A Quiet Day In The Ward

It's become kind of a trend right now in Facebook to have a picture something like the one I copied the other day and tagging your friends to the picture. I wonder how many variants of the same thing can they do before they run out of ideas (whoever 'they' might be).

Anyway, I was supposed to be oncall today, but then a friend of mine wanted to change calls with me, so I was oncall yesterday instead. Thursday calls are the best - there is no passover on Friday (we have CME on Fridays) and you get to go back at 12pm on Friday (if your department allows pm off postcall), so there was almost no way I was going to say no when the Thursday-call offer came along.

*passover is when you have to present whatever new admission you have to the MOs, specialists and HOD the next morning.
*CME is like a short lecture/presentation given by various departments every week - kind of to keep you updated or to refresh your knowledge about certain topics.

It was a really, really good call, and I will be very surprised (and happy) if I have other calls like that again.

I had 1 admission - at 5.30pm.
I had 1 blood taking to do at 4am - the child was big enough to not cry (in fact, the child didn't even say a word).
I had 1 blood taking to do at 6.45am - cried a little, but didn't fight.
There was one child in the acute side, but he was quite stable, so nothing to worry there.
There were some minor problems, but everything was settled by 12am.
I slept from 1am-4am then from 5am-6.30am (although for some reason, I couldn't sleep very well last night).

All in all, a good great call.
What a contrast form my first call (which was in the same ward).
My friend, who changed calls with me, wasn't very happy and had vowed that she would NEVER exchange calls with another person ever again. :)

My First On Call

This was something I wrote a long time ago, back when I didn't have internet.

Today was my first on call by myself.

I have been on 6 tag-calls previously – there is another person oncall, but I am also required to stay the night so as to learn up more about doing on call.
My buziest tag-call was on New Year in the neonatal ward.
My tag calls in the pediatric ward have never been that busy – I get to sleep at least about 3 hours.

I had 6 admissions during my call - 5pm, 6pm, 8pm, 11pm, 1am and 6.30am.

I had 2 patients who needed their blood taken every 4 hours.

I had one patient who needed to be reviewed almost every hour. This was quite a hard task because she kept crying whenever anyone went near her.

There was another patient that I needed to check on every 2 hours.

I had one patient who suddenly started vomiting and not tolerating orally.

I had one patient whos temperature spiked and needed to be started on antibiotics
(previously planned) and needed a blood sample to be taken.

3 mother complained that their child was not eating/drinking properly.

1 child had a fracture (just admitted) and needed ortho referral.

1 child had a perichondritis (inflammation of the external ear) and needed ENT referral.

1 child had a planned platelet transfusion had 3am.


I was in the clinic from 8am-5pm.
I had my lunch at 1pm.
After the clinic, I rushed to the ward I was supposed to be oncall in.
I had my dinner at 3.30am.
There was no on call food – thankfully, my friend bought me some bread and I had that.
I slept for a maximum of 1.5hours.

My first on call.
Hard to forget.
Hopefully my next calls will be easier (although I am quite sure in other postings it will be worse ‘cos there would be people collapsing every now and then).

20.01.09

Disappointed

I feel a bit disappointed.
I felt a lot disappointed on Sunday (when the ward roster for the week was posted), but now I am just a bit disappointed.

Paeds in Ipoh has 4 different wards.
6A - Paediatric ward
6C - Neonatal ward
(if you are wondering what is 6B, it is a surgical ward - I have no idea why it is not a paeds ward)
PICU - paediatric ICU
NICU - neonatal ICU

When you are first posted to the department, you will be sent to 6A or 6C, then PICU then NICU. Even when you do oncalls, you start with oncalls in 6A and 6C and then only progress to oncalls in PICU and later on, NICU.

I have been to 6A, 6C and PICU.
I have done calls in 6A and 6C.
I have not done a single PICU call and I have not been posted to NICU yet.
I am disappointed.

This is my 3rd month in my posting.
I thought that this week I would get to go to NICU, but instead, I have been posted to the clinic.
(In the clinic, you see children as outpatient, mostly who come for follow up check-ups).
I was really disappointed when I saw the week's roster.

