Do you know what fluffers are? I am sure you do. For those of you who are sweeter and more naive, Fluffers are professionals in the adult entertainment industry whose job it is to keep the male “stars” in a state of perpetual readiness for when it is their turn to be on set, as it were.
Fluffers should be the inspiration for every FY doctor about to commence a ward round; the observation chart, the drug prescription chart, the fluid chart and the blood sheet should all be to hand for every patient, the notes immediately to hand and the nurse for each bay identified and informed that the ward round is about to begin. The aim is to keep the consultant ward round moving and keep them happy, in a state of perpetual readiness and contentment. The senior person doing the round should flit from patient to patient, like the Queen being manoeuvred through the crowds at a royal gala film premiere, or Putin on a tour of a power plant.
Keep them moving, keep the information coming and give them what they want.
Tell them what they like to know, find out their little peccadilloes and peculiarities. It may be serum phosphate, it may be the antibiotics, it may be nasogastric tube aspirates; find their thing and make sure you humour them.
My things that I like to know from the juniors, without me asking, are all abnormal bloods, the potassium level (even if it’s normal), the C-reactive protein change since the last time it was checked (not just the meaningless value), any antibiotics and for the emergency admissions the urinalysis. Why do they never remember to check the urinalysis? They make it so easy for me to seem clever when they miss all the UTI’s and renal colic.
Ward rounds are your chance to show how smoothly you are running things. Bring gloves, be prepared, make sure you know who has done a poo and who hasn’t, who is burping non stop and who is passing flatus every hour on the hour.
When I was a girl I used to come in at 6am to prepare for the professorial grand round and I would conduct a mini pre round ward round to make sure I knew what I was talking about. I don’t expect anyone to do the same but if you do, you’ll get some teaching on the ward round instead of us spending all the time checking up that you are doing your job properly.
This man doesn’t look well at all, have you passed wind today sir?