Saturday, March 28, 2009

How Did She Do It?

I think I am not cut out for this job.

Yesterday, I was on call in PICU.
Overall, it was quite a busy day, more for my MO than for me.

There is a term used in Malaysian Hospitals - Jonah.
I have no idea where the term originated.
I have no idea how to even actually spell it.
But when one says 'X is Jonah', that means whenever X is on call, there are many admissions.
Conversely, the term anti Jonah refers to a person who doesn't have many admissions during their call.

My MO yesterday had a Jonah call.
She said that it is because it is not her call; she was taking over the call of another MO who has a long-standing reputation of being Jonah.

I don't know how many admissions 6A and 6C had.
PICU had 2 transfer in cases from 6A, 1 post-op observation patient, 1 new admission to HDU and 2 new admissions to the ICU.
The 2 ICU admissions - really ill patients.
Not only that, my MO also received a few phone calls, not just from the A&E but also from other hospitals all over Perak asking about management of patients or regarding transfer of critical patients over to Ipoh.

If I were her, I would most probably just break down and cry and give up.
What do you do first?
What to do, how to do?

My MO was SO COOL!
She didn't once panic or stress up.
Didn't once flinch.
She just did her job like it was second nature, like it was no big deal.
I know that that is what one is supposed to be like.
But then how do you not get worked up when so many things are happening at the same time?

I know that this situation is not something one sees everyday in Paeds Ipoh.
PICU can be quite quiet sometimes.
But yesterday was I would say a very busy day at the PICU (OK, maybe it can get worse, but I've never seen it busier).
Even I know that much.

The 2 ICU patients were transferred over from other small hospitals in Perak because they naturally lack the facilities there.
I was wondering, if it was me, in the district hospital, would I know what to do?
Would I know when to transfer patients over or when not to?

When do I learn when to manage an unstable patient?
I have been in Paeds for 4 months, and I still don't know what to do.
When to start inotropes? When to give boluses? When to get worried? Most importantly, when not to get worried?

Once I finish my Housemanship I will become an MO and have to do district posting.
Will I ever be prepared?
Will I ever be confident to manage anything without an MO watching over my back?

Will I ever be that cool? That chilled-out?
How will I ever be able to not get stressed up over an ill patient?
My MO could still smile, could still joke (of course after the patient was stabilized).

She was resuscitating a patient and at the same time monitoring the progress of the other patient.
I was just basically hanging around, passing her stuff or doing what she was telling me to do.

I want to be like my MO.
I want to be reliable, to be able to do my job.
Why have I not learnt that yet?
Am I nothing more than a clerk?

To my MO yesterday - I salute you!
I hope, someday, I can be like you, or at least partially like you.

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