The thing is, nowadays HOs have to fill in a procedure book. Each department has a different procedure book. This book has a list of procedures that you have to do when you are in the department.
Some of it are simple, daily stuff. Some of it are more advanced stuff.

In my list of procedures, I am having problems getting intubations done.
The chances of getting to do an intubation in 6A and 6C are next to nil.
The chances of getting to do an intubation in PICU is maybe about 10%.
Most intubations are done when you are in NICU because when working in NICU, you will also have to standby in the labour room or when a C-section is being performed to care for the newborn baby. Sometimes, babies are not born healthy and may need to be intubated for a short amount of time.

If I am not posted to NICU, I can almost never do an intubation.
My HOD wants us to do at least 10 intubations.
I don't blame him.
One should be able to intubate a child.
When you are in the district posting, there is no one to help you but yourself.
If you can't intubate a child during an emergency, then you are quite useless.
But how do I get the chance to do intubations if I am sitting in the clinic the whole day long?

I think I might get extended.
At the back of my mind I know that it is not that bad if you get extended.
You get a chance to learn more and do more stuff since you have more time.
But then of course if I can avoid it, I would like to avoid it.
No one likes being extended.

What should I do?
The excessive number of HOs that we have right now is not helping matters either. We have to fight for procedures. That is bad, isn't it; but the thing is, we don't have a choice.
I really hope that by next week I will be posted to NICU and I will get to learn intubations.

*fingers crossed*

Friends and Characters

I came across this picture in someone's facebook profile today. I am going to attempt to match the descriptions given with friends I made in Moscow. For the characteristics that I can't associate with anyone, I will just leave it blank.



A good friend : Puspha, Fen Fang, Swee Hung, Von Yen, Yee Gin, Beng (although he forgot my birthday)
The slow one :
The pimp :
The good little church girl : Huey Yin, Natiara
The shy one : Fen Fang
The one who always swears : Rajiv Bhanot
The grumpy one : I guess everyone is grumpy at some day or other
The one that always gets hurt : can't think of anyone
The one that's up to no good : Saman
The jock :
The one with the bad memory : Me!
The geek : Von Yen, Puspha
The innocent one : ME!!
The goody two shoes :
The drama queen : Penguin?
The lazy one : Me, Beng (:P)
The gangster :
The stylish one : Mun Yee, Yee Gin
The flirt :
The tiny dangerous one :
The tower : Angeline
The one with all the gossips : currently- Swee Hung
The ladies man :
The one you can depend on : All group 7 members and Malay guys
The annoying one : Someone who used to sms me (those close to me will know who it is)
The cutie pie : Me (:P)
The princess : if it means someone who is manja then it's Von Yen
The funny guy : Wei Shiong
The one that always gets hungry : Beng

Hmm...looks like quite a lot of the 'labels' go unmatched..

Tagged

For the first time the other day I was tagged in Facebook.
I decided to just copy-paste the whole thing here and answer the questions here.

Rules:
Use the first letter of your name to answer each of the following questions. They have to be real...nothing made up! You cannot use any word twice and you can't use your name for the boy/girl name question.

1. What is your name: Sharini

2. A four Letter Word: Seat

3. A boy's Name: Sundram (saw him many times today)

4. A girl's Name: Swee Hung (my sayang!!)

5. An occupation: Staff nurse

6. A color: Suede

7. Something you'll wear: Skirt

8. A food: Shrimp

9. Something found in the bathroom: Soap

10. A place: Singapore

11. A reason for being late: Slept

12. Something you'd shout: Shut-up (I rarely shout, I think)

13. A movie title: Shrek

14. Something you drink: Soup

15. A musical group: Scorpion

16. An animal: Snake

17. A street name: Sulaimani (Jalan Sulaimani - my secondary school was at that street)

18. A type of car: Sentra

19. The title of a song: Somewhere Over The Rainbow

Hmm...if any of you think you are free and would like to try out this 'tag', just copy and paste to your page and leave a link in my comment box!

