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Saturday, July 31, 2004
I just wrote a whole entry on H@N. Now it's gone.
Hospital at night
I’ve typed this this afternoon, but thought that since I am watching CSI right now, might as well do something ‘constructive’ by recalling what I typed earlier on.
Anyway, this ‘Hospital @ Night’ is an audit of, literally, the hospital at night, finding out how the redundancy of docs can be reduced (eg. does the hospital really need an A&E SHO and Orthopedics team on duty at the same time). The hospital pays medical students (yours truly) shitloads of money (to me, at least!) to shadow the docs through the night and record the activities which take place, and when they get bleeped and for what.
I was assigned to the Paediatric SHO. 2 of them, the usual being just the 1 SHO/Reg. Hmm... maybe they should pay me to try to figure out how to split myself into two. I thought I could catch a couple hours of sleep during the night when there's a lull, esp since my place is just 5 mins away from the hospital. It was not to be. 10 mins into the shift (managed to tap into the wealth of knowledge of the Paed surgical trainee, as he so kindly offered to teach me abt 1 of the patients who has intussusception and is going into theatre that night, esp when he found out that I have exams *soon*), a shout came from one of the rooms "Respiratory Arrest! Room 22! I need help!" It was one of the Paed SHO. Everyone ran there. One of the nurses passed me the oxygen, another was going for the crash trolley, the SHO was trying to stimulate the babe into breathing. In the background were faint commands of "Fast bleep the Reg and PICU"... "Get the syringes ready"....
Now, we were employed to audit, and were specifically instructed not to help or participate in any way, even though we are medical students. I mean, in such a situation like that, how can I not help? I just instinctively did what I had to do, esp when an extra pair of hands was needed. I remember once, during a particular crash call at St Helier's during my gen med firm, the students just stood to 1 side, looking on helplessly, while the others rushed here and there, trying to resuscitate the patient. We were more of a hindrance than anything else. That sucks.
Outcome: the 7 week old infant was rushed to PICU and was intubated. I felt so sad for the parents. At no point did they want to leave their child, yet it was so terrifying to witness the whole thing. Watching your child get intubated is so... brutal. Not knowing if your child is going to live or die, esp in PICU, is heart stopping. I wouldn't want any parent to witness anything like that. It just scares them all the more.
Throughout the night, we were rushing up and down 5 flights of stairs, from the Paed wards (at 1 end of the hospital) to the A&E (the other end), continuously. There was bleeps, LITERALLY, every 10 mins. Most of the time, it was to do Venflons and more venflons. Waking kids in the middle of the night, kids screaming for their mums to stop the doc when the needle pokes, or babies wail. If the SHO is lucky, just Venflon will do it. If not, 5 stabs are not uncommon. Some mothers can't stand to see the procedure, so they leave. So the SHO and I are the ones there. I try to distract the kid while the SHO does her job (coz they will HAVE to have a venflon no matter what), but I have to hold them down to stop them from struggling (esp the cerebral palsy kids) or from kicking the doc with the needle. It was heart-breaking, but I was rewarded with smiles before the stab, but sometimes, even giggles after that. Think I'll make a very good playmate. =p
Among these were 2 cases of fits. One was an 8 year old cerebral palsy kid, part of a set of triplets, the other two of whom were well, and the mother couldn't cope with the unwell one, so she fostered him out. Apart from giving lorazepam, the SHO couldn't do anything else, coz he is already on high dose phenytoin. 'Just keep him comfortable', she said.
The other was this 13 year old girl in the long stay ward (where all the ALL, PENTA and BMT kids stay). She has Hodgekin's lymphoma Type II and had just undergone chemotherapy earlier in the day. The SHO said that the fit was probably a side effect from the chemo, and she'll get lorazepam and try to keep her comfortable. Her father was there, and he was so distressed that he just broke down. He just felt so helpless. I guess, in a way, for a non-medical person, it's even more scary for your kid to have a fit, and u just dun understand what is happening and you don't know what to do. I felt so heartbroken for him.
The night was littered with many other small incidents, most of which I shall not mentioned here. Suffice to say, an SHO's job is not easy. Even the Paed HO seems to have an easier time of it. Considering the high possiblity that I might venture into Paediatrics, this H@N was a blessing in disguise. No doubt it was interesting, showing me more varied cases that I ever saw during my 6 week Paediatrics rotation in the same location, it also reinforced my resolution that it might actually be the right choice for me! (Yeah, yeah, lots of things count against me, but hey, the SHO didn't get as many smiles and giggles as I managed to elicit from the cuties! =))
This afternoon, I was in my housemate’s room, fiddling with his guitar. I’m so glad that I managed to tune it pitch-perfect. =) Was just strumming a couple of chords, and ended up composing some impromtu tunes there and then (which I asked my housemate to write some words to it). Only problem? The tunes are long gone from my mind (I have a huge problem with short-term memory), and he can’t remember the whole of it. Oh well, figured out another tune for him ‘Shakespeare in Love’, then started harmonizing with the CD in his stereo. Oh, it felt good. *Taralyn, star and wushu D – bring out the voices and the guitar!!
Now listening to Budakmentary by Budak Pantai. Acapella. Yummy.
Cleaned up my room today. Though it’s neat and tidy now, I can’t bring myself down to earth. I hate orthopedics. Bummer.