24th January (Saturday) - I come to work with a heavy heart. Don't ask me why, but whenever something bad is happening, my sixth sense is never wrong. It has always worked that way. And it did. After bed-making and shower, the CI and Sister went through one of my patient's I/O chart. He's on a very strict I/O with nephrostomy and a strict restrict fluid of 500ml/day. I gotten to know him as I took care of him for the past few days. Especially with me following his primary doctor most of the time. Today he was due for a stenting, so we got a nice dose of blood for some samples and kept him fasting to prepare for the stenting. So the CI went through my I/O, and said something is not right with the previous shift. The Sister who was hovering nearby frowned and did some calculations. Night shift had total up the final intake/output wrongly. The Sister then asked me to calculate, I total up some correctly, but often, often, I admit I do careless mistakes like forgetting to add up additional things like the drainage output and the medicine input, which of course, leads to an imbalance. This causes the Sister to snap at me. I know she's trying to teach me the importance of the intake output and balance, and I know I often did careless mistakes, but her words really stings me when another prof was nearby. She basically went, "You see, we had a shortage of staff, but you think the company wants to keep these kind of people who can't do a simple I/O?" Seriously, I will say it again, I had never been good with intake output. In my student years, I often get yelled by the CIs who are often frustrated with my carelessness. It wasn't until the end of my 2nd year, in my 4th semester when I was posted to the CCU, that I met my old senior. He's an excellent student, with a CGPA of 3.9 and above, I partnered up with him a few days and even had dinner with him when we are in noon shift. I wept to him once about how no matter how many time I tried to do I/O, I always ended up screaming as the whole thing does not make any sense. Seeing how I was struggling, he got me several blank I/O charts asked me to total up whatever he had wrote in, starting from easy to hardest. It was thanks to him I was finally able to do my I/O without screaming my head off.
Wait, I went a little sidetracked there, so let's get back to the matter at hand. Okay, the Sister thought I was a sort of simpleton who can't do a simple I/O. Isn't this familiar? "You are always doing wrong, so zip it. I don't want to hear any of your excuses." I just sat there, stiffly and poker faced as the Sister and CI went on and on about how awful my calculations are. It does not help that everyone, including the profs are all there, listening to the comments. I can't even say anything to defend myself. Why? Because according to my feedback, "She always fights back and makes tons of excuses. How despicable." I felt like clawing myself again, worse, I felt like I want to die. Really, I wanted to die of shame right then and now, praying that something will fall on me and knock me out.
To make things worse, I heard more bad rumours about me. Especially the most recent one. The time where I assisted my 'big bro' in his patient. I accidently drew Lignocaine instead of Heparin Saline prior he came. The rumour went how I administered the wrong drug to the patient. How dare they!!! I did not give the wrong drug to the patient. I drew the Lignocaine out as I was preparing the tray before prof came. Not during!!! But the damage was done, cause everyone is saying (behind my back) about how awful I was and thank God the patient was alright. NO, I DIDN'T GIVE LIGNOCAINE. I QUICKLY DREW OUT THE HEPARIN AND SET THE LIGNOCAINE ASIDE!!! FAR AWAY FROM MY TRAY!!! God, somebody please just kill me. Put a bullet in my head already.
Trying to shake off the negative feelings, things started going downhill. One of my patient's drip was off, but no one passed to me anything about his drip being off. Foolishly I connected his drip back, only then they told me that his drip was off. Oh no. I already opened a new one, I can't just rip it off, the poor patient... In the end, the only way to make the drip worthwhile was let it run a little bit til at least it was half in and then spigotted back. It's the only way I can compensate the patient.
