Multip 35+4, PPPPSROM with PET was MLC now CLC, PCR 80, low PAPPA-A, IUGR, on mag, having IOL synt on 1.2, she’s 3 in 10, last VE 5cm OAT, CTG suspicious with early decels”
Me: “Does she…want an epidural…?” 😅
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After an obstetric Night Shift of back-to-back sections I managed to get myself to the newly refurbished local lido this morning for a lovely swim! Didn’t think I could motivate myself because I am like a zombie but really proud of me for following through! Totally worth it 😁
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18. There is an ICU bed available! Anaesthetists happy, Surgeons happy, PACU staff happy, but mostly…NELA happy. Fin.
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7. Novice is asked to draw up drugs and can be heard mumbling, “something to get them to sleep, something to keep them asleep, something to keep them still, something for sickness, something for pain, emergency drugs…”
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I rang haematology
Haem SpR: “is it your first day? How’s it going? It gets better! Tell me about your patient”
Micro SpR rang the ward to discuss a pt I had never met
Micro SpR: “that’s ok, you have the notes and the obs and the drug chart, that is a great start” 2/3
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A junior doc from another specialty bleeped me. I answered “hello it’s the anaesthetic SHO” She launched into a long story. Became clear she had bleeped the wrong number (wanted medics) so I told her.
She then proceeded to TRY AND BLAME ME for her bleeping the wrong number?! 🤯
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Can we please abnormalise doctors saying to other doctors,
“Didn’t you learn this in medical school?!”
It’s happened to me and it’s happened to colleagues and on no occasion has it been helpful. Just fuels the imposter syndrome tbh.
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A New Year, a new 🧵 (trying to distract myself from all the NHS sadness)
Dr Mike Wazowski, Anaesthetic Trainee, rotates to Little Monsters Hospital Inc
#MedTwitter
#AnaestheticTwitter
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@DrJSherrington
Teaspoons! The staff room where I used to work had a teaspoon attached to a long wire literally bolted into the wall 😂
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Survived my first set of solo nights as the obstetric anaesthetic reg 😅
Feel like a zombie now but really proud of myself overall for managing 🥳
(11 epi, 5 CS, 2 perineal tears, many cannulae…no idea how workload compares to elsewhere but felt…ok?!)
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9. Patient needs a dose of Teicoplanin and Novice disappears to draw up. Time passes and SR finds them shaking the Teicoplanin like a maniac with two wasted vials that have exploded sat in puddles on the side
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Anaesthetic friends - Are there anaesthetic machines with USB ports?
I feel this would be an excellent addition!
Means we can charge our phones without needing to stand up from the chair of anaesthesia, which we know can be disconcerting for our surgeon friends
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Just finished my last CT3 shift & the theatre team are the cutest 🥰 gifted me my favourite treats including the best biscuits!
It’s the longest period of time I’ve spent working with the same team & they have played a massive role in my development. Rotating is hard 😔
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Being a Novice anaesthetist means literally every day is a school day…and some school days are a bit scary 😱❤️🩹
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Public service announcement for anyone who didn’t know - M&S sell frozen versions of (IMHO) the best almond and hazelnut croissants so you can enjoy them hot and fresh from the oven *at home* 🤤
Also I live alone but they are both for me.
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@DrSidSeth
Honestly it was *full* input/output with daily weights! She had also written him out a drug chart and ticked when meds were given! Wife was retired Senior Sister which explains a lot...
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This week I’ll be on strike with JD colleagues✊
When not on the picket line I’ll be revising for an exam to progress in my training. My colleague will be working on her trainee portfolio.
We are using strike time for work related activity. JD work doesn’t end when shift ends.
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Mid-Caesarean
Pt: Oh I could never be a surgeon!
ODP: Well I guess that makes sense given that you’re here having a baby
Pt: ???
Everyone: What did you think she said?
ODP: “I could never be a virgin”…?
🤣
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I have always hoped one day I would get to work with medical school friends again and it has happened! A really lovely surprise doing our first nights as regs together ☺️
@willboltontiger
Neurosurgery SpR and me, Neuro ICU SpR! Yay team brains 🧠
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Went to an excellent paeds course recently - genuinely the best postgrad course I’ve ever done. However, I was laughed out of the room when I asked about using VL in very smol people.
I have now intubated a 3 month old and a 4 month old with VL and it was… *chefs kiss* 👌
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@zackferguson
You joke but during the 3-hour Primary Written exam (online) we were allowed a single 3 minute bathroom break. Think one of my main concerns sitting that exam was the risk of needing a poo 🙈
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All my internal feelings whilst putting in a spinal and having the foetal heart rate very loudly announced every 3 seconds.
This practice has great evidence at making the spinal:
1. Safer and
2. Faster 😑
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17. Ward round is finally over and she leads her junior entourage to the Holy Land…the hospital coffee shop. Much better. Fin.
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Got an exciting new laryngoscope badge for my lanyard but it turns out everyone thinks it looks like a sickle and I’m repping communism instead of anaesthetics 😭🙈
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11. ODP brings the first blood gas result and before Anaesthetic Consultant has said a word they are setting up the rapid infuser
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12. Despite attending mandatory training last month SR and Novice now cannot fathom the new blood prescription charts that have too many colours and only have space to write 3 units per chart
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Cons: “What size ETT will you choose?”
Trainee: “The one the ODP gives me”
Cons: *Nods in approval*
Happy ODP day!
