Started with oncall from Wednesday into Thursday. Luckily it wasn't that eventful. Managed to catch 2 hours of sleep which was not too bad. Most sleep I got was 3 hours.
Was woken up at 4am cause there was a new admission. Naughty 2 year old put a small dice up her nose. Initially it was still visible in the right nostril but after she struggled so much while doing the head x-ray, the dice went in further and was not visible even on x-ray. ENT tried to dig it out but failed. In the end, admitted to the ward that I was covering for endoscopic removal under general anaestetics. Had to insert a cannula into a strong, struggling child with a dice somewhere inside her oropharynx which might have gone in even further after I stressed her out even more. Listened to her chest after....no stridor. So, all is still well. Sent her off for chest-x-ray. Might have seen some white shadow around the level just below her chin. Hmmm....it's gone in quite far. Had a really bad stomachache cause had my dinner too late at night when food has already gone bad but was too tired to think of my own health and just swallowed it down within 5 minutes cause new admission had arrived at midnight. Regretted that terribly.
Struggled to stay awake the whole of Thursday. I still don't understand why my energy level keeps on falling after each call no matter how much I rest. Found out during passover round that there was going to be an exchange transfusion that night. Made my friend promise to call me when it has started. Went back to my room, ate, showered, waited for call but fell asleep. Woken up around midnight....found out that exchange transfusion was going on, went back to the ward to observe and learn something. Went home around 2am.
Got called by friend who was oncall at 5.55am to ask for help to take 6am bloods. So, went back to ward, took first patient's blood and suddenly was called to sedate patient for reintubation as patient pulled out endotrachael tube. Struggled to sedate for almost an hour. Continued with the morning bloods and ward round. Couldn't be bothered to do much as was seriously too tired. Doctors in Malaysia don't get any public holidays, but at least I got a half day. Was at the verge of tears when had to take at least 6 mls of blood from a patient for some stupid research which HOs must carry out under orders from research assistants (which get paid to collect data and they by right should collect the bloods themselves) but we don't get any extra pay or recognition and patients lose more blood. Was asked to give up on my attempts at getting blood from a meningitis patient as I was ruining all the available veins. At this point, I couldn't care less for the patient. Will attack him again tomorrow for the sake of research. I'm so glad that today is the last day of this research.
Stayed back to complete a transfer summary for a patient who had been in PICU for the past 2 months. Made it super duper brief and packed my bags and disappeared from the wards before I was asked to do something else.
Counting down to New Year in my room after hibernating. Going to continue hibernation. Will go to wards by 6.30am to help oncall houseman to take bloods. Fingers crossed that my life will be smooth sailing for year 2011.
Happy New Year!!!!
Friday, 31 December 2010
Meeting up
Met up with M and YH at Midvalley. Long time no see!
Took the KTM to and fro as I'm still not confident enough to drive alone. Going was all right. The way back was almost a nightmare as the same scenario of watching people trying to squeeze into the coaches like sardines is still happening. Luckily, there were 2 trains one after the other at that peak hour and I caught the one less crowded. I even managed to find a seat.
Today's half day for me cause Malaysia won ASEAN Suzuki Cup. We definitely need to win more. Enjoying my chance to hibernate and recharge this evening. Will separate out another post about my work cause that's another category and a total contrast to this post.
Saturday, 25 December 2010
survived
Yesterday, I somehow did the work of 2 houseofficers as my other colleague was off sick. Before I came, there were 3 HOs on the Paeds ICU ward. When I started, there was only 2. Yesterday, it was only me alone. Almost died from exhaustion and nervousness as I was still unfamiliar with the work there. It's still depressing to me that I had to start work earlier and go home much later.
Oncall again tomorrow followed by Wednesday. It's every other day. Trying hard not to think about it too much.
Oncall again tomorrow followed by Wednesday. It's every other day. Trying hard not to think about it too much.
Wednesday, 22 December 2010
So unlucky
Seriously, I just don't understand how can so many unlucky things happen to me within the span of 2 days.
