My Fingers Are Too Short!

I've learnt one very important fact in my life as a doctor yesterday.

MY FINGERS ARE TOO SHORT!

And I thought my fingers are quite long for my size because of my piano playing background. In fact, I recalled measuring my fingers with my classmates last time, and they were surely longer than theirs!

So I was quite surprised to find that my fingers are too short for a simple manual evacuation yesterday.

hehe.

For those naive to medicine, let me tell you the satisfaction of a manual evacuation. (no not really...not so much satisfaction....more of a disgusted feeling!)

Right. The situation was this elderly lady was in the post-operative period. She has been constipated for a good few days. She has tried various laxatives to help with it, but unfortunately, none was working. I suggested a trial of a phosphate enema (you know, those things that you stick up your bum to activate a bowel motion).

To my horror, the nurse returned to tell me that she was so impacted (ie, her anus was so stuffed with faeces), to the extent that she could not even use the phosphate enema!

The nurse asked me, "So what are we going to do?"

I dreaded the thought I had in my mind.....and I reluctantly said, "Guess, the next step would be manual evacuation."

A manual evacuation of faeces is when a person inserts his/her fingers in a rectum to digitally remove faeces inside it. It is helpful in people who are rather constipated....and just need to unblock the hard faeces that is blocking the rectum. Once evacuated, it makes it alot easier for the person to open the bowels again.

I couldn't have found a better time to perform this procedure......which was after my lunch! Perfect! (I was crossing my fingers that I will keep my food down).

I explained to the patient what I was going to do....and she told me that she did not care how uncomfortable the procedure was going to be, as long as she could get rid of the discomfort she was having as a result of the constipation. She was more concerned that it would be unpleasant for me! How thoughtful!

I said, "Don't you worry about me, my dear....that's my job...to make you more comfortable!"

Prepped with double layered gloves and lots of lubricating jelly, I started the manual evacuation by inserting 2 fingers into the rectum. And............my fingers could not really reach the hard faeces stuck inside. I could feel it with my fingertips. So I just thrusted my fingers deeper into her rectum, and at the same time, wishing if only I had longer fingers. The poor patient was looking quite uncomfortable. She told me not to worry about it. *Bless her! And eventually after a few minutes, I managed to dig out at least 4-5 blobs of really hard stools.

I have to admit that this was probably the most disgusting thing I have ever done! I really wanted to vomit...due to the smell of the faeces...and just the thought of me, digging out faeces from a rectum. (I salute you fellow nurses/HCAs/cleaners)

The lovely patient was feeling so much more comfortable after all of that. She was able to sit comfortably on a chair as she didnt feel too impacted. All the nurses in the ward was laughing at me for having to do this manual evacuation...and the wise registrar said, "Well done. The only time you won't do a manual evacuation, is when you're a consultant! This is probably one of the MUST-DO when you're a junior doctor."

It was quite an experience....and I am glad that I've helped to make someone's life better!

hmm.....if only me fingers are bit longer.......

I don't have a straw!

I couldn't stop myself laughing today. I know, I know, it is not very professional and nice of me to laugh at my work colleague....but what he told me today was hilarious!

He will be working this weekend on-call. So I said, "You have the short straw eh?"

He replied," What straw? I don't have a straw."

I was like huh?!

"I meant you are the unfortunate one that has to work this weekend," I told him.

He, then burst out laughing, and so did I. haha.

He said, "I didn't understand what you mean by straw. Guess it is just the way you say things here."

I wonder....

I wonder sometimes whether I am being ignorant, or, the nurses just don't pay any attention.

hmm...

An elderly lady has been admitted with severe heart failure. She has longstanding bilateral leg oedema for the past 5 years, and as a result she has suffered from a degree of venous eczema. Both her lower legs have looked red for years. She has been a patient of that ward for 2 to 3 weeks now, and the same nurse has been looking after her for the past 7 days.

Now, this evening, I got a worried phone call from her. She was concerned about these red legs which she has never seen before. So I went on to review it. The legs were as red as they were when we looked at it many weeks ago. There are not hot or tender. There are unchanged. The patient herself did not notice any change the in the condition of her legs either.

