AAAAAAaaaaaHHHHHHhhhhhhhh.......................
AAAAAAAAAAAAaaaaaaaaaahhhhhhhHHHHHHHHHHHHHHHHH..............................
Ok. Shut up Saw Ling.
I am feeling kind of ....errmm... dunno what word to use.... depressed? in a daze?
I dunno. Again, it is one of those days, in which I felt crap.
This is pretty weird, considering that I did not feel like that for patients in the gastro ward. Probably because I think most of their illnesses are self-inflicted. But in this cardio/endocrine/general medicine ward, it is really sad seeing people die in front of my eyes.
Today was a very great example. The events were as follows:
13:00 I inserted an IV cannula into P to prep him for his CT scan.
14:00 ATSP re: funny turn. P is known to have absence seizures and has diet-controlled diabetes. He was fasted from morning for a CT scan. When I approached him, he was acutely confused (he wasn't like that before). His vital signs were normal, and blood sugar level was 4.6. He seemed to be having a tiny seizure. Although I know that it is not THAT low, I decided that maybe I should pump some glucose into him, since he was fasted.
15:00 Patient's BM better, but he was more agitated. Whenever I asked if he was alright, he said, "Ok. Ok," and made funny lip-smacking sound. He was trying to climb out of bed. I thought this was weird. And decided to give him a tiny dose of lorazepam to calm him down.
15:30 Asked by the nurse to seem him again. This time P's face was purple. His oxygen saturations dropped to 83%. I started him on trauma mask and this only pushed his sats to about 92%. He became tachycardic, and an ECG showed ST depression on leads V4-V6, which were not present before. His chest sounded horrible and I thought he was in acute pulmonary oedema. I gave him a bolus of 80mg furosemide and he did get some diuresis from it. He was also in respiratory acidosis. I felt that I was out of depth. Because whatever I was doing obviously wasn't working. I tried to call my seniors, but the operator kept giving me the wrong page numbers. Finally, I got hold of my registrar, and he came in no time. He started P on a GTN infusion. When I left, P's condition was generally deteriorating. I think he is not going to make through tonight.
I find it really disturbing how a patient can just be so unwell within an hour or so. The fact that P was actually complaining to me about why he needed to be fasted for the scan, and how fed-up he was with hospitals, made this event a shocking and depressing experience. It is times like this that made me feel that I should not be a doctor. I feel depressed seeing him so blue and grey....sigh. =(
3 comments:
hey my dear, you should not give up no matter what. Remember that you always have your family and friends who supported you all the way! I'm one of your friend who will stood by you at all time. I'm sure you are 1 good doctor! May God bless on you. Be optimistic,k! Your birthday is just around the corner. Cheer up!
You did all you could do in your power and you called for senior help early. Sometimes that's all you can do. Despite all the good intentions, we can only do so much. Remember that it is only the sick patients who make it into hospital. While we make most of them better, we are only delaying the inevitable in some of them.
Take heart and don't be too upset. x
Thank you guys for your words of encouragement. P is now well. =) Felt happy that we managed to treat him.
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