I'll be honest. This week of nights at Kingston has not been kind to me. Lots of handovers, lots of admissions, lots of MET calls. It seems Kingston has just managed to admit all sorts of sick patients before I start work every night.

Last night was a kicker though. I arrive at 10:30pm to get handover from the evening HMO. The registrar was sick so Kingston was being covered by two HMOs instead. They had been called to a MET call at 8:00pm for a patient who was hypoxic at 84%RA and drowsy. They saw the patient, applied high flow O2 via a Hudson mask and then...left??? Seriously, I couldn't believe the handover.

"Patient is hypoxic, I just got paged to let me know he is still 94% on 6L but I asked them to wean the oxygen as they can"
"OK, why do we think the patient's hypoxic?"
"Well, he was seen choking a bit on his dinner so maybe he aspirated? Also, when I listened to his chest, he had creps bilaterally so maybe heart failure as well"
"Great, so how much frusemide did you give him? Did you start ceftriaxone?"
"No...."
"Why not?"
*silence*
"Hang on. So what you're telling me is you saw this hypoxic patient, gave him oxygen but did nothing to treat the cause?"
*silence*
"OK, can you do me a favour? I have another MET call I need to go to now (pager just went off), could you please quickly go and give the patient some frusemide and tell the nurses I'll be up to see  the patient soon?"
"OK" and she leaves...

I sort out the MET call patient, about half an hour later I go up to the ward and she is STILL there, unable to put in the IV. In addition, the patient looked very sick from the end of the bed and he was now on 93%8L, RR of mid thirties and drowsy as hell.

I gave up, sent the HMO home (the other one had seen fit to leave already), put in an IV, gave the patient the frusemide and ceftriaxone he should have gotten 3-4 hours ago. Seriously, where do we get these doctors from???