So I reassured the nurse that there isn't anything to worry about at the moment. I've also explained to her that she has venous eczema. The nurse said, "oh really? I've never seen her legs like this before....it is new." I replied, "well, I have been looking after her, and I am 100% sure that her legs have been like that for many weeks now."

I can only conclude that she hasn't seen those legs while looking after the patient. Or, she was just not paying attention during the ward round, because, we examine her every day, and expose her legs every day....so how could you not have noticed that?

I dunno.

GGGggrrrr

*GGRRrrr

The year of the tiger should start with a bang. The tiger is a fierce and ferocious animal. So I believe that I should begin it with something grand. Unfortunately, there isn't anything exciting in my life at present.

1st of January 2010 went on like any other day. In fact, it was strange having to countdown in the hospital. I had to do the night on call then, and the nurses, and my fellow colleagues, turned on the telly for awhile just to catch the live telecast of the fireworks display in London.

And look at how first time flew by. It is February already.

Well, if I can't start the year like the way the tiger pounces on its prey, then, I should end the Ox year with a few resolutions.

My new year resolution is to pass all the exams I am attempting. I really need to, if I am thinking of entering into the specialty of my choice in a year and a half. I seriously can't afford to fail any.....moreover, these silly exams are so bloody $$$ anyway.

My second resolution is to plan and go on a cycling holiday break during Summer. I have always wanted to visit a place in Europe that would allow me to do cycle around the streets, and doing some tourisy things at the same time. I've heard that Amsterdam and Italy are good places for this activity. So hopefully, if all go as planned, I might be able to do that this year!

And finally, I would like to save enough money to get me-self an iphone! haha. yes...what a treat eh? I have 10 reasons for wanting one, but one reason not to....and that is because I find the current package deals wee bit pricey. So, if I save enough, I won't feel the pinch, no?

So listen, I will try to update my blog more often (I know I have neglected it for quite a few months now). And, I will give myself a huge pat on the back if I do fulfil these resolutions. Till then, Happy Tiger Year everyone.

Too early?

Is there such a rule that states a person should not put up a christmas tree in the house 4 weeks before christmas day?

Well I hope not!

Because I just set mine up a few days ago! =)

hehe...I have been looking for the so-called "perfect" tree a few weeks ago...well, to be honest, ever since I saw christmas decos in the shopping malls. I thought about getting a nice lovely black tree, rather than the traditional green one.

So I went hunting, you know, whenever I went out for a little shopping spree. Finally, I found the perfect tree! I am sure everyone would agree that you can get almost anything from Argos. Yeap, I stopped by Argos last weekend, and looked through their christmas catalogue.....and hold and behold, I saw a tree that I liked.

It was a 6 foot tall ash black xmas tree.....the fact that it was discounted, made it even more attractive. So I purchased it without much thoughts. I also bought new white LED lights to match it.

When I got home, I could not wait to put it up.... (I know, it is pretty pathetic). To be honest, I am sucker for things like this. I like to see nice little things in the flat, I like to feel all christmassy....I mean, it is only once a year...so I might as well enjoy it to the max. hehe.

Anywho, with some help from Kevin, my brand new tree is all set up! There are a mix of red, gold and purple baubles. It looks absolutely lovely! It is so therapeutic just looking at it, especially when the white lights flash around. I actually look forward to turning on the lights when I get home from a tiring day at work. All I need now is to get a few christmas pressies to put under the tree.

It is amazing how simple things in life can just make it so much more colourful.

30 days and counting down to Xmas..... =P

Doubting Myself

I just completed a set of night shifts. I was really frustrated last night...because of A nurse in this haematology/oncology ward. I am happy if she wanna tell me what to do...but to say that she's not happy with my instructions until i speak to the consultant? now....does she think i'm rubbish? or what?

There was a very sick young boy last night. I told her I was going to check his blood gases (ie, to check the oxygen level in his body). And this nurse said, "Oooh...no...you cant do blood gases. It's not appropriate in these patients...we do not do blood gases in this ward."

I was like what? How can you say that? How do you know its appropriate or not? It isn't very helpful to say such a thing especially when somebody is so ill. Blood gases are indicated if a patient is extremely short of breath, and is not able to maintain his own oxygen saturations such as this poor sick boy.