It first started on Monday morning, when I had to help sedate a patient during intubation. I don't know if I was too tense or too tired, but I actually misinterpreted the amount that was drawn up into the syringe that I under-dosed the patient by 1/10 of Actracurium, which is a muscle relaxant therefore, the patient wasn't relaxed and the senior doctors couldn't open his mouth at all. Luckily my MO spotted my mistake and we gave him the right dose after.
Take 2 of unlucky events:
Next unlucky thing that happened was during the afternoon presentation. The presenter before my turn used her own laptop for her presentation. But when the projector was changed back to the desktop, the screen of the monitor was all black. So, as I turned around to look at the screen behind me, I accidentally knocked my pendrive out of the USB port at my knee level and it broke into half. What a joke, right in front of all the professors and lecturers. It died straightaway. I had to run all the way back to my ward to retrieve another copy of the presentation, borrowed a pendrive to store it, and luckily managed to give the presentation in the end. Phew.
Take 3 of unlucky events:
As I was preparing the IV drugs for 4pm, I found myself struggling to open the glass vial for Ranitidine. Finally when it decided to break, I ended up cutting my index finger. Haih.....what a great way to start my oncall.
Take 4 of unlucky events:
I managed to go back to my room at 1am during oncall to take a shower and to catch a bit of sleep after. Was woken up around 2.30am as there was a new admission. I made my way to the ward only to realise that I left my bag and keys locked inside my room. Luckily I had my stethoscope, calculator and my list of things to do. Continued my sleep at one of the deserted beds in the ward before getting up to review patients an hour later. Went back to my accommodation and luckily the porter was around and had spare keys. I was let into my room safely but had to go back to work shortly.
Take 5 of unlucky events:
Assisted in sedation for reintubation of the previous patient as there was leakage and his saturations was dropping. As I was drawing up drugs with the guidance of my MO, I accidentally placed my index finger (yes, the same finger) over a vial which was already open and sustained another cut. 2nd cut since I'd started on this new ward. Haih...... went home at 8pm that day and I was postcall. Who said doctors don't work up to 36 hours. Actually that statement is true. We work more than 36 hours.
For today, I started work at 7.15am and went home at 9pm as I stayed back to attempt a few transfer summaries. I want to retire NOW! At least I didn't encounter any further bad luck.
If anyone has luck to spare, please send your donations to:
Paeds ICU, 5th floor, Menara Timur,
Pusat Perubatan Universiti Malaya.
P.s.
Saw a former patient today who was at the verge of dying from Dengue haemorrahgic shock syndrome but improved after days of infusion of coconut water. I guess we'll start trying everything when hope is all gone. The patient looked so well that no one would have believed that many gave up on her when she was at her most critical condition.
There's still miracles in this world and maybe that's why I'm still staying on this long windy path.
It first started on Monday morning, when I had to help sedate a patient during intubation. I don't know if I was too tense or too tired, but I actually misinterpreted the amount that was drawn up into the syringe that I under-dosed the patient by 1/10 of Actracurium, which is a muscle relaxant therefore, the patient wasn't relaxed and the senior doctors couldn't open his mouth at all. Luckily my MO spotted my mistake and we gave him the right dose after.
Take 2 of unlucky events:
Next unlucky thing that happened was during the afternoon presentation. The presenter before my turn used her own laptop for her presentation. But when the projector was changed back to the desktop, the screen of the monitor was all black. So, as I turned around to look at the screen behind me, I accidentally knocked my pendrive out of the USB port at my knee level and it broke into half. What a joke, right in front of all the professors and lecturers. It died straightaway. I had to run all the way back to my ward to retrieve another copy of the presentation, borrowed a pendrive to store it, and luckily managed to give the presentation in the end. Phew.
Take 3 of unlucky events:
As I was preparing the IV drugs for 4pm, I found myself struggling to open the glass vial for Ranitidine. Finally when it decided to break, I ended up cutting my index finger. Haih.....what a great way to start my oncall.