Useless News

Ever since I started working, I have not been following the Malaysian news.
I didn't know about the cave collapsing in Ipoh until about a week after it happened.
I didn't know the economy was getting worse until about a month after people started getting retrenched.
The only reason I knew about BN taking over the Perak state government was because I happened to be examining a patient in a room where the TV was on and the news was aired at that time.

Now, even with the internet, I don't feel like reading the newspaper because it is so full of shit useless stuff.

The day I choose to read the newspaper, there were a few articles about the new Perak MB (I have no idea who it is) who is having some problems with the Speaker or something like that - didn't really bother reading about it.

And then there is the whole issue with Elizabeth Wong. How many times have we seen things like this. Someone having a successful career and all of a sudden some video or nude pictures of them comes out and they have to resign or leave the country or hide. Come on la..let people have their privacy. What is it with us Malaysians? Why are we SO concerned about what people do behind closed doors? If A has sex with B, how is it going to affect your life? How is it going to affect their capability to do their job? It's not like they cheated someone or killed someone.

I think it's time we moved on. The only reason why this kind of pictures and videos keep coming up is because some people choose to make a big deal out of it. So what if she has sex? If you ask me, we should punish the asshole person who took the picture and spread it around. Why is it that we never do that? Why do we allow people like that to get away with it?

So, tell me, is it worth reading the papers when all I read are petty things like this? I might as well sleep or read story books or reply messages in facebook.

p/s if you ask me, Elizabeth Wong SHOULD NOT be allowed to resign.

Safe To Work?

Today is the last day at work in Ipoh Hospital for some of my friends. They are JMO's (junior MO's), soon to be MO's. As of 1st of March, they are no more housemen and are officially safe to think and manage patients by themselves.

I think it is rather scary to be an MO.
For now, whatever decision I make, I can confirm with my MO.
If I don't know the diagnosis, I can just say I don't know and don't have to think that much.
If I can't set line - inform the MO and they will set the line (doesn't happen very often, usually the staffnurse will help with the line setting).
If a patient is in serious condition and I can't handle it, call the MO.
If anything goes wrong, I am just a houseman, I am not to be blamed (unless of course it is a really, really horrible mistake). The MO's and specialist have to take responsibility for whatever happens.

It's different for MOs.
They are supposed to be capable of handling almost all cases.
They are supposed to be reliable.
They must be able to handle emergencies.
They must not do stupid mistakes.
The only plus point - they have weekends off AND they don't have to do petty ward work - leave that to the housemen.

One can't remain a houseman forever.
Either you become an MO, or you are branded unsafe to work and are not granted a full registration and you end up looking for another job.

Yes, I can't wait to finish my housemanship.
At the same time, I am worried about the responsibilities I would have to face as an MO (assuming I am not barred from the proffesion).
For now, I am trying my best to not think about what is to come in about 2 years to come.
I am going to go through my housemanship posting by posting and hopefully by the end of it, my brain won't be as empty as it is now.
HOPEFULLY!

It Will Just Hurt A Bit

Do you know how strong kids are?

Twice in the same day,the other day, I had to take blood from 2 3-year-old kids.

The thing about blood taking in kids is this :

- the really small ones, few months old - you can just push them aside position them in a way that is convenient for you, hold their hand, prick and take blood from them. The most they would do is cry and kick, which won't affect you too much.

- the ones more than 10 years old are usually matured enough to not fight and USUALLY can remain quiet while you take blood from them.

- the in between ones are the problematic ones. Those between 1 and 10 years old. They cry and they kick and they scream and they make you feel like screaming as well. The younger ones, I can accept them crying..but then sometimes you get 12-year-olds who cry and that is SO DAMN IRRITATING!

The whole crying-kicking thing, it not only makes it harder for you to take blood (and hence prolonging your work-time), it also makes your blood pressure go up and makes you feel irritated and tired.

Anyway, as I was saying, the other day, I had to take blood from 2 3-year-old kids, one after the other. I was shocked at how strong they were! 3 people had to hold 1 kid down just so that the blood taking could be done without much hard done to the kid (and also to the person taking the blood). 3 adults and 1 kid. I never knew kids were that strong!