So then, I thought, right, maybe I'm not doing it right....I doubted myself...which was so silly of me. Anyhow, I contacted the consultant to inform him about this ill patient, just to inform that about what I have done so far and if he has anything else to add. He also advised me to check his blood gas....

Later, she refused to give this poor gentleman paracetamol until I speak to the consultant first?! Now....i think that's just taking the mickey. Apparently this man has been sneaking some paracetamol of his own, and has been told against doing so. But that story was a good 3 days old. If worried about an accidental overdose, his LFTs and coagulation screen would be off by now. But they aren't. His temperature has been sky high all day and night...clearly he hasn't taken any! She said she's not happy to give him paracetamol, unless the consultant gives the heads up. Luckily it was nearly 7 in the morning when this incident happened...and I didn't feel too guilty contacting the consultant. Imagine, making the phone call at 3 am???

We were all trying to work in the patient's best interest, but I didn't understand why it didn't feel that way.

Would You Like An Eye Opener?

It was 8.30 am in the morning. I was on-call overnight, and was just trying to get things ready for the morning ward round.

While looking up a patient's blood results, a heard a patient calling me.

"Doctor, doctor, can I go home?" said patient G.

I turned around to see who that was...and soon realised that patient G was admitted overnight with an impulsive overdose of his epilepsy medications. He was drowsy initially, but he had obviously improved.

"No, not yet. The consultant needs to review you first."

"Oh ok. Errm, can I get a bottle of vodka please?" asked Patient G.

"Errmm...no. This is a hospital. You can't get vodka in here. Would you like a cup of tea instead?" I replied.

"No doctor, you don't understand. I need my vodka. I normally drink some first thing in the morning," added patient G.

It was very unprofessional of me to chuckle to myself after he went back to his bed. But, I found him really amusing, because he was really honest about needing an alcoholic fix.

This is a classic patient we normally see in the hospital. He clearly has an issue with alcohol dependence....and he would score a point with the CAGE questionaire, for needing "an eye opener" to steady his nerves in the morning. With the help of a nurse, we managed to sit him down, and offered him chlordiazepoxide instead. Unfortunately, it didn't work very well...and he started to pace up and down the ward. We had to give hime some benzoes to calm him down before the consultant finally discharged him home.

Unexpected!

All of us at work were really shocked to learn that one of our patients, XX, collapsed and died the morning after XX's hospital discharge.

XX has been in the hospital for nearly one month. XX was diagnosed with multiple PEs. We had organised various investigations to find a cause for her multiple PEs, as she was very young. All investigations were negative. As XX was clinically better, we discharged her, with follow up arrangements.

Who would have expected XX to die the next day?

No one.

Maybe it was purely coincidental. Maybe XX was going to collapse the next day, and it could have happened in the hospital, where we could all jump on her chest and start resuscitation. But somehow, one could not help but wonder whether we have all missed something, or under-investigated her.

RIP.

Please Give Me a Chance to Speak!

Oh dear....this job is really emotionally challenging at times.

Today, I spent 1 hour on the telephone just trying to explain to an extremely dissatisfied, and misinformed daughter of a patient about her father's care.

I mean it is alright if she does not have a clue about medicine, or she has no idea about what tests we are doing to investigate the cause of her father's initial presentation.

But what I really could not understand was how could someone not even attempt to listen to what I have to say! I mean, come on, no matter how unhappy you are about any part of the care, just please, give me a chance to explain and provide you with more information.

She was extremely unpleasant to me over the phone, which, is fine, I mean, I can tolerate that. However, whenever I tried to say something to explain the situation, she just spoke over me.

She felt that catheterising her dad, who came in with acute urinary retention: "appalling."

The fact that we were not able to perform a 24 hour Holter because her dad was uncooperative (ie, kept pulling it off his body): She thought we were not doing anything.

She did not believe me when I told her that her dad was very confused and agitated. She said it was all because of the sedative meds we gave him. Ok, yes, we sedated him alittle because he was at danger of harming himself by trying to tug at different things.....But, the fact that the reason he was acting like that was due to underlying sepsis has been absolutely pushed away by her!

I dunno. I really felt like giving up at the end of the conversation. She was not listening to what I have to say, and I felt that there was not much point in even explaining things. I just wish, sometimes, people would just listen first, before jumping into any conclusions.