Take 4 of unlucky events:
I managed to go back to my room at 1am during oncall to take a shower and to catch a bit of sleep after. Was woken up around 2.30am as there was a new admission. I made my way to the ward only to realise that I left my bag and keys locked inside my room. Luckily I had my stethoscope, calculator and my list of things to do. Continued my sleep at one of the deserted beds in the ward before getting up to review patients an hour later. Went back to my accommodation and luckily the porter was around and had spare keys. I was let into my room safely but had to go back to work shortly.
Take 5 of unlucky events:
Assisted in sedation for reintubation of the previous patient as there was leakage and his saturations was dropping. As I was drawing up drugs with the guidance of my MO, I accidentally placed my index finger (yes, the same finger) over a vial which was already open and sustained another cut. 2nd cut since I'd started on this new ward. Haih...... went home at 8pm that day and I was postcall. Who said doctors don't work up to 36 hours. Actually that statement is true. We work more than 36 hours.
For today, I started work at 7.15am and went home at 9pm as I stayed back to attempt a few transfer summaries. I want to retire NOW! At least I didn't encounter any further bad luck.
If anyone has luck to spare, please send your donations to:
Paeds ICU, 5th floor, Menara Timur,
Pusat Perubatan Universiti Malaya.
P.s.
Saw a former patient today who was at the verge of dying from Dengue haemorrahgic shock syndrome but improved after days of infusion of coconut water. I guess we'll start trying everything when hope is all gone. The patient looked so well that no one would have believed that many gave up on her when she was at her most critical condition.
There's still miracles in this world and maybe that's why I'm still staying on this long windy path.
Sunday, 19 December 2010
Why the double standards?
Other government servants get public holidays and weekends off. Why can't doctors get the same? Both are human but one lives like one and the other had no human rights to rest in the name of saving mankind.
Saturday, 11 December 2010
Random
It was great catching up with you. Now, be a good girl and study for MRCP when you return. Hahahaha.
Food. I think my blog feels incomplete without entries on food. Both eateries are around Petaling Jaya.
Really delicious fish soup noodles with deep fried pork coated in breadcrumbs. Recommended.
This was at one of the market stalls in PJ. The Seafood Cantonese Style Noodles is highly recommended! Overall, food there is delicious. The Yong Tau Fu is expensive at RM1.20 per piece.
Covering the wards this weekend. Having pre-calls depression cause I'll be oncall on Monday. I've found solitude in the library which helps me forget about things. I'm such a bookworm. The thing is, I spend 99% of the time reading the newspaper and storybooks instead of revising. Oh well. I just hope that depression doesn't get to me.
Thursday, 9 December 2010
Learning to live with it
I can live with being scolded for my own fault but to be scolded by 2 different people for 2 different reasons which are not my fault.
So, I started meditating, 'They're scolding someone else, not me. They're scolding someone else, not me'. Put on the never ending loop like a spoiled cassette player till the noise pollution dies down.
As guinea pigs, if we're not eaten alive by any one of the predators, we will still escape with bruises and injuries. Wait, I think my situation is worse than that, I cannot even run. We're just planktons. Haih.....no wonder people said that HOs are of the lowest of the lowest class followed by the medical students, the cleaners, the hospital attendants, etc.
So, I started meditating, 'They're scolding someone else, not me. They're scolding someone else, not me'. Put on the never ending loop like a spoiled cassette player till the noise pollution dies down.
As guinea pigs, if we're not eaten alive by any one of the predators, we will still escape with bruises and injuries. Wait, I think my situation is worse than that, I cannot even run. We're just planktons. Haih.....no wonder people said that HOs are of the lowest of the lowest class followed by the medical students, the cleaners, the hospital attendants, etc.
