2 more nights to go!

5 days have passed quickly. I am into my 6th night receiving shift later on tonight, and I'm so so sleepy! You would have thought I have adapted into the different working hours, but nope, I haven't.

Every morning, after work, I could not sleep immediately. Why? I dunno. My night receivings have been pretty busy, therefore, I should be feeling really tired. The fact is, I am tired, but my brain is still wide awake! It would be about 3 pm when my brain slowly shuts down, only to go into active mode 3 hours later. *yawn...

oh dear, only THREE hours. The dark circles around my eyes are getting blacker and puffier...

However, on the brighter side, I have only 2 more nights to go before I go back into normal shifts. Hope no one becomes unwell later!

Double arrest and still alive...

It is a wonder how God helps us in a mysterious way.

A lady went into a cardiac arrest about 2 weeks ago, and she survived. And again, tonight, she arrested and survived, only without her normal reflexes. She is one lucky woman. God is not willing to let go of her yet, I think.

How Fashionable Am I?

Did a quick Q&A session about fashion online at The Star website, and I was labelled the

"Sensible Chick."

---> You are aware of the latest trends but aren't religiously keeping up with them. Instead, your personal sense of syle prevails. Most of the time you are dressed impeccably but you are more practical than anything else.


I couldn't agree more. I am indeed a very sensible and practical person! =)

Condolences

I do not know what it was. But I never looked at my handphone when I am on-call. However, last night was an exception.

It was just the usual busy night at the medical receiving unit. I decided I needed to take a few sips of water and then, I decided to have a peek at my hp. Surprise, suprise, there was a message left by my beloved cousin sister back home. She does not usually send me a sms except during her school holidays or during a festive event. This was abit unusual. I looked at the sms and received the shocking news of the death of her father, my uncle. The death occurred rather suddenly. As far as I can remember, the last time I heard about him was about the tiny little wound at his toe and the fact that it was difficult to heal due to his diabetes, and, his new recently developed chest pain and a "swollen artery" as his doctor put it.

It was such a pity. She said she just spoke to him on the phone the night before, and her youngest brother, invited him to sleep over at his place. He did not want to trouble his son and decided that he'll just sleep at the comfort of his own home. The next morning, my cousin's youngest brother phoned their father to ask him out for breakfast, but no one answered the phone. So, they went over to his house, and found him dead. Tragic. He died all by himself and none of us know the cause.

My condolences reach out to my cousin sis and her family. I am sorry for their loss and wished I could be there for them, especially my cousin sister. She is very pessimistic and has put the blame on herself for the death of both her parents. =( Dear cousin, please be strong!

Losing An Hour

Damn! I lost an hour from my weekend! Today, the clocks went forward by an hour. =(

An hour extra during my weekend can be filled with plenty of activities....sleep...more sleep.... more more sleep... haha.

I am also trying to adjust my sleeping pattern so that I can cope with my night shifts better. Initially, I have planned to sleep late, but I'm really sleepy now. Looks like its off to bed for me soon!

Despite losing that one precious hour, I did however had a fun-filled weekend! Again, Sze Leng came up from her kampung (Ayr is a kampung area) to visit me. So we had food...lots of food, from Japanese to Spanish. yum yum! The Japanese restaurant served chocolate wasabi cake...which was really rich and yummy (but couldn't really taste the wasabi). Also went shopping with her...and we both ended up buying a dress each! *yaawwnn...think that's it for now. Nite nite!

Doing My Head In

Trust me, I have nothing against nurses. However, there are times when I wished I could just strangle them. My apologies to anyone who felt hurt by my rants here.

1. "Doctor, this patient's BP is 179/136. It is very high. Pls review her." I looked at her previous blood pressure recordings and they were all normal. I asked her if she has checked it twice or checked in the other arm or tried a different machine. "No" was the reply. I got her to repeat it...and they you go, it was a technical error. Her BP was actually fine.

2. A patient has severely low potassium levels in the body. I asked if they could hook the patient up to a cardiac monitor. Guess what was their reply? "Oh, we can't do that. We do not know how to read the monitor." Now, what kind of an answer is that??? Luckily, the bed manager (who is like their big boss) came along and asked me what's the problem. I told him that this patient is unwell and needed a cardiac monitor. Again, the nurse said the same sentence to the bed manager. He just answered her, "Well, when I come back, I want to see her on the cardiac monitor." Almost immediately, the nurse went to get the monitor.

3. The nurses could never leave me in peace. They kept calling my name nearly every 30 minutes for the most random and minor things, in which, in my humble, they could actually sort it out themselves, except that they were just too lazy to think.