8 weeks into the job....and?

It has been just over 2 months since I've moved onto a new job. It is really strange, i know, but somehow, I miss the lack of staffing levels in my previous hospital, miss my old work colleagues, and miss all the banter.

I have been asked the same questions a few times over the past couple of weeks.

"So how do you find your new job?"

And my reply would be, "Its alrite."

Funnily enough, the person would say, "Why? You don't enjoy working here?"

hmm... I think using the pharse "not enjoying" is incorrect. In fact, I do like it here. I mean, I have a registrar who I can turn to, the consultants are so friendly, and almost everyone I have met so far has been extremely pleasant (apart from the odd few people).

I guess, most people think that working in this hospital is like a dream! Probably because it is a very big district hospital, with almost every specialty under the sun. But working in such a big space, means you dun get to know everyone well. I used to recall knowing all my fellow SHOs, which nurse is dating who, or what scandals there are amongst us doctors, but now, there is no such bonding. In fact, there is hardly anytime for that.

Everyone is just busy with their own jobs.

That aside, the job has been pretty hectic, and just like every other hospital, we are short of doctors!

?

I wonder whether I am asking too much out of life. Maybe I should try to be more understanding, or maybe I should just accept things as they are.

Come on, let's face the fact. You can't change the environment you are in, but you can certainly change the way you react to the surroundings. So if somehow hurts you, or if something bad takes over your life, you should really just take control of your emotions and act wisely. No point in throwing tantrums, or making yourself feel miserable about the whole issue.

Life is indeed a bumpy road. But somehow, you can only hope for that much to happen. The rest all depends on faith and fate.

I dunno. I am only ONE human out of the billions of us on this planet. But, I hope that somebody would appreciate me as I am, and not take me for granted, sometimes. I guess I can only wait and be patient; time will soon tell, but I hope that by then, I won't be tired of waiting.

Boiling Me Up!

I dun understand why some nurses can be so irrational!

Dun get me wrong, majority of nurses are fantastic. They know what they are doing, they care for their patients and understand the politics in hospital.

Yesterday, I was bleeped by a nurse from a ward at about 4.30 pm. She asked me to admit a patient, who was just transferred from A&E. I told her that I was in the middle of a meeting, and I would be unlikely to make it there by 5pm to clerk the patient. She repeated herself to me. Again, stating that there is a new patient that needed to be clerked in. So, I told her again, I understood what she was telling me. but I am unlikely to be able to make it there by 5pm. And told her that, it is probably best to get the on-call team to clerk the patient.

She put down the phone.

I finished my meeting at about 5.10 pm. Suddenly, I was fast-paged by the same ward again. Fast-paging is only used if there is a clinical emergency. So I answered the call. It was the same nurse again, and this time she said, " I'm calling about the same patient. She is now vomiting, and you still havent clerked her in."

I replied, "Is she unstable? Is she vomiting profusely for the past 20 minutes? Are her vital signs unstable?" She said,"I just wanted someone to write her up for an anti-emetic." I was like it is now past 5 pm, and I still have hundred things to sort out, why didn't she think of asking the on-call team to sort the patient out? and the fact that she has misused the fast-page just boiled me!

Anyhow, I told her nicely that it was probably best to get the on-call team to get her to prescribe the medication, and even gave her the page number. She was annoyed, and wanted my name, to file a complaint against me.

Now, I personally do not think I was doing anything wrong. The patient was not critically ill. The patient just needed some symptomatic relief. I do not see why she could not get the on-call team to sort it out. Moreoever, we all have to try our best to adhere to the EWT directive. I felt rather pissed off actually. It wasn't like I was sitting down drinking cups of tea, and ignoring my work! sheesh.

Go Away, Kidneys!

Kidneys.


The vital organs in your body that helps to get ride of our daily toxins. When the kidneys stop working, the human body struggles to function properly. In certain cases, in which, the kidney becomes dysfunctional, dialysis may or may not be deemed appropriate.


I never liked renal medicine as a student. I found it all so complicated. I could not get my head around which part of the nephron absorbs or excretes what. (Yeap...I am still confused!)