Then I had to do a wound packing for another patient. Since everyone was busy, and there's only me left, I took up the challenge. It's the first time I'm doing wound packing and I'll admit, it scares me a little, but after assessing the gaping wound, I slowly did my best by irrigating with saline and then drying it with gauze then packing another gauze in by opening and folding it as thin as possible then sliding it in until it's fully covered, then add another layer of gauze on top, a little loosely as per order and secure it with hypafix. Alright. :D
A few of the patients who were close with me asked a little about my health, since they said I looked rather sad. I didn't tell them about how I was hurting, but instead try to make them feel better by just saying I was tired from lack of sleep. I did my best to comfort them, to support them, to help them. Some really patted me on the back and said I was kind and caring with patients. What shocks them was I was only nearly six months old, and yet they said I looked like an expert in handling patients. I only smiled and told them the credits goes to my college, with the tutors there grooming me to be kind and caring. Most of them were going to be discharged so I told them to take care of themselves, that I will be going on a week long break. They were sad to see me go but nevertheless, told me to enjoy my break and go shopping for Chinese New Year as the sales are all drawing near. It really brings me to tears because the patients truly, genuinely appreciate me for every thing I had done, whether it's little or big, from helping them in taking hot water, changing soaked dressings, or answering their questions, including times where I pop in to say hello to them and asked really simple things, like whether they had taken their meals and how are they feeling today. The patient who I first mentioned was also happy with me, and was concerned of my well being as I had a hypoglycemic attack since I was given no chance for a rest at all in sending him up and back due to his procedure being postponed. He won't be discharging anytime soon, so I told him to take care of himself, and that if he's still around, I'll see him again. It makes him smile and he said, "You are a really good person, I'm happy to be under your care."
While the day started off really bad at first, the patients' words really kept me going. I always thought of myself being worthless but being able to make patients happy is a reward itself to me. So, here comes my long week break. See y'all soon.
Saturday, January 24, 2015
Friday, January 23, 2015
Holding Prof's Hands
23rd January (Friday) - Once upon a time, some people always loved to complain how I never follow doctors in their rounds. Well, with shortage of staff and the amount of double shift locums going on now, the moment I drop one folder, another prof come and I'll be taking his hands to the patient, and the cycle goes on and on until they stop coming. This pretty much shows how crazy it is. Certain profs I managed to catch their style, but those who rarely comes, I'm not too familiar, unless you count my big brother (cough, cough) whom after I get the major bullocking in the first round, I was able to catch his style after that.
Certain profs have their own certain styles. There are the perfectionist types, like my big brother who expects 120% out of everyone, which means you got to know what he wants and prepare it before he comes. There's another prof whom I don't really know well but he gets very annoyed if you don't know his style. Whenever he does an operation, he expects to have scalpel blades ready to open the op site dressing. If you ran out of scalpel blades,you're going to have to search every single nook and cranny til you find one. If you don't, he'll start being ballistic.
Then are the happy-go-lucky types. Sure they are profs, with years of experience, and are tip top in their speciality, But if you expect them to be tigers, threatening to bite your head, well, they don't, actually. Instead they joke around with you and patients, as evidenced by one of the profs I often follow around. He looks mature, had appeared on several TV shows to give advice on health, but he acts like a teenager. Seriously, he treats patients like little children and he love to make jokes with all the nurses. Of course, some of them are strict, but not to the point of perfection.
Then there's the type who rushes. As in, everything they do is super fast, and if you can't keep up with them you are history. One thing I always keep in my pocket are stacks of paper. Everything they say, I jot down in quick speed, then I double check with their notes. Some profs don't bother to write, so it means whatever you heard and written down is something to take notice of. Only certain few are like that, most profs will write down their orders, even if some does looks like chicken tracks or squiggly worms (I mean no offence, it's just a descriptive.)
Then we have the nice ones. They are nice and you won't feel tense with them, but certain things, like Cardiologists and Nephrologists take certain care on I/O charts, so if you miss updating on them, you'll get a major yelling from them. Some may just look calm on the outside, but on the inside, they are fuming, seething to the point where they'll complain to the CI or Sister. Very dangerous, so keep your guards up and be on your toes on all time. After assisting so many profs in blood taking and branulla insertion, I think I had enough blood for a life time. One more day to day off.
