*phew
What a day man! And I went to work today thinking that I would be able to finish on time. Wishful thinking indeed.
Had a bad start in the morning. I felt extremely guilty for what happened. It all began with the sister asking whether a patient, with poor renal function, needed to be given a drug that would protect his kidneys prior to his angiogram. To be honest, the cardiologist has seen the patient multiple times before this, and they are well aware of the patient's bad kidneys. So if they thought that the angio was going to bring more harm to his kidneys, they would have decided on a different investigation. Therefore, I told the sister that, "Yes, patient is going for his angio. Cardiologist didnt give me specific instructions about giving that drug to protect his kidneys."
Sister wasn't really happy with my answer. Then, my consultant to the ward came in, and the sister immediately approached him and said, "I spoke to the resident about this patient's poor kidney function. She said we do not need to do anything about it and just send the patient down for the angio." The consultant himself wasn't sure whether or not we should be giving any kidney protective drugs, and suggested that we contact the cardiologist about it. I couldn't get hold of him, so I left a message with his nurses, who advised to leave the patient in the ward first until the cardiologist gives the green light to proceed. After another 20 minutes, I finally managed to get hold of the cardiologist, and he wasn't too concerned about the patient's creatinine of 320. Off the patient went for the angio.
It was a total chaos during the whole event. Because, patient was transferred from bed to trolley. Patient was then transferred from the trolley to the bed when the nurse advised to keep the patient in the ward first. Then, once green light was given, patient was moved from his bed to the trolley again! Imagine the total chaos! I have to say I felt totally responsible for it. It totally ruined my thought process for the whole day. I apologised to the nurses for the chaos and also to the sister. She wasn't happy at all. And finally, when I met my consultant again later in the afternoon, I told him that I was really sorry about the event this morning. He said I shouldn't put the blame on myself because, really, the person who is going to do the angio should be responsible for the patient's kidneys. Oh well.
The day went on alright after that. However, about 4pm, an arranged admission arrived....and he wasn't the easiet patient to clerk in. The only information I have about the patient was a sheet of clinic letter. Patient himself was quite vague about the reason for his admission. Then at about 5 pm, a patient of mine went into acute urinary retention. I tried to pass the catheter twice, but no urine was obtained. Instead, bright red thick blood came out from the catheter. I was concerned that he might have clot retention in his bladder. I phoned the urologist on-call, and only about an hour later she arrived. As expected, she shoved a big rigid catheter into that patient, and out came 2 litres of urine!
At the same time, another patient became very septic...and so I had to sort him out. It was only at about 7pm that I managed to print out my blood request forms for the weekend. I left the hospital at 7.30pm! =( I was hungry, tired and slightly frustrated. So SzeLeng had to bear with my rants all night! haha.
So it was a bad start to the day, and undoubtedly, a bad finish too....sigh. Just glad it's Friday!