My first day weekend on-call was about 1 week ago. I was given the task of covering the Renal Unit. Oh how exciting....NOT! I hardly have any experience in renal medicine as a SHO....the only experience I had was when I was a junior house officer. At that time, all I had to do was to do the paperwork when admitting patients, perform ECGs or blood tests, and treat patients with high potassium levels in their body.

I have to admit I was pretty intimidated by the on-call itself. The day didnt start too badly...but as the time passed by, things started to go haywire.

Renal patients are chronically ill. They always seem to be unwell either DURING or AFTER dialysis. Why is it so? I still haven't found the answer. They seem to have extremely difficult veins for cannulation. I recalled spending at least 30 minutes just trying to find a suitable vein for IV access.

All of the sudden, there were 3 people kicking off in the ward. One was having his/her dialysis, the other 2 were patients post-dialysis. All scoring a EWS* of 5-7!!

I did not know where to start. I decided to go to the patient with the highest score. This person apparently just finished dialysis, and became "funny." Yeap, it doesnt get any more specific than that. To be honest, I didn't understand what the nurses meant by the word "funny"....so I decided to assess the patient myself. He was semi-conscious, speech kinda slurred, breathing really fast. I went through a few differentials, and came to the conclusion that he was profoundly septic.

The other patient had 5Litres of fluid removed from his body...and, surprise, surprise, he was profoundly hypotensive!

The last patient who was unwell during his dialysis had an "unresponsive" episode, which recovered after 5 minutes.

The weekend just kinda went into such trend. A few sickies at the same time. I guess it has given me good learning opportunities in managing ill patients. But I still do not like renal medicine.

Tickle tickle....

A cough certainly takes a long time to heal!

I developed this tickly dry cough last week...and it is still here.

For the first time in many years, I've decided to spend some money on a cough mixture, like simple linctus. I would not say that it tasted nice...it was quite sweet actually. But it didnt really help to relieve my cough.

The moment I closed my eyes, the cough became worse. I coughed and coughed, until tears started to roll down my cheeks. I took some hot water to see if it helped....no, not really. My throat was just SO TICKLY. Later, I realised that the cough was worse when I was lying flat on the bed. So I laid on the bed at about 60 degrees angulation. I continued to cough, but guess, my tiredness took over me...and I finally fell asleep.

I can say for a fact that the sleep was disruptive. Many a times I woke up coughing. I was so sleepy when I got up this morning. The cough was better in the morning...but it irritated me a lot at work. It felt like I was the ill patient in the hospital!!

As a result of the cough, my voice has changed. My patients and their family members could not really hear me clearly.

I am attempting to sleep earlier tonight. Hopefully the cough will be less annoying.

Come and gone...

I'm feeling quite sad at the moment. Mum, Dad and Bro came to visit for 2 weeks...and I sent them to the airport this morning. I just couldn't believe how fast the time flies when you're enjoying yourself.

We actually didn't do much. The weather was not good at all....it was raining everyday of the week, except on Wednesday. We saw the shy sun for about 2 to 3 hours most evenings. The wind was very strong and chilly too. But anyhow, we managed to make a few short trips to the surrounding area.

First stop, was Glasgow. I know I just moved down from Glasgow...somehow, this town is very charming. I honestly miss Glasgow. I miss the good food, the lovely cafes, the hussle bussle of Buchanan/Sauchiehall Street, the Scottish pipers....and the Accent! yeap......I miss hearing them say "cannae," "doon," "wee."

I took my family to savour the delicious Rumours cafe (malaysian cafe) in Glasgow....The wa tan hor made my day. The next day, I took them to eat brunch at Berits n Browns. Mum & dad were intrigued by the pancakes with bacon....and I must say, they were impressed with it!

On Wednesday, when it was sunnier, we decided to make a trip to Alnwick Castle and Garden. I was NOT impressed at all. Firstly, I paid 18.50 pounds each to enter...and the garden was not THAT pretty. I heard alot of good things about the garden....but I was rather disappointed. Guess I went in with high expectations. I had seen more beautiful gardens than this, and paid half the price to enter!

The only beautiful thing in the garden was the fountain cascade. The Castle was better though. It was huge, and well-maintained. We visited the part of the castle that was used for the filming of Harry Potter.