Tuesday, 7 December 2010
The best cure
This weekend was so eventful that I've had enough excitement to last me a year. It started with Friday evening where we encountered this really obnoxious mother of a patient whom was dissatisfied from not having an ensuite room for them till not being able to meet the professor. Looking at the bright side, this scenario proved my inexperience in handling these sort of situation and getting too emotionally involved. I still have a really long way to go. Saw her again yesterday. The best cure for mending any misunderstandings is actually with her son getting better. Really mellowed down a lot and a 180 degrees change was not all that surprising.
Oncalls on weekends and holidays are depressing. I still didn't have time to eat all meals but at least I managed to feed myself something for dinner which turned out to be my previous lunch, current meal and next day's breakfast.
Post-call was horrible too. My brain's function decreased to about 10% of its usual capacity, had to use every single resource of communication skill that I had to handle the previous patient, then when I was staying back overtime to settle the discharge summaries, I somehow ended up together with my other HO in the doctor's room with my MO and lecturer and was grilled on Asthma management and my method of explanation of the Asthma Action Plan and diary to parents. It was the first time that I witnessed extreme stress from my fellow HO who had to leave straight away right after we were released from the torture chamber. For me, the brainwashing that I've been self implementing somehow worked. I felt happy that I'd learned the proper management and method of effective delivery of information across to patients. Plus, both MO and lecturer stayed overtime to grill us! What dedication.
It is always a good thing that I'm being scolded then not cared at all cause the reason why our teachers scold us is that they want us to improve. If they're not bothered, it means that they've given up on us.
Oncalls on weekends and holidays are depressing. I still didn't have time to eat all meals but at least I managed to feed myself something for dinner which turned out to be my previous lunch, current meal and next day's breakfast.
Post-call was horrible too. My brain's function decreased to about 10% of its usual capacity, had to use every single resource of communication skill that I had to handle the previous patient, then when I was staying back overtime to settle the discharge summaries, I somehow ended up together with my other HO in the doctor's room with my MO and lecturer and was grilled on Asthma management and my method of explanation of the Asthma Action Plan and diary to parents. It was the first time that I witnessed extreme stress from my fellow HO who had to leave straight away right after we were released from the torture chamber. For me, the brainwashing that I've been self implementing somehow worked. I felt happy that I'd learned the proper management and method of effective delivery of information across to patients. Plus, both MO and lecturer stayed overtime to grill us! What dedication.
It is always a good thing that I'm being scolded then not cared at all cause the reason why our teachers scold us is that they want us to improve. If they're not bothered, it means that they've given up on us.
Wednesday, 1 December 2010
There are good days, there are bad days
When you think that you're unlucky enough, more bad luck comes along when you least expected. For example, I was wondering why even the phone can bully me by falling off the table and wire unplugged from its socket when I was answering an important phone call. Luckily my lecturer accepted my apology the next day. Phew......
Today, came a phone call for me from the department asking me to help cover another ward for the whole day tomorrow. Hmmm....will I be of any help I wonder. Why choose me of all people? I don't even know if I can contribute much. Haih.....will worry about it tomorrow. Any luck that you can spare for me?
The good things that happened to me today was that my clerk helped me to change the appointment date for a patient who has to travel miles and miles to this hospital for her appointment. My good attendant helped send the blood sample for crossmatch at lightning speed and rushed back half an hour later to collect the blood without anyone reminding her to do so. Imagine if I had to run to the blood bank. I would have gotten lost somewhere and my poor patient wouldn't have gotten her blood by midnight.
Today, came a phone call for me from the department asking me to help cover another ward for the whole day tomorrow. Hmmm....will I be of any help I wonder. Why choose me of all people? I don't even know if I can contribute much. Haih.....will worry about it tomorrow. Any luck that you can spare for me?
The good things that happened to me today was that my clerk helped me to change the appointment date for a patient who has to travel miles and miles to this hospital for her appointment. My good attendant helped send the blood sample for crossmatch at lightning speed and rushed back half an hour later to collect the blood without anyone reminding her to do so. Imagine if I had to run to the blood bank. I would have gotten lost somewhere and my poor patient wouldn't have gotten her blood by midnight.
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