I really struggled to get up on Friday. I arrived at Jooste at 9h20 and still found the ward-round nowhere near finished.

After the ward-round finished I spent some time doing ward-work. I took an ABG and VBG from some patients and took some bloods. I put up drips.

I saw a 33 year old severely wasted HIV+ TB+ patient who was suffering an acute deterioration of function. He complained of leg weakness. He had a cough and was leaking urine unintentionally onto the bed. He also defecated on himself a bit. After quite a struggle I managed to get a nurse to do a dipstix and found out that he had HIV associated nephropathy. His blood gas showed that he did not have a lactic acidosis. It’s also possible that he had developed MDR-TB

I took a very breathless woman to the side-room to do femoral venepuncture on her. I initially did try take venous blood from her but she had shit veins. She was very short of breath, possibly gasping, and very confused once I got her to the room. I hooked up her oxygen and eventually managed to get the blood and get her back to the asthma corner where she was sitting. I told the doctor that she was very confused and I thought she was retaining CO2.

A few hours later they found her lying dead in the bathroom.

It got very busy later on. There were patient lying on stretcher on the floor. There were no psych patients that required sedating. A gun-shot abdomen came in and was placed on the floor of the resus room for a period of time.

I asked the doctor running the rotation if I could join his rotation for the rest of the block. I will be working the graveyard shift for next week