This reminds me about a primary school friend of mine. We have always known that she is afraid of needles, but then we only knew how bad her fear was on the day that we were getting our BCG shots. At first she was OK, because it was not her turn yet. When it was, she cried and she struggled and she had to be held down by about 4 or 5 people before they managed to give her the shot. A while later, we asked her whether or not she thought the injection was painful - she claimed that she did not even feel the injection! All that fuss for nothing!

Well, life goes on. Tomorrow I will still have to face the kids, who probably hate us doctors for pricking them, but hey, we don't like taking blood too! We are forced to do it!

Argh..I think I am crapping already...Good night!

Boring Story

KV and I followed a specialist to Batu Gajah Hospital today.

The specialists from Ipoh Hospital do district visits once a month. Each specialist have a district that they frequent, hence people who need specialist follow up don't have to go all the way to Ipoh for check-ups. Quite a good idea, really..Among the districts HRPB (Hospital Raja Permaisuri Bainun a.k.a Ipoh Hospital) covers - Batu Gajah, Sg. Siput, Changkat Melintang, Kampar, Tambun (kem transit) and Cameron Highlands (because it is nearer to Ipoh than Kuantan). There are a few other districts, but I can't remember where else..:P

Anyway, it is a little weird to just be sitting in the car while the specialist drives to the district, but then it's not like we have a choice. We tried our best to talk about stuff, making small talk. The ride wasn't too far and the specialist was really nice so it wasn't too awkward a drive.

Batu Gajah Hospital, according to my specialist is a pre-war building, built during the British times - most of the buildings were wooden buildings and the buildings were quite spread out. There were many greeneries here and there - in fact, it looked more like a school than a hospital.

First, we followed the rounds in the pediatric ward of the hospital. Then after that was the outpatient follow-up time. Most of the patients have been treated in HRPB at some time or other and are just coming for check-ups every 3 or 4 months to see their progress. Basically me and KV will review the patient, then present the case to the specialist and she will decide what to do. Overall I think we did OK..at least I hope we did OK.

We were done by about 12pm, then we had lunch, then we had a CME delivered by the specialist at about 1.30pm..After that, we came back home. All in all, a nice day (especially since we get to come home early)..:P

What a boring story, huh? Well, that is all the excitement I get in my life for now...so bear with me..

Anyway, I have another short story - this conversation took place the other day when I was buying my broadband..

Celcom lady : Kerja mana?
Me : Hospital
Celcom lady : Oo...Nurse, ya?

Upon relating the story to KR, KR said my looks are more of a nurse than a doctor.
My justification - nurses are usually cute, and her thinking I am a nurse means that I am cute.:P
What do you think?

My New Celcom Broadband

Finally.
FINALLY, I have my internet.
It's about time, don't you think?
It took me more than 2 months to do it - I was supposed to do it by 2 days.

My original plan was to get the Maxis ZTE modem. However, when I went to Maxis last Friday, they said that the ZTE modem cannot be used in Ipoh (although I have used it before) and that they don't have the modem in stock. They also didn't have the broadband modem in stock and said that it would be available only on Monday. Since they open only during office hours, and I am working during office hours, it would be almost impossible for me to go get it.

Then, I went to Celcom (both the shops were close by). They had the broadband modem in stock, but then it was quite expensive. It was decision making time. I didn't want to keep on postponing and postponing - I miss the internet too much!!

Maxis modem is cheaper (forgot how much the price really is, but think it's about 100+), but then the monthly fee is about RM118 or RM138. Celcom modem is RM400 but monthly fee is RM68 or RM98. After thinking and thinking (and since I won't be able to get the Maxis modem immediately), it seemed more logical to take the Celcom modem - in the long run, it would be cheaper.

That is how I ended up with a Celcom modem.
However, unfortunately, I couldn't use the modem until today 'cos they needed time to be activated (at least that is what they claim) and I was oncall yesterday and so couldn't use it yesterday.

I am happy that I now have access to the net.
It was rather sad though - handing over RM500 to the Celcom lady. But then, it's not like I have a choice, right? I mean, it's the internet..I NEED IT!!