4. "Patient's temperature is 37.5 degrees. What you want me to do?" said one nurse. I looked back at her and noticed that she appeared really clueless. "37.5 is fine," I replied. She said, "You sure? You don't want her to get paracetamol. You don't want blood cultures or anything? err... yes I'm sure and no she doesn't require blood cultures.

Oh, I don't know. It must be the loonng day, or the fact that I wished the nurses could be slightly more competent. And I do not why certain doctors are such a wimp too.

For eg,

"Oh, I feel snuffly today. Don't think I can work till 9 pm tonight. Would you mind covering for me today?"
(to be fair, she wasn't very snuffly. I would personally put up with it and finish up my on-call)

Sigh. Nevermind. I just need to remind myself to SMILE!

Ok...so what if you feel snuffly? If you're on-call, you're on.

It's The 1st Day of Spring!

Welcome Spring!

We, or rather, I have been waiting for this day to come. The winter had been very wet and bitterly cold. Even today, the temperature is sitting at -4 deg Celcius. Daffodils are blooming, new shoots are sprouting out. I could actually hear birds tweeting outside too in the morning. =) The day is getting brighter earlier, which is really nice, as it makes most people less depressed!

Anyway, I gotta go off to work now. Have to cover a sick houseman. Hope he recovers soon!

ABCDEFG

After a horendous week of medical ward cover, I figured I was going into an arrest, or what we like to call a peri-arrest situation.

A - self-maintaining

B - equal chest movements bilaterally, tachypnoeic, saturation: 96% on air, chest auscultation: clear -----> need oxygen mask

C - cold & clammy, capillary refill time>2s, hypotensive, tachycardia, no urine output for 12 hours -----> need IV access + fluid challenge

D - Glasgow Coma Scale:
E 4 (hmm...maybe actually there is ptosis in both eyes),
V 4 (I'm mumbling but appears to be slightly confused/disorientated)
M 5 (will not obey commands, such as, drug prescription, venflons etc, but responds to pain)
= 13/15 (not a bad score at all!)

E - Looks in distress, sweaty, puffy eyes, dry mucosa, decrease skin turgor (dehydrated, totally forgot to drink), bilateral ankle swelling (standing all day), tender calves (again due to long
hours of standing), nil else to find on examination

F - Apyrexial

G - Blood glucose 1.6 -----> need 50 mls of 50% dextrose stat!!!

Lucky me, I did not go into an arrest. Otherwise, god knows what would happen! *phew

Red As A Tomato

Do not know if I have mentioned this before, but I was asked by my senior to do a presentation about a study for The Journal Club last Friday. But it wasn't done due to a technical error with the projector. This presentation was then pushed to today. Again, the projector wasn't working. All the consultants tried to work it. Their efforts were futile. One of the consultants kept insisting that I ruined the whole projector....and said, "May I suggest you follow the instructions on how to turn it on?"

I was like what?! I am not THAT IT illiterate. I know how to work stuff. Nevermind. I assured him that I did follow the sequence to turn it on but ain't working!

So, in the end (about 30 mins later), we decided to inform IT about it and they will fix the problem after lunch. As it was my last week in the Rheumatology, I have to present the findings of the study today, by hook or by crook.

I turned the laptop around so that it was facing everyone and began. While explaining to them about the patient selection, a consultant stopped me and asked, "What sort of general population are you talking about? Did they compare the study group of patients with RA with a controlled group of the general population?"

hmm....I just told him that it was THE general population, no criteria was set for them...you know, just the general population.

Then, after explaining the findings of the result, another consultant said, "I do not find anything surprising with the study. We all know about those. Lousy study. Why did you even choose this study to present?"

"Yeah, I think this study shouldn't even be published," said another.

*fuck

I totally turned as red as a tomato. I answered by saying that it was given to me to present so, that's it.

Well, I kept my cool and carried on. I was glad to finish it. Switched off the laptop and let the consultants discuss the topic among themselves. It was really not a very pleasant moment for me, I have to say.

Later in the morning, the consultant said to me, "Good presentation. Don't worry, we are not blaming you for the facts of the study. It was really a rubbish study and I do not think it should even make its way in the journal."

Right. Thanks.

Hope I do not have to do another for a long time!

It Heard Me

On Tuesday night, the pager just did not stop ringing. And yeap, I complained.

It heard me.

On Wednesday night, I received only 2 calls during my entire on-call. Both were minor stuff like prescribing a blood transfusion and checking a patient's blood result. Believe it or not, I was so worried that my pager wasn't working, till the extent that I decided to page myself!! *tsk *tsk *tsk

Please Stop Buzzing!