Alnwick Castle (this was where Harry Potter was filmed)

The rest of the week was spent driving to nearby towns, such as Durham, York, Redcar, Whitby and Scarborough. We kind of just visit the main attraction in each town...and spent time sitting down in a cafe sipping coffee, or eating dinner.

Scarborough was rather interesting. Guess most people will know of Scarborough from the song sang by Simon and Garfunkel. The beach was not bad. I was amazed by the local people there, who were half-naked on the beach, exposing their body to the strong chilly wind. They were also dipping themselves in the sea?! It was so cold!!! And I could not see any sign of a shiver on their faces or body!!!

Anyway, the highlight of the trip to Scarborough was the food. I managed to convince my parents to share an ice-cream with me. They would prefer to drink a hot cup of tea than eat something icy! Guess what I got?


Yeah!!! Let me introduce you to the Mega Treat ice-cream! There were 6 flavours in it...and boy, it was good! Dad was shivering halfway through the ice-cream, but insisted on eating more...haha.


Good times.....wished they could come up more often. Its back to reality for me. Its a long week ahead for me...but I'm sure it will pass quite quickly.

Time Out

My car has timed out on me...... it has failed its MOT today! =(

arrghh.... what a lovely start to my 1 week holiday eh?

I could only drive my car from the test centre back to my home. It is illegal to be driving a car without a MOT in the UK.

So, I have to find a repair centre to fix my car. Apparently, due to an accident 2 years ago, the damage to the car has started to present itself. The radiator is leaking loads, the metal thing that holds both of my front car tyres is twisted,....and as a result of this, the tyres have worn out. The exhaust pipe is "funny"....etc...

The lady at the MOT counter said, "I suggest to go to your insurance company to make a claim."

I was rather shocked. It sounded as though my car needed a massive operation! I can't imagine how much this repair is going to cost me.......and my agony has been prolonged with the fact that it is bank holiday monday here. Therefore, I can only get a quotation for the repair, at the earliest, on Tuesday! This is so frustrating.

If I make a claim from my car insurance, I would lose my NCB! I was thinking, if the price is about 500 pounds, I would pay it on my own, but anything more, I will ask the insurance company to fork it out.

Also, in view of the damages, I was thinking that maybe this is an excuse for me to get another car! I could get a higher CC car, with air conditioning? ahh..i dunno. It is a question of whether to pay few HUNDREDS to fix the car, or pay few THOUSANDS to get a new one......decisions, decisions!!!

Sigh. And now, I have just paid at least 150 pounds to rent a car for the week, just so that I can take me family around visiting....

This is just so troublesome, and stressful too.

Getting Out of My Comfort Zone

A new chapter begins this month.

1. New job

yeap...the new job started in the first week of august. It kicked off with an induction on day 01. Then, I had 1 day off, before I started my night on calls. It wasn't too bad...guess I was expecting worse. The only bad thing about starting off with night on calls was I didn't know how the whole hospital functions! I didnt know how to do simple matters, like taking blood cultures or even obtaining a radiology card to request for a chest x-ray!

The hospital at night also works so differently from my previous job. There were no nurse practitioners, no clinical support worker. And, we have to walk around carrying PDAs?! We receive our task list via the PDA....I thought it was rather fancy...but actually, carrying that gadget is so troublesome! I have to remind myself to tick the boxes on the PDA and also, charge the battery when it runs low.

System is different, but I'll slowly pick it up, I'm sure...its all about adapting!


2. New flat

=D yes....finally I can rent the whole flat by myself! woo hoo!! hehe...I have moved into a 2 bedroom flat, which is literally less than 2 miles away from the hospital....it is SO convenient. No more long distance travel....I can wake up later, get ready slowly, and I can leave my flat later too.... such pleasure!

Did I tell you about the pleasure of living on my own?? I get the whole flat to myself, of course! haha. No more loud music when I am not up for it, no more dirty sink or messy kitchen, more space for me in the fridge, no one intruding into my roon without permission....and no more using my laptop behind my back! yay! it is simply fantastic!

oh...I also got myself a little something....keke....yes....it is not little actually. In fact, it is a 32 inch LCD TV! I know, I know, 32 inches is not THAT big....but heck, this is my first TV, purchased with my own hardwork! It felt great.... The size of the TV is just about right for my wee flat. =) I am loving the fact that I can seat on my sofa, and enjoy watching what I wanna watch....I wasn't really able to do that in my previous flat coz me housemate used to watch all the soaps on the TV all night.


