Thursday, April 29, 2010

Is It Trust or.....is it just plain laziness?

hmm.....I kept asking myself these questions over the past 3 nights.

Yeap, I am doing the night shifts these week. Someone has got to do it...and it so happened to be my turn this time.

I am not complaining about it...

But I somehoe dread going into the shifts.

I mean, no one can predict how busy it is going to be....what sort of disaster is going to happen.... or whether it is going to be a quiet night (oh no, I said the dreaded Q-word!).

But, but, what really bothers me is my senior colleague I am working with.

Senior Colleague's name is J.

J is a medical registrar. So J has to oversee everything in the hospital. He is the boss at night, second to the consultant who is on-call from home. Yes, so J's responsibility is HUGE.

So I really wonder, how come J goes to bed every single night of these shifts from about 1 am to 6 am?? J has left me with all the acute admissions during that time. If it is a ok night, I really do not mind at all. But when there are 10 people on the board waiting to be seen, and more to come...surely, J should help out, no?

J is the registrar, yes, I know that.

But, this is the first time I'm working with J. So, J doesn't know whether I know what to do, whether I am careless or careful...etc.

So the question is.....Does J really trust me so much that he has left me with all the admissions? Or, is J just plain lazy? When J wakes up later, he will just say," Oh there were more admissions this morning, eh? Everything ok?"

Hmm...I don't know. I want to say that he trusts me. But deep down, I think there is a tiny bit of laziness there.

Saturday, April 24, 2010

Unexpected Visitor

I seem to attract the authorities. This is my 4th encounter with the police.

This week, I came back from work as usual. I was really hungry that day, and quickly heated up my leftovers in my microwave. While enjoying my dinner, I suddenly heard a loud knock on the door.

I was like....hmm...who could that possibly be? I thought it was a delivery man, sending a parcel.

So, I peeped through the hole in my door.

Oh-uh, there was a police officer standing at the front of my door. Immediately, I could feel the adrenaline rush....my heart started to thump really fast and hard. A few thoughts came to my mind.

Did I commit a crime? Did somebody sue me? I dunno.

I opened the door to greet the police officer.

"Hello," he said.

"Ermm...hi," I replied.

"Just wanted to ask you if you knew your neighbour living over there?" he said, while pointing to my neighbour across the corridor.

"No, I don't know him. I don't know my neighbours at all," I said. (and this is true)

"You not seen him moving furniture or anything like that?"

"No I haven't. I've seen those girls living opposite him, but not see him."

"Oh ok then. Thank you very much," he said.

After I closed the door, I still felt weak in my legs. My heart was still thumping.
Don't get me wrong. I was glad that he wasn't looking for me.....glad that I wasn't in trouble. But I can't help feeling intimidated when I meet a police officer.

I speak to police officers occasionally in the hospital environment, and even prison officers. But I do not feel scared when doing so. It is probably because I was in a hospital, where there are other colleagues around me. While being at home, there is no one else.

Sunday, April 18, 2010

I am so Stiff!

It was a lovely bright sunny day yesterday. I have been working for the past 2 weeks without any break.....therefore, I decided that it was time to soak up some lovely sunshine, and fresh air.

So what did I decide to do?
Go for a jog around the park.

It wasn't a bad idea to start with. I used to run 9 miles a week (6 months ago!). I stopped running because the weather was becoming colder, and I moved down here to M'bro. I had to quit my old gym....and was TOO lazy to get myself registered in a new one locally.

I got changed into my exercise gear. Did bit of warm up...and started to jog at a slow pace. After one round, I was panting like I have just completed a marathon run. My heart was thumping so hard. I could not continue running. So I stopped to catch my breath. After a few mins, I started to run again....but found myself stopping another time just before the second round was completed.

=(

Yes, clearly I have lost my fitness level...how upsetting!
I remembered being able to run around the park 3 times without stopping....and now, only just one round?! Gosh...how bad is that?!

Luckily there was the happy sunshine and fresh air to cheer me up a little.

This morning, I got up with stiffness all over. My quadriceps are stiff and achy....my lower back is just the same too.....sigh, these are the consequences of not exercising regularly.

I shall now attempt to run bit more regularly.....i hope! no more excuses, now that the weather is so much warmer!

Wednesday, April 14, 2010

If Only I Can Split Myself into Two

Exactly....it is impossible....well, not entirely, it can be done, only that I have to lose my life.... *yikes (that's not ideal!)

I really do love my job. I really do...trust me. The only thing I struggle with is trying to be in 2 different places at the same time. I am sure many other doctors out there will agree with me. This situation is made worse when you're in an on-call shift, where you are IT. You are THE ONLY doctor on-call for the wards...in charge of looking after more than 100 patients during that shift.

I found myself caught in a dilemma over the weekend. The situation was:
  • a patient was scoring a EWS of 12?!
  • a patient complaining of chest pain
  • a man who had more than 1 litre of ascitic fluid drained from him, and now hypotensive
  • a patient with pyrexia
  • a patient who has disseminated malignancy in severe pain (despite being on really high doses of opioids)
Now, I received these many calls within 10 minutes. HELP!

I told myself...prioritise....prioritise.....breathe....breathe....dun panic.

So off I went to see this patient with a EWS of 12. He was really really sick. After performing a few resuscitative measure, I quickly walked across to the opposite ward to check on the ECG for the patient with chest pain.

Great! Now he is in uncontrolled AF! A quick assessment was done followed by giving him a rate limiting medication.

Then, I rushed back to that sick patient....still very ill.... did a few more things for him....but he was too ill to be left alone. So I called the ward to ask about the hypotensive patient...who apparently looked "washed out" according to the nurses. I told the nurses to give him a fluid challenge to see if it would help.

The patient I was with was now scoring a 14. !!!!!!
I actually did contact my SPR for some advice...which he did provide...but clearly none of them was working. He needed HDU/ITU support. I called my SPR again...it took him such a long time to come review this ill patient (it wasn't like he was busy in the MAU!).

Anyhow, in between all these chaos, the poor cancer patient has been left in pain....I felt so guilty. I told the nurses to give him some IV morphine...but none of them could cannulate him... so I told them to give it s/c instead.

Finally the ill patient went to HDU. I was now able to leave him to carry on with my other tasks....

*sigh.... it was certainly a challenging day. I was so exhausted in the end. To add to that tiredness, was plenty of guilt. I felt that I was not doing a good job. The poor cancer patient was left in so much pain....in fact, he was in pain for nearly 9 hours, before I could sit down and calculate how much morphine he requires in a syringe pump.

Imagine if one of my family members were left in so much pain.....that would be horrible...I would not be happy to leave them in pain for so such a long time! Luckily the cancer patient and his wife were so understanding.

SIGH. Another sigh.
Glad I am not on call for the rest of this week.