I'm doing a 9-9 shift this week. I start my on-call from 5 pm onwards. Since 5.30pm yesterday, I did not have at least 10 minutes of silence as my pager kept ringing.

I was expecting my pager to go off about 7-ish yesterday evening. However, it started to buzz at just 20 minutes past 5 pm. It was the JHO from a ward who said she needed help to do her phlebotomist bloods AGAIN! So, went over to help her.

Here is an example of the calls I recevied.

*beep
Pt needs warfarin prescribed.

*beep
Pt needs insulin prescribed. Oh and a cannula for IV antibiotics.

*beep
Pt needs warfarin prescribed.
(I personally think that the ward JHO should be responsible for prescribing this).

*beep
Pt died unexpectedly.

???excuse me

I asked the nurse, "What do you mean unexpectedly?"
"Well, we were not expecting her to die so soon."
"Right ok," I said. I was thinking to myself that if she died unexpectedly, then I am in deep trouble....

*beep
Hi, sorry to bother you. A pt here needs vancomycin level and another one needs gentamicin level checked pls. I am calling from Ward 30.

ermm..sorry I do not cover that ward!

*beep
Pt dropped sats from 94% on air to 69% on air. Looks very unwell. Pls come and see her asap.
(This elderly lady was quite ill. Spent alot of time with her, in order to sort her out.)

*beep
The pt is just in the ward. She needs to be clerked in.
(This one kind of annoyed me. Reason? Because the JHO told me that he saw her in the investigation suite and did sort of clerked her in, but he just didn't have the time to write it down into the admission notes. Now, can anyone tell me what total rubbish that is?? What you mean you do not have chance to write it down. The bloody admission packs are sitting in your ward. Just go back to your ward and write it all down, and then, tell the nurses that it is all done and they just need to stick it into her folder when she arrives at the ward.)

*beep
I need a venflon pls.

*beep
I need a venflon pls.

*beep
Pt is pyrexial at 38.3. You need to do blood cultures.
(Went up to the ward to ask the nurses who that patient was....no one can remember! Talk about incompetence!)

*beep
Hi. Its Nuala. How are you doing?
(Never been happier to hear the voice of the night JHO!)

Left the hospital at about 23.15 yesterday.

Irresponsible

I am sorry to say this but I really do think certain doctors are very irresponsible.

How could they possibly ask an on-call doctor to do a job that was meant to be done in the morning?

If they have requested a blood test for their patient, there is certainly a reason for them to do so, ie, if there were to be any abnormality, they could act upon it before the end of the day. However, they said they were too busy to do it, hence they passed it on to the on-call person. I feel that this is very irresponsible.

I mean, I am happy to do it if I have nothing to do. But, an on-call person DOES NOT do the tasks that were meant to be done during the day. I know it is an hour past 5 pm when your shift has ended, and you are desperate to go home. But, I personally do not think this should be passed on to the on-call person. You said you have a lot to do...but so do us, who work in the medical wards (although some wards certainly have less jobs to do). You just need to prioritise and pls be more responsible. Thank you.

Blood Diamond

Excellent movie.

Leonardo di Caprio was really good. Even better than his previous great shows like Catch Me if You Can, and The Departed. I watched this movie without knowing what the whole thing was about. But I guess this made it even better.

Cheesy Chat Up Line

It was a Thursday night, as I walked home from the gym.

Out of nowhere, I heard: (orange - stranger, green - me)

"Excuse me....excuse me."

I chose to ignore it.

"Excuse me."

Right. So I turned and looked at a man in a black jacket.

He smiled and said, "Hi. Have I met you before?" (that phrase is such a cheesy chat up line)

"Err...nope. Don't think so."

"I'm sure I have. I've seen you in the gym before."

"Oh ok."

"I have quite a few chinese friends who go to Glasgow Uni."

"Oh ok. I don't go to Glasgow Uni."

"Oh ok. You look familiar to me. Do you go to the gym often?"

"Err...no not really."

"You just live around here, yeah?"

"Yeah."

"Can I ask what's your name?"

I gave him a funny look and walked away.

Junior Porter

Yesterday, I was basically working as a junior PORTER instead of a junior doctor.

In my ward, I was given the fun task of organising the weekly radiology meeting. All I need to do is get all the names and details of patients that are to be added on to the meeting and pass it to the radiology secretary. Yeap, as simple as that.

