Monday
Don't remember what happened on Monday. Probably nothing significant. A group of 10 final year medical students came to join us in the ward. Their job is to make me happy. I am their boss. I am so grateful they are here. Dr Andrea gave me a pen and a notebook (to write down my jobs) - that's very nice of her and I am grateful for the presents (hope I won't lose them because of the past few days I nearly had).
Monday night to Tuesday morning I was oncall. It was horrible. Luckily the two MOs were kind enough to help me out. I was so slow to do everything. Bloods that needed to be taken, cannulas that were to be inserted, patients that needed to be clerked in were only done, on average, two hours after they were supposed to be done. One major delaying factor was that I had to go down to MR scan 3 times to sedate this lady, which was a scary experience on its own. When clerking patients, it's such a pain when you cannot read the previous person's clerking, and having to ask around the nurses. The nurses... what shall I say... were just not being supportive during the night. I felt so useless not knowing how to manage anything and having to phone my MO for everything. Call call call coming non-stop. The lady gaga ringtone of my phone got more and more irritating as the night went, and I thought for a few moments that I was having auditory hallucination of the sweet romance ringtone. I need to revise my medical emergencies management and learn how to priorities better.
Tuesday
I was so tired post call that all I could think was can I please go to sleep stat? All I could recall was a really long teaching ward round which lasted until 3pm. The peak of my sleepiness came about during the discussion of renal tubular acidosis in a young patient. I don't care how interesting the physiology of the disease is. I want to get this over with and go home and sleep. I ended up doing discharges until 11pm that night. Working continuously for 42 hours in hospital. Can you imagine my exhaustion?
Wednesday
I made a patient cry today because I have poked her too many times for ABG. I really cannot understand - this is the second patient that I have encountered that I just simply cannot get any ABG. I did it the usual way which I can proudly say, yield rather good success rate. I tried for about 10x before giving up.
I suddenly had a sense of how meaningful my job is. There's this patient whom I really wish not see everyday. He has chronic renal failure and pulmonary oedema, and it is my job to take blood from him everyday. Unfortunately, he pulls up a 'tak-nak tak-nak' show every single morning. Come on... I haven't got time for this: I have 27 other bloods to do! What I normally do is to leave him alone for a while and come back after I have finished everyone, by then he would normally be in a better mood for me to poke around. I had a really important job today, which was to sort out his social welfare. His son and his life has been in a mess for years but no one had bothered to properly get the necessary help for him. The registrar had assigned this important job for me. I helped him write support letter, get the social worker to see him, get help for dialysis etc. I was proud that I was able to put aside my vengeance on how he has made my life difficult every morning and rise above to understand that he's only acting like that because he is ill. I am really determined to do this part of my job well.
Thursday
I really hate relatives surrounding the patient when I am trying to take blood or put in cannula. It's ok if it is easy and requires only one shot. But if I have to try 5/10 times before I get it, I feel the pressure as the relatives get distressed for seeing the patient getting distress. Normal people are just not emotionally numb to patient in pain like doctors are. I am considering if I should ask the relatives to go away while I do these next time.
Dr Andrea made everyone wear pink today. We took a group picture. That was really sweet.
Dr Yusniza, my registrar gave me two of her white coats today. Aghr.... now I have no excuse for not wearing it anymore.
Untraumatic radiology scans requests today. HAHAHA!!!
Friday
Started the day with one of my patients collapsed. Thank goodness she was found before I arrived in hospital, or else I'd be clueless on what to do. Abi, who was oncall, dealt with it impressively. I did my first successful femoral stab for her (with all the surrounding nurses cheering). Unfortunately, we arrested not long after, and we did CPR for 50 minutes - unfortunately she did not survive. Quite sad.
There's another reason for me to be proud of myself today. One of the patient needs cannula for blood transfusion. She's been ill for so long already, she's literally skin and bone. She needs a pink one, but all her veins were of the blue size. The medical students and I had tried so many times - left hand, right hand, left leg, right leg - nothing went in. I was already on the verge of giving up when I thought I felt a small vein on the leg. Went for it, and hurray - it's in. I'm so proud that I persisted and did not go asking for help without trying my best. (at the expense of the patient suffering of course).
Saturday
Dr Andrea gave me a day off. Will grab the opportunity to study.
Sunday
It started ok. 4 discharges. Before my ward round finished, my already getting calls. It was only a tidy bit better than my on-call last time. I still haven't finishes the discharge by 8pm. Luckily there was a very very kind medical student to help me with 2 discharges, or else I'll be stuck with discharge and delay the rest of my on-call work by another 2 hours.
I have still not learnt the art of prioritizing yet. There's new patients from emergency and admitted electively to be clerked in - supposed to be seen as soon as they arrive in ward (take history, examine, take blood, and prescribe medication so the nurses can give them out asap as a minimum) . Also in patient who suddenly has problem like shortness of breath, chest pain - some of which, obviously I need to drop everything and go as soon as they call as it could be a matter of life and death. Finally, there's petty jobs like take blood, insert cannula - not unimportant either because the patients who usually need blood have dengue or electrolyte imbalance who need regular monitoring, and patients who need cannula would have needed it for IV antibiotic or blood transfusion. Many a times when I'm trying to sit down and do something, I get called to do something else, which fragments my job. So 10 jobs becomes 30 jobs because I have to go back and forth 3 times to complete the unfinished work. Of all the jobs amassed during my oncall, only about 50% have been done. I feel so bad because the patient don't get the treatment they need. I've also really not been having time to document everything I've done - this could well come back and bite me in the future (really, of so many jobs I have during oncall, documenting is the least of my priority. But I need to make it the priority to cover my ass). So far, my MOs (more senior doctors) had been very supportive, but I feel the support has gone to the point of burden. Like last time oncall, I skipped lunch, dinner, breakfast and lunch next day just because all these were not my priority compared to clerking new patients and attending to acutely ill patients. Was absolutely totally exhausted. Didn't finish oncall work until 9am next day.
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