Wednesday, January 21, 2015
Punch Drunk
19th January (Monday) - Ohhh, I didn't get enough sleep last night. Insomnia struck last night, so I looked a lot like a zombie. Ah, so tired. I'm not taking things on auto-pilot this time, but my mind seemed half shut down. Nevertheless I was able to follow profs and do my reports with ease. It's just that there are tons of scans to go through. Because I was in charge of kids this time around, I had to follow a little baby down as I take her for MRI scan. Of course it took me more than an hour since i had to stay down because we knocked her out with chlorol hydrate elixir. I even brought an extra bottle with me in case the child became restless, but nope, she's as sweet as an angel. Although there were some instances I was having a heart attack cause her oxygen level was 88 or so, but it always picks back up to 96 to 100 after a while. Thank heavens.
In between I did prof round. The super particular patient is a little better today. With no more drip and just her antibiotic, she's much happier and willing to listen instead of jumping into her own conclusions. like how she told me that her line was clotted and that's why it's hurting. Geesh, if the line is really clotted, her drip wouldn't had been able to run at all. But I'll just entertain her because as the saying always goes, customers are always right. Mmm-hmm. The one thing I really envy her, she has a very loving and supportive husband. He really cares for her, you can see from how he holds her hand, that touch alone and he's able to feel the pain she's going through, especially with the antibiotic. He even gave her massages and opened the curtains for her so that she can see the view and sunlight. My goodness, seriously, her husband sleeps with her every night, and before he leaves for work in the morning, he make sure the maid is there to keep her company. Hats off to you, sir. The patient is super lucky to have such a good husband.
I met an old lady who was for surgery on the next day, she just came in for inspection. Although she's in her 80's, her skin is beautiful and her hair is like soft fluffy snow clouds. And she's really funny. She saw me when I came in to update her I/O and the first thing she asked me was, "How many kids do you have???" Er, um, I'M NOT MARRIED. People often seemed ot think that I'm married because most nurses married young, but if you don't find the right man, how are you going to marry? But she did wished me all the best in looking for a suitable man.
Let's see, I got this really funny uncle in the ward who was really weak on the first day he admitted, but little by little, he became so much stronger. To the point where he could walk around the corridor and dance. Oh yes, he did, and some of the other nurses rushed to him in case he fall, although he claimed that he had no need for us cause he can walk. Well, for his safety and to prevent any falls, one nurse watched over him while we handle the paperworks.
Okay. Many ops are coming in for this round. First round, go. Second round, my friend went. Third round, me. At the same time she got called back down to retrieve a patient. It's one of those seasons, you know. Near holidays like December there'll be nobody, but in January, where everyone are coming back to work, there's the mad rush of admissions. I was being blur about half the time and I couldn't recall most things I did, well, only the important ones. Patients are all nice enough, and besides, I think most of them can go back soon.
Alright, time to sleep, cause tomorrow we're going to have a big day ahead.
In between I did prof round. The super particular patient is a little better today. With no more drip and just her antibiotic, she's much happier and willing to listen instead of jumping into her own conclusions. like how she told me that her line was clotted and that's why it's hurting. Geesh, if the line is really clotted, her drip wouldn't had been able to run at all. But I'll just entertain her because as the saying always goes, customers are always right. Mmm-hmm. The one thing I really envy her, she has a very loving and supportive husband. He really cares for her, you can see from how he holds her hand, that touch alone and he's able to feel the pain she's going through, especially with the antibiotic. He even gave her massages and opened the curtains for her so that she can see the view and sunlight. My goodness, seriously, her husband sleeps with her every night, and before he leaves for work in the morning, he make sure the maid is there to keep her company. Hats off to you, sir. The patient is super lucky to have such a good husband.
I met an old lady who was for surgery on the next day, she just came in for inspection. Although she's in her 80's, her skin is beautiful and her hair is like soft fluffy snow clouds. And she's really funny. She saw me when I came in to update her I/O and the first thing she asked me was, "How many kids do you have???" Er, um, I'M NOT MARRIED. People often seemed ot think that I'm married because most nurses married young, but if you don't find the right man, how are you going to marry? But she did wished me all the best in looking for a suitable man.