3. New environment

A survey 1-2 years ago said that M'bro is the worst place to live in the UK! Now, that is really intimidating for a newbie like me. I moved from a lively city, Glasgow, to a quieter place like M'bro. Not saying that Glasgow does not have its rough bits, but I don't think it is in the top 10 of the worst place to live.

Anywho, the area I'm living in doesnt seem too bad. The buildings and restaurants definitely do not look as interesting or eye-catching as Byres Road or the Merchant City. I have yet to pass by a nice looking cafe....I really miss hanging out in TinderBox or Berits n Browns.

I miss my shopping in Glasgow!! The best shopping experience here would be in Gateshead Metro Centre, which is a good 1 hours drive from here. Otherwise, the nearest retail park is at Teeside...which is actually decent. You can find the usual high street shops, just in smaller sizes. There is also a TGIF! haha.

The weather here also seems warmer and drier than cold wet Glasgow!


4. New look

I was really tired of my bob hairstyle...and decided to just go back to my short hair. My hair is now easier to manage. Drying it takes only a few mins, no styling necessary, the messier, the better!


5. Dreaming of a new MacBook!

Trust me, I have been dreaming of this for more than 1 year now. I kept telling me friends that I will buy it soon...but until now, I'm still stuck with this old notebook, which is extremely temperamental. It hangs whenever it wants to, it resets itself automatically without being told, it loads things which I did not ask for...etc...you get the idea. I have reformatted it before, but the problem persisted. So I really would like to change it, bcoz it is doing my head in. Guess it is time to make my purchase soon...but having spent so much money buying stuff for this flat....think I should postpone it will next month.


hmmm.....

The only thing lacking here is my friends and K in Glasgow. Sigh. Glad that he's coming to join me this weekend...and mummy n daddy will be here too!!!! how exciting! =)

My first weekend here was pretty boring. I spent most of the time at home, reading and cleaning up the flat. Guess I need to find more things to do, and of course, make new friends to hang out with. Moving down here has certainly opened up a new chapter in my life....and as much as everyone hates changes, I think it will only make you stronger, and it pushes one to get out of his/her own comfort zone.

CHEERS TO MY NEW FLAT!

What is the point?

What is the point of being a consultant?

What is the point of having your own outpatient clinic?

What is the point of having a timetable created to your own needs?

What is the point in smiling but not listening?

What is the point in what is the point??



And more importantly, what is the point in even bothering?!
.........................uurrgghhh............I DON'T KNOW!!

I am so frustrated today. I don't understand how a consultant can be so slow in reviewing patients at the outpatient clinic. This consultant has a timetable created to suit his/her needs...but he/she has failed to follow it correctly!!!

I mean, how difficult is it to complete your ward round on monday, rather than postponing it to another day, in which you are busier?

There are at least 30 patients in the outpatient clinic awaiting review...and this consultant only saw 5 of them?!

HELLO??? ARE YOU HAVING A LAUGH??

arghh well. What is the point in even moaning as I can't change the situation? I just have to suck it up....that's what it is.

26 days and counting

I can't believe there's less than 1 month before I move down!

All the chaos and stress in applying for a new job began about 6 months ago....and finally being told I have secured a new job down south a few months thereafter, seemed so long ago.

I am having mixed feelings about it all. I have to admit that I am slightly excited about the whole thing, you know, moving down to a new place, new environment, entering the English health board, and, living in a new flat on my own (for the first time!).

On the other hand, I don't like the feeling of leaving my current cosy flat and a few of my friends here in Glasgow. In fact, I feel extremely heavy-hearted to leave Glasgow itself! I can't believe I actually just said that. I recalled the first time I moved down here from Dundee, I felt so miserable....I didn't like the environment, didn't like the transportation system, didn't like the people....but that's all changed now.