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HRI picket has grown nicely! ✊ Thank you to the people of Hull for your incredible support and thank you to our amazing SAS, GP and Consultant colleagues who are keeping everything running safely inside 💙
#JuniorDoctorsStrike
@BMA_JuniorDocs
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3. SR calls the Anaesthetic Consultant, who is thankfully still in the hospital and just finished their 12th coffee of the evening
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Something so special happened today! I have been parading my strawberry crocs around work for a few weeks now and one of our scrub nurses has made me MATCHING STRAWBERRY SCRUB HATS!🍓
I didn’t ask, she just made them!
What a lovely lady and what gorgeous hats! I am so happy! 🥹
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@GinnyAB
I didn’t at the time (think I was a bit stunned!) but after the support on here I think I will have a quiet word with him about it.
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8. Patient arrives and the surgical team want to crack on so get scrubbing
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Obs theatre is more fun with Language Line
Interpreter: I didn’t catch that word
Obs reg: Labia
Interpreter: Sorry what was that?
Obs reg: Labia
Interpreter: Say it again
Whole theatre: LABIA!
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First time in MRI and I am glad I had a consultant there to reassure me that during MRI the ECG “will often look very weird” 😅
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5. As they move to the next patient, Consultant spots the patient opposite trying to pull out their fluoroscopically inserted NG tube
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University Challenge tonight had a basic diagram of a neurone and I got all the labels right so think I’ve probably got FRCA in the bag
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13. Surgical team keeping anaesthetic team informed of progress
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Anaesthetists of Twitter please can you share your labour epidural tips! The epi rate in my hospital is so low I’m not getting enough experience to know what technique suits me (or the range of options!)
Would also appreciate any “get out of jail” tips for when it’s tricky 🙏
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17. Surgical SHO is left to fit the stoma bag…Anaesthetic Consultant turns off the TIVA
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2. Inevitable call from the surgical team - there is an emergency laparotomy
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Me and my ODP were discussing the junior doctors strike with our patient and I said I would be going on strike…
Then my patient piped up “GOOD ON YOU GIRL! Solidarity!” ✊🥹
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Lindsay Lohan as the medical SHO(s), a thread:
@admit_medics
how did I do?!
#medtwitter
#parenttrap
Arriving for their first shift on AMU, they meet the consultant who was only expecting one SHO on their service
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I have embarrassed myself twice now thinking that there was a sevo leak in my circuit and spending ages hunting for the issue and getting my ODPs involved in the mystery…turns out there is a men’s aftershave on the market at the moment that - to me - smells like sevo 😂🙈
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@RoshanaMN
@cannula_service
@uhbtrust
@PreetKGillMP
Just heartbreaking 💔 to add insult why have the BBC called Dr Vaish Kumar “Ms” throughout the article? She was a doctor and should be titled correctly.
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6. Anaesthetic Consultant wants to do TIVA and the hunt for BIS/Entropy begins
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12. Therapy horse arrives on The Unit and Consultant still isn’t sure how she feels about this particular choice of animal for therapy purposes
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4. It’s time for ward round and the juniors are presenting the patients. Consultant tries her best to be supportive and encouraging
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Nights currently atrocious, pressure is indescribable. My Consultant was up most of the night with us 😟
Positives:
1. Said consultant emailed us all to say thanks and well done
2. Amazing teamwork
3. I put in 2 CVCs overnight where not a drop of blood reached the inco sheet 😇
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4. Patient is in resus so the Anaesthetic team head downstairs
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Scenes this week when I turned up to an arrest to find the Consultant General Surgeon managing the airway like an absolute boss 👌
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14. The ward round is starting to drag and caffeine deficiency is at critical level
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I really enjoy writing comments on MSFs for colleagues and I try to keep it professional but sometimes I just want to write “Dr X is a good egg” because I cannot think of a clearer way to say they are someone to cherish in our profession 🥰
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“When you start cycling to work then maybe I’ll stop using nitrous”
Another day another dinosaur 😑
I drive a hybrid, rental flat so no setup for electric & have no choice of hospital rotation. I am doing my best. It’s not a race to the bottom.
@GASPAnaesthesia
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On transfer, paramedic waves to another ambulance…
Me: Oh that’s nice that you wave to each other!
Para: Yeah! We always wave to each other and we wave to the police!
Me: Presumably you wave to firefighters too?
Para: No, we have beef with them because they never wave back! 😂
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3. She’s made the decision for own clothes instead of scrubs today and it’s a whole new flex trying to avoid touching anything
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10. Patient is unzipped…“There is faecal contamination”
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13. However Matron reminds her of how she coped with the previous therapy dog
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@MSharifpourMD
Agree!! Cannulae without wings are the worst (in adults)! Surely though, this is the most superior of the pink cannulae…?
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2. The night registrar delivers the handover but Consultant is keen to start strategy planning with her consultant colleague as soon as possible
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ST4 anaesthetics interview booked 😅 Have been in some sort of weird fever dream all day refreshing Oriel every 5min and watching Green Wing to distract myself 😂 I’ve had more productive days but so relieved the interview is actually happening 🙂
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9. One of the vascular patients needs a new arterial line and she sends SHO to sort it out with strong encouragement
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My anaesthetic department is planning to phase out our remaining desflurane vaporisers before I rotate in August. This is EPIC news! 💚🌱🥳
@GASPAnaesthesia
@alexiskeech
#ditchthedes
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