Let's see, I got this really funny uncle in the ward who was really weak on the first day he admitted, but little by little, he became so much stronger. To the point where he could walk around the corridor and dance. Oh yes, he did, and some of the other nurses rushed to him in case he fall, although he claimed that he had no need for us cause he can walk. Well, for his safety and to prevent any falls, one nurse watched over him while we handle the paperworks.
Okay. Many ops are coming in for this round. First round, go. Second round, my friend went. Third round, me. At the same time she got called back down to retrieve a patient. It's one of those seasons, you know. Near holidays like December there'll be nobody, but in January, where everyone are coming back to work, there's the mad rush of admissions. I was being blur about half the time and I couldn't recall most things I did, well, only the important ones. Patients are all nice enough, and besides, I think most of them can go back soon.
Alright, time to sleep, cause tomorrow we're going to have a big day ahead.
Sunday, January 18, 2015
Digging Through Thrash
18th January (Sunday) - Discharge tsunami incoming...! Today is also one of the rare instances I did not do bed-making. Why? Not even 7.30 prof already came, ready to discharge his patient, who's keen to go home.. At first things we're okay. He exposed the post CABG incision that he did few weeks back. Looks good and clean. Then he moved to the uncle's leg. Previously he had a femoral catheter inserted, wounds look okay, but there's a bulge near his groin. When questioned, uncle says it was worse previously but now the swelling has reduced a lot. Prof did a lot of prodding and stuff and he concluded that it shouldn't be bulging, it must be clots. He then asked me to get ready the dressing trolley and suture set. I told him the suture set is at the other side of the ward and he said it's fine. So off I went to retrieve the suture set from the CSSD cupboard and here we go.
This is the first time I'm assisting him with no one to help me out this time, so I got the lignocaine prepared as prof tore the suture set open Then because we don't have scalpel blades, I asked the TL for help while prof say he'll try made do with the stitch cutter. if this was another prof, he will definitely go ballistic. Okay, I saw him cutting the bulging part and then, this part is where things get messy. He used the forceps and scissors and start cutting and digging, yes I do mean literally, digging into uncle's muscles and start pulling out all these lumpy clots. G-uh! There's so many of them, some as big as marbles, some stuck together, all the time blood kept gushing out, staining the bed sheets, uncle's gown, the sterile drape that prof had set up, the gamgee and gauze that I stand by every time one gets fully soaked. It was an hour plus when all the clots are finally gone and prof took the suture and start sewing four stitches on the cut. Finished, now uncle can go back home.
Moments later I got a call from his wife, who was going on and on about the post op site dressing being soaked. So I came over with some gamgee and hypafix and oh God, uncle's leg is bleeding like mad. Like a blood waterfall. Even with the amount of gamgee I applied pressure on, it becomes soak within minutes. in the end, I put one on top, grabbed another fresh set, this time with my friend coming along to help me apply pressure dressing. It fixes alright this time. Praying hard uncle will be able to go back home.
Then we got a whooping total of eight discharges in our ward. So all that's left to do is wait for the profs to authorize the discharge. One lady who had been waiting to go home for Chinese New Year is finally happy that both profs came to allow her to go home. My friend and I helped them both as they did the dressing, change the post op site into Aquacel dressing and she's free to go. I thought she was a nice lady but prof, prof just have to go and tell her that she's free to go and pay the bill and promised that she'll be first in line to the point where her children all chased us at the counter. "Is the bill ready?" "Can she go back yet?" "Prof say she can go back already, so why is the bill taking so long?" "Why you cannot give us a specific time?" Oh for God's sake, you think we are superwoman. You're not the only person who is being discharged you know. There are 7 patients all in queue, you yourself included. Urgh, and prof was hogging the folder when I want to write my report. He was calculating every single consultation fees in two sheets of paper. I can't believe these people. In the end, prof went to the billing and the lady was allowed to jump queue. Grrr, unbelievable.