As much as the weather is always wet, I think I would really miss it. There were Scottish bag pipers playing their tune while I was walking along Buchanan and Sauchiehall Street last weekend. And I thought to myself, "Man, I am going to miss this....the shopping is great, and where in England, would you hear the sound of bag pipes whilst shopping?"

I soon found out that the people here are friendly....and the transportation system is pretty reliable.

Anyhow, I think it is always difficult moving out from your comfort zone. I mean, why would someone leave a place that he or she is so comfortable with?

This will be a new challenge for me.
26 days and counting....

Was That Even Necessary?

Why do people need to act like a complete arsehole?


I had a few encounters with my work colleagues recently during my weekend on call. I am a pretty easy going person. But I really could not tolerate those who are irrational.

I received a referral from the A & E department about an elderly gentleman who is now having difficulty swallowing and persistent vomiting. As a result, I was told he looked quite dehydrated. I said, "That's fine...just send him up to our medical ward for further assessment." Later, I received a phone call from the managers that his admission was highly inappropriate. First of all, I was told by this colleague of mine that I do now know this patient at all (which is very true...I have never met him before...so therefore, assessment is even more imperative, no?). Then, our conversation went on like this:


Colleague X: What are you going to do about his swallowing problem over the weekend?


ME: Well, there isn't much we could do over the weekend, until he comes extremely unwell, he which he may require an urgent endoscopy. Otherwise, we should give him IV fluids and make sure he hasn't aspirated."


Colleague X: Exactly. You can't do anything for him over the weekend. If he were to get a scope...you can only do it on Monday, so why bother admitting him?


Again, I had to repeat myself.


Colleague X: I find it really hard to understand why someone with your capabilities would want to admit that patient from A&E.

I was utterly shocked and speechless.


ME: OK, look. If you think this patient is well enough to go home, why don't you document that in his notes, and discharge him from A&E. From my point of view, as I haven't laid my eyes on the patient, I would not know if he is fit for discharge. If anything happens to him, I am the one responsible because I am the person on-call.


I was arguing over the telephone! It was embarassing because I was speaking in the medical assessment bay where new patients were waiting to be seen. After a good 10 mins worth of arguement, we both put the phone down. I felt that it was complete unneccessary. I mean, I know we were verging on being short of beds, but I honestly could not simply discharge a patient without seeing him first. And I hate to say this, but, you are only in charge of the beds....you are not trained to assess whether the patient is fit enough to go home!!!

Urgh...I felt so frustrated after that.

Then, the next day, I received another mouthful from another colleague. This time it was because she thinks the patient has no comprehension of what was going on. She was unhappy that I told the patient about her diagnosis of cancer, and that she her prognosis was poor.

The thing is, this poor elderly patient of mine was clearly living the last few days of her life....and she hasn't been told what was causing her to feel so unwell. When I first assessed her, she could tell me the events leading to her hospital admission, she was well orientated to time, place and person! So on that basis, I felt she was able to understand what was going on.

This fellow colleague of mine, (lets name her Colleague G), was again being inappropriate.

Colleague G: Look, I find it shocking that you think she has even the slightest understanding of what is going on. She is completely off her head. She mumbles all the time! And you told her she has cancer?

Me: I completely respect that. But when I saw her, she was orientated, and was able to tell me her history. And she is my patient, she has the right to know....especially when she is so ill.

Colleague G: Well, I find that hard to believe. I have been a nurse for more than 20 years...and I know for a fact that she is utterly confused and has no comprehension.

Me: Ok...I know you have the experience. But even if she is that confused, she still has to be told.

I left the scene....and about 1 hour later, I received a phonecall from Colleague G. Mind you, I was on-call that day.

Colleague G: Ling, just for your information, I went back to ask the patient if she remembered talking to you. She said, she recalled that a doctor saw her, and she said something was wrong with my tummy. But she couldn't remember what was wrong with it. So there you go, for your information, she has NO CLUE what is wrong with her!

I was like WHAT?!!! Do you actually need to purposely call me to just prove a point?? Is there any need to do so??

No there isnt! Even she doesnt remember, I am still responsible for her, and she has the right to know.

Me: Ok then. Thank you for letting me know. (I was gritting my teeth while saying that). bye.

Man....what is wrong with these people?!

OR,

Maybe I have lousy clinical judgement. I dunno. This is so frustrating.