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Saturday, December 10, 2005

First week of Medicine

This week hasn't been too bad. It took a little adjusting to, especially the ward rounds being long, lasting for 2-3 hours, not finishing by 11am. (I don't get to have breakfast!, which we usually do in Surgery!) Ward rounds supposedly start at 9am. But my Reg comes at 9.30+... And so, I end up doing other things, such as bloods first. I've managed to femoral-stab an IVDU patient in a total of 10s, to get 10mls of blood. A pity the syringe is not self-filling, if not, that will be a record time! =p

But anyway, my Reg is super thorough, and very anal. So much so that even after I recite the exact values of the obs and the blood results, she has to look at it herself. Gah... Maybe she doesn't know how I work, so that's why that happens. Hope that happens less in the weeks to come.

Two things which boggles my mind: 1) Why in the world are the treatment rooms (with all the equipment and blood bottles) so disorganised and chaotic?! Lots of stuff, eg. certain blood bottles seem to be out of stock for days on end! 2) Why do Pharmacist technicians have difficulty accepting the fact that I do TTA/Os in advance? Why do they have a problem with that? Considering that I'm making their job easier (so that htye can prepare it in advance), and my job easier (so that the nurses don't bleep me at unsuitable times to do TTOs). I think it benefits both parties, plus the patients too, as they don't have to wait till I have the time to go up and write the TTO and for the pharmacy to dispense it, before they can go back. That will take several hours. Ridiculous.

I had my first on-call on Thursday. I was on the cardiac bleep. In my head, I was petrified. I have absolutely no idea what to do in situations of cardiac arrests, and I was hoping and praying that the bleep wouldn't go off. But as Sod's law would have it, it did. "Respiratory arrest in Byron Ward". Ran up the stairs, and being nearest to the ward, I thought I would get there first and not know what to do, but the SHO was already there, and so standing there, doing nothing for 30s made me fidgety, and so I went to get some bloods/cannulate and do ABGs.

Then later on that night, I was called to Dickens Ward because a patient was tachycardic and having rigors. However, his temp was 36.5 degrees C. I did all that I could - oxygen, bloods, fluids, measure urine output, history and examination, ECG, ABGs, IV paracetamol, CXR, you name it, it's been done. As it was at the end of my shift, I went to hand over to the night SHO for review, and asked if there's anything else I need to do, and there wasn't.

Now, I spent the weekend on-call covering the elderly wards (>75 years of age). It is depressing. Just looking at them is depressing. Some of them are nice and it was really enjoyable to banter with them. However, majority are either demented or senile. Most have been DNAR-ed. Saturday was full of routine, boring, mundane jobs on the wards and reviewing patients. A few patients went off on Sunday. Then it comes to the dilemma of whether you need to do active resus or not. How much is active resus? Oxygen, fluids? What kind of intervention do YOU think is required? IT is indeed a murky world of greys and borderline decision making that I'll not delve into right now. Too complex for this tiny brain of mine on a Monday night/Tuesday morning, at 1am.

Just give me an acutely sick patient, and I can deal with it. Initially, anyway. Anything else, either poses less of a challenge, or doens't provide enough of an adrenaline rush, or it's un-interesting such that I don't really know what to do with them. Haiz...


Xmas Ball

My hospital had a Xmas Ball at Leeds Castle last Wednesday. I was on cardiac bleep the whole day till 5pm, when I swapped the rest of the hours with one of the floats. But I have to bring up 2 events. One of the house officers bleeped me at 3.30pm, wanting to hand over several jobs to the on-calls, coz he 'wanted to get ready for the ball'. It only starts at 8pm, and we were going to take the coaches at 6.45pm anyway. Besides, I was also going to the ball and I wasn't leaving early, so why was he? He said that he wanted to go the gym before that. @#%@$

And that was the same excuse he gave the next day as well, bleeping me at 4pm, when the jobs could and should have been done during the day itself! I told him off, and said that that was very unprofessional behaviour, and he wouldn't like having that done to him now, would he? He commented that I was bring harsh and difficult. But up till now, I still hold my stand. I don't think I was being difficult. He was being lazy and very unprofessional. You can ask your colleagues to help out once or twice, but for valid reasons, eg. when you're in theatre or dealing with a sick patient, etc. He was just taking the piss. *Grrr*

But anyway, back to the Xmas Ball. It was a big event for the whole hospital, and the Astley Cooper nurses had a field time with us. =) The colorectal table was actually not a colorectal table after all, coz the bosses couldn't make it at the last minute, but ultimately it was way good. We had a chocolate fountain which was awesome! All of them, plus Mary and Alex were justsaid that Asanga and I were compatible and we look well together, yaddah yaddah, and both of us should just run away and elope. *guffaws with laughter* It was a delightful thought though. Hehe... ;) It was marred by 2 medical students and a few SHOs here and ther who were trying to pick me up. Boy, their lines were cheesy. "I really like your cheeks" - like, huh? Doh....


On another quick note, I had this conversation with JTI 2 nights ago. Didn't realise he still read my blog, and only realised that he did when he messaged me that night... "You miss our squash sessions?" "Yeah, I do actually" .... which went on to "Do you want me to bring back anything from home" "No. Then again, if you could bring one or two fitties back, that would be good" "Erm... I can't. I'm already bringing myself back" "... don't consider you one. Have tried to correct those who say you're fit, but to no avail" "Eh, who leh?" "Getting sleepy now. zzzzzz.... Nite...." "JTI!" (JTI goes Offline)

Grrr... Now I'm intrigued. Whooooo??? A and Faiz said some here at Medway thought so too but didn't want to name people.

Then my cousin saw my MSN pic, and msged just now "who's the chick in your pic? Looking good"... not realising that I was actually IN the picture. *slaps forehead* When he finally knew, he changed his tune "... well, you stand out, but from a cousin point of view, you don't stand out THAT much". *Rolled on the floor laughing*

That makes my night. I'm going to sleep now. =)