Then uncle's dressing went soaked again, and once again, my seniors and I did the dressing. Because it was a lot of blood again, my friend did vital signs checking and I went to billing to write my report while getting away from the havoc, like the lady's children chasing for the bill to be out NOW.
Speaking of blood, remember the suture set earlier on? I remembered that there's a piece of paper inside it. I don't see it in the patient's room, and it's super important. If it's not in the patient room, *gasp* OH HELL. I ran to the clinical waste bin and started digging for the bag I threw earlier on. Digging through the blood, drapes, gamgees and and all. When I got to the bottom of the bag I finally found the paper. PROF, WHY???? T.T
If you think that's the end, guess again. A mother threw her baby's pampers even though we told her many times that we needed to measure the pampers. Again, I ended up digging through thrash just to get two chocolate-stained pampers, which also smells of rotten eggs. Urgh. Why me???
This is the first time I'm assisting him with no one to help me out this time, so I got the lignocaine prepared as prof tore the suture set open Then because we don't have scalpel blades, I asked the TL for help while prof say he'll try made do with the stitch cutter. if this was another prof, he will definitely go ballistic. Okay, I saw him cutting the bulging part and then, this part is where things get messy. He used the forceps and scissors and start cutting and digging, yes I do mean literally, digging into uncle's muscles and start pulling out all these lumpy clots. G-uh! There's so many of them, some as big as marbles, some stuck together, all the time blood kept gushing out, staining the bed sheets, uncle's gown, the sterile drape that prof had set up, the gamgee and gauze that I stand by every time one gets fully soaked. It was an hour plus when all the clots are finally gone and prof took the suture and start sewing four stitches on the cut. Finished, now uncle can go back home.
Moments later I got a call from his wife, who was going on and on about the post op site dressing being soaked. So I came over with some gamgee and hypafix and oh God, uncle's leg is bleeding like mad. Like a blood waterfall. Even with the amount of gamgee I applied pressure on, it becomes soak within minutes. in the end, I put one on top, grabbed another fresh set, this time with my friend coming along to help me apply pressure dressing. It fixes alright this time. Praying hard uncle will be able to go back home.
Then we got a whooping total of eight discharges in our ward. So all that's left to do is wait for the profs to authorize the discharge. One lady who had been waiting to go home for Chinese New Year is finally happy that both profs came to allow her to go home. My friend and I helped them both as they did the dressing, change the post op site into Aquacel dressing and she's free to go. I thought she was a nice lady but prof, prof just have to go and tell her that she's free to go and pay the bill and promised that she'll be first in line to the point where her children all chased us at the counter. "Is the bill ready?" "Can she go back yet?" "Prof say she can go back already, so why is the bill taking so long?" "Why you cannot give us a specific time?" Oh for God's sake, you think we are superwoman. You're not the only person who is being discharged you know. There are 7 patients all in queue, you yourself included. Urgh, and prof was hogging the folder when I want to write my report. He was calculating every single consultation fees in two sheets of paper. I can't believe these people. In the end, prof went to the billing and the lady was allowed to jump queue. Grrr, unbelievable.
Then uncle's dressing went soaked again, and once again, my seniors and I did the dressing. Because it was a lot of blood again, my friend did vital signs checking and I went to billing to write my report while getting away from the havoc, like the lady's children chasing for the bill to be out NOW.
Speaking of blood, remember the suture set earlier on? I remembered that there's a piece of paper inside it. I don't see it in the patient's room, and it's super important. If it's not in the patient room, *gasp* OH HELL. I ran to the clinical waste bin and started digging for the bag I threw earlier on. Digging through the blood, drapes, gamgees and and all. When I got to the bottom of the bag I finally found the paper. PROF, WHY???? T.T
If you think that's the end, guess again. A mother threw her baby's pampers even though we told her many times that we needed to measure the pampers. Again, I ended up digging through thrash just to get two chocolate-stained pampers, which also smells of rotten eggs. Urgh. Why me???
