Cry wolf, and still I come

I am bound to my bleep. I carry that absurd relic of technology around, dragging out of the pocket of my lightweight scrubs and it makes me a slave to one way communication.

There are different ways to be summoned by a bleep. The least urgent is just a couple of bleeps with an extension number that flashes on the screen; you might return the call in minutes. In an emergency, you are summoned with a different sort of noise and a crackly voice message telling the relevant team where to go and when: ‘Trauma alert A&E resus ten minutes’.

Then in a particularly pressing emergency, you hear a couple of fast bleeps and a voice, telling you, specifically, to go somewhere, immediately.

This is the type of call you drop something and run for.

‘Intensive care registrar to A&E resus immediately.’

I wasn’t yet finished morning handover when I got this message, but the consultant said ‘you’d better go, I’ll fill you in’ so I left and scurried down two flights of stairs, along a corridor, turned left in the foyer, down to the end of another corridor, left again, through some double doors, through the major injuries department and then arrived; to one patient, one advanced clinical practitioner and one charge nurse in the resus department.

‘Intensive care registrar,’ I said. ‘You called me?’

The advanced clinical practitioner started off the tale of the history of presenting complaint. Catching my breath, after ten seconds I stopped him; ‘can you just tell me the emergency bit and we’ll get to all that afterwards?’

‘What?’ he asked.

‘The emergency bit, that you called me for; you know, A, B, C or D?’

‘Oh, well we haven’t got intravenous access and we’ve estimated 500ml of blood loss.’

I looked at the monitor; heart rate 72 beats per minutes, mean arterial blood pressure 62, saturations 100 per cent, normal respiratory rate. I looked at the patient; awake, alert, pale lips and pressure dressing on her groin, no active bleeding.

‘Has anyone else here tried?’

‘No.’

‘Have you looked with the ultrasound?’

‘No.’

‘…and that’s what you put out the fast bleep for?’

The practitioner seemed irritated and said ‘Yes. Do you think that’s it’s inappropriate to call you?’

‘No’, I replied, ‘you’re always welcome to ask for help, but I think it was an inappropriate use of an emergency fast-bleep, but anyway, let’s leave that for later’.

The charge nurse wheeled the ultrasound into the cubicle and I placed two cannulas into the patient’s arm.

The practitioner had gone to the bench to write his notes and so I approached him and said that I was sorry, if I had seemed grumpy, but I didn’t feel that was an appropriate call. I told him that I am a registrar who will always run to an emergency if asked and that I didn’t want that to change.

The patient was still stable, so I left, still a slave to that little black boxed relic of one-way communication and knowing that because it is my job too, to care about the flock of sheep, that I would in reality, always find myself running to a boy crying wolf.

By the Secret Doctor

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