However, the radiology secretary was driving my nuts yesterday. She phoned me up and said, "Hi. Listen, can you do me a favour? Can you go to Ward 8 to collect T's x-rays, Ward 30 to get Y's, Orthopaedic reception for Z's?? I am really busy."

In my heart, I was like, "Hello?! you think I am a porter?"

Basically, the job of collecting x-rays is not mine. It belongs to the porters who are hired to do that. Why the hell are you asking me to do it?

It wasn't like I was free. I had 2 new admissions into the ward and they are my priority at that time. So politely I said, "hmm...I am actually quite busy too. Can you not ask the porters to do it?"

She answered, "Well, I kind of need them soon. Porters take ages. So, would you mind?"

I realised that there is no point in my arguing back, hence, I agreed to do it. I turned into a junior porter for a day. I walked up the stairs (it was at the 4th floor) to go to ward 8, then walked down the stairs, and climbed up the stairs to ward 30 and down again to orthopaedic reception, and walked through the looonngg corridor to the radiology department....boy, what an exercise!

The worse thing was the radiology department is MILES away from my ward. And prior to her call, I have already walked there 3 times!!! sigh.

A Very Grateful Patient

I met a very grateful patient today. She was admitted for treatment of her illness. This involved receiving IV infusion of a drug for a few days. When I was clerking her in, she mentioned that the last time she was in the hospital, there was extreme difficulty in inserting a cannula. She admits that she does not have good veins and added that it would take about 5 tries before a cannula is inserted successfully. She was badly bruised and in pain by the end of her treatment at that time. Hence, the consultant told her that NO JUNIOR DOCTOR is allowed to insert a cannula into her in the future.

My experience so far as a junior member of this profession has taught me that never ever ask a senior doctor to insert a cannula unless you failed miserably. (otherwise, you'll get unhappy seniors). So I decided to coax the patient into letting me try. She was quite happy for me to do so. My first attempt failed. To be honest, I was rather nervous while carrying out that procedure for fear that I would have to try many times before I gain success. However, I managed to get it in on my 2nd attempt! =) I was rather happy and so was the patient......to the extent that she gave me a HUGGIE!!!!

haha...It was really awkward for me because all I did for her was insert the cannula....it wasn't like it was a matter of life or death, and she was UBER grateful! After that, she started telling everyone in the ward about how good I was at that procedure, and how caring I was. Boy, talk about gaining a reputation for that!

Monday Blues

Can I not go to work today?

Pretty pretty please???

Do I really need to go to work????

hello? someone please answer me!

hmm...I could just call in sick. Or even better, say that my flight from KL has been delayed.

YES! I can do that.

No. No. You need to be responsible.

sigh. I am so blue today.

Back in Glasgow

After travelling for one day, I'm now back in Glasgow. The weather was suprisingly sunny when I arrived on Saturday noon, however, it became rather chilly later at night. I spent my time unpacking, buying groceries for the week, washing my sheets..... Everything is back to routine. Just like what Green Pea said, "Euphoria ends."

Sigh. Now it's Sunday. Oh no, it means I have only 12 more hours before the end of my holidays!!

Took this pic just before leaving...Kiki, miss ya!

Time to go back...

In just about 8 hours, I will be on my flight heading back to Glasgow. How sad.

It marks the end of my holiday and it is back to work for me this Monday....sigh.

Ahh....going to

• MISS my family & home food
• MISS the comfort of home
• MISS Kiki (my wee doggie)
• MISS my bed
• MISS my friends
• MISS maggi mee goreng
• MISS nasi lemak
• MISS driving around in my car
• MISS the warm but humid weather
• MISS astro (?! i actually miss it...hehe)
• MISS...i dunno...so many other things...

It's time for me to go back. Will blog from Glasgow. Cya.

The First in Many Years

I can't remember when was the last time I ate Yee Sang. I think it was probably back when I was in secondary school...which is like, more than 5 years ago.

During this CNY, dad received loads of hampers, and one of them had a DIY Yee Sang kit. Yeap, you know what I am going to say next. We had it for dinner today. Preparing it was really easy...all I needed to do was open the tiny plastic tupperwares which stored the ingredients and arrange them nicely on the plate. My bro's gf added a few more stuff into the dish. Once everything was ready, it was time to LOU SANG!

I wanted to be kiasu this year, therefore, I tossed everything higher than the others...tee hee hee. The Yee Sang tasted really nice. It was my first in many many years. This was followed by a steamboat meal....ahhh....we were very full after all the food. But we still had a tiny space for longan dessert! =)

The Yee Sang

It's Lou Sang time.

Yummy...