C.B.I.
17th January (Saturday) - Today isn't so busy, but there's a little procedure that I'm in charge of. CBI. Ah, now that's a procedure I haven't done in a while. Continuous Bladder Irrigation. :D But I haven't done this in a long while and I'm out of practice.Um, um, okay, whatever goes in must come out. Every time you put one in, the moment the jar is nearly full, you clamp the bag and measure the out. Ah, okay. Simple enough.
Ahm, I forgotten how heavy the 3000ml irrigation was. It's like carrying a bowling ball. A very lumpy bowling ball although I actually enjoy playing with it. Great fun for poking besides the autolagus bag. And did I mention that I was struggling with the seal as well. Once I realized you need to break it, not twist it, I managed to snap it open. Then comes the most embarrassing part of all, poking it through. I knew it was tough, but I didn't expect it to be that hard to poke the needle I know it's all about twist and twist and push and it should go in smoothly, but the needle just won't go through. Ohhhh, the patient felt so sorry for me that he helped me hold the bag while I managed to poke the first one through. Okay, that acts as a back up irrigation while one is running. That way all you have to do is open the next clamp. Simple enough right? Back in the students day, we used alternate bags by marking each bag with a number. Then we start off with 1,3,5,7,9. Thank goodness it's not too complicated here.
The lady whose admission I did on the previous day, she's really...particular. I like her family, they are all nice and understanding people, although they tend to compare hospitals. Well, as I often said, if you compare Hospital A whose price is super beautiful, of course the room and service are beautiful, whereas we over here, with a small fraction of the price can only get you basic, although we try to give good nursing service to the best we can. Back to the point, the lady called me because there were a few bubbles in her tube. It's not air bubbles, but her antibiotic.The solution is so thick to the point that there are some bubbles in it. But the lady made me sit in her room and flick the tubing until the bubbles are all gone. Ohhhh, how can she expect me to sit there and hit all the bubbles until they are gone? It was near her branulla some more, and she refused to let me open and flush it. No, she asked me to flick it. When flicking doesn't work, do you know what she wants me to do? She wants me to do what we usually do. Open the tubing and let everything out. NOOOOOOOOOO. Absolutely out of the question. For Normal Saline and D/Saline, Dextrose 5%, all those normal drips, we can do it, but NEVER, ABSOLUTELY NEVER, antibiotics. To flush the antibiotic out means wasting the medicine itself. And those antibiotics can't be replaced once wasted. To give too little antibiotic means under dose, and then she will never be okay. But she doesn't understand, even when I explained to her. I had to tell her family who backed me up. Thank God.
Few moments later, she called again, this time regarding about her oxygen saturation. She told me she was having difficulty in breathing and demanded me to check her saturation, of course I did. Her fingers weren't too good, they looked a little blue at the nails. 88 - 90%. It cannot be. I wasn't too happy about it even after I waited for so long. Then I went to her feet to check. 94 - 96%. Much better. She then demanded, yes demanded for a face mask. Urgh, her saturation is okay. It's only because her fingers were a little blue, but it wasn't cold. Even so, she made a big fuss til I grabbed a face mask and brought it to her, telling her that she can use it if her saturation is very low, but for now, it is okay. Her relative helped me out by explaining to her too much oxygen is also dangerous due to too much oxygenation, and she got it.
Back to uncle once more, I had to back up his drip once again, ohhh, not again. This time uncle pushed the needle in together with me cause he can't bear to see me struggle. Sigh, embarrassment, hence why I dislike bowling.
I went to check up on the little boy. He's looking much better now, walking about. Bit why is still on that temporary sling? I caught sight of a cute Angry Birds arm sling and I asked the mother whether it's his, and she said, yes, that was the arm sling that the father brought. I asked the mother why she didn't bother to change the temporary arm sling and she said cause he didn't want to. But the Angry Birds one is so much cuter. Oh well... Tomorrow tons of patients are discharging. I better get enough sleep otherwise I won't have the energy to handle the discharge rush.
