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SAS doctors are staff grade, associate specialist and specialty doctors. They typically are four years post qualification with at least two years in a given specialty and spend the majority of their time working in the NHS.
Dr Amer Jafar is an Associate Specialist in Care of the Elderly at Aneurin Bevan University Health Board
I start my day at 9am with a white board meeting to discuss the progress of my patients and their discharge plans. I raise a few questions about the availability of social services for a stroke patient that I would like to discharge early with support in the community. The meeting is positive.
At 9.30am, I sit with the foundation doctor on the ward to go through the blood biochemical results of the patients on the ward. We have two patients with low potassium levels. We review these urgently and start them on intravenous fluids with KCl supplements via a pump. As it’s a Friday, we see all patients on the ward before the weekend.
At 11am, I write five discharge letters to the GPs of my patients following their discharge from the hospital. I complete the letters online and I rush to help another colleague who finds herself overwhelmed on another medical ward, as she was on her own today. We started assessing a patient who is septic, following the Sepsis 6 protocol. I spoke to the next of kin of my patient and we decided to escalate the care; I transferred the patient to an acute medical assessment unit for further management.
At 2pm, I joined the front end of Royal Gwent Hospital to review patients who came through emergency services for expected stroke. The staff nurse mentions that there are four patients awaiting to be reviewed. One of the patients is an elderly woman with slurred speech and mild weakness on her left arm. I notice that she has a dressing on both of her legs. I admit the patient under the care of the elderly team as she was displaying signs and symptoms of cellulitis. Her TIA (transient ischaemic attack or “mini stroke”) can then be supervised by our team locally.
At 3.30pm, I speak to the general practitioner of another young patient who has been complaining of numbness in her right upper and lower limb. She has been referred to me as a stroke patient. The specialist stroke nurse has managed to arrange a CT brain scan for the patient, which has come back as normal. After the clinical examination, I make sure that her symptoms are actually functional and not pathological as psychological factors can have a lot to do with it. I then inform her GP and offer all possible support for her.
I continue reviewing the new referrals to the medical assessment unit until I notice it’s time to hand over to my out-of-hours on call colleague. Until tomorrow.
If you’d like to provide ‘A day in the life of’ in your specialty, email [email protected]