Friday, January 16, 2015
Full House Madness
16th January (Friday) - Oh boy, I came in with a feeling of dread, and I have every right to be. Full house. 19 patients = 4 staff working, Minus the TL and Med Nurse, two of us only. Another girl was supposed to go back but she was asked to do locum so she did. So between three of us we ended up running up and down. Especially with the profs. One after another they kept coming. I didn't had time to write my report when the next person kept on coming. And coming. And coming. And coming. I scrambled all over my reports, rushed patients to OT, chase the billing department for another insurance form for another prof. You name it...
I'm only thankful that most of the patients are nice people, so they didn't give us much trouble. Most of them commented they haven't seen me til up late and I told them that's because I was running after doctors, running to the OT, running to billing, on and off doing errands to cover the poor attendants. We are running short on measuring jugs and bed pan liners and yet we have many patients who are on strict I/O. Urgh. To make matters worse, morning shift left half of the work for us to cover. I prepared a little boy to OT and shoot, no one bothered to pass the medication. I only found out at the last minute when I opened the prof's notes. Gyaaaa. Lucky I quickly pass over to the med nurse and she got the medicine for me. Close call. I know most profs are nice enough people, but cross their bad side by not completing your orders and you're history.
For some weird reason, I followed an anaest and inside, she's fuming. After we got the consent, she started going, "Who gave me the wrong patient during operation? Wasted my time for 30 minutes." What the- There was an incident of wrong patient??? These days I haven't been sending patient down to OT much, but I've been in the morning as well. So no, I haven't heard anything much about wrong patients being sent down. Apparently, hearing from her, it seems that it was our ward who sent down the wrong patient since it was an Obs and Gynae case. And because the wrong patient was sent, everything was delayed for thirty minutes. Yikes. She was basically chucking the prescription form at me. Well, what to do? She's just expressing her feelings. To make matters worse, last minute we got another call from OT saying they need a LMA size 2 and 2.5. I managed to get 2.5, there were plenty, but size 2, crikey, we're out of stock. Urgh. Nothing I can do about it but pass over to the OT that they will have to make use of size 2.5 alone. And because the anaest did not come to see the patient, he didn't know there was a loose teeth on the patient's lower gum. Sigh.
Today seems to be burning hot than usual because I stepped into OT many times and yet my back is sweating. OT is supposed to be freezing like being inside the freezer but we're all sweating, even my patient. His whole head is damp when I came to pick him up. Poor guy. All in all, things were hectic but slowly cooled down after 6.
I'm only thankful that most of the patients are nice people, so they didn't give us much trouble. Most of them commented they haven't seen me til up late and I told them that's because I was running after doctors, running to the OT, running to billing, on and off doing errands to cover the poor attendants. We are running short on measuring jugs and bed pan liners and yet we have many patients who are on strict I/O. Urgh. To make matters worse, morning shift left half of the work for us to cover. I prepared a little boy to OT and shoot, no one bothered to pass the medication. I only found out at the last minute when I opened the prof's notes. Gyaaaa. Lucky I quickly pass over to the med nurse and she got the medicine for me. Close call. I know most profs are nice enough people, but cross their bad side by not completing your orders and you're history.
For some weird reason, I followed an anaest and inside, she's fuming. After we got the consent, she started going, "Who gave me the wrong patient during operation? Wasted my time for 30 minutes." What the- There was an incident of wrong patient??? These days I haven't been sending patient down to OT much, but I've been in the morning as well. So no, I haven't heard anything much about wrong patients being sent down. Apparently, hearing from her, it seems that it was our ward who sent down the wrong patient since it was an Obs and Gynae case. And because the wrong patient was sent, everything was delayed for thirty minutes. Yikes. She was basically chucking the prescription form at me. Well, what to do? She's just expressing her feelings. To make matters worse, last minute we got another call from OT saying they need a LMA size 2 and 2.5. I managed to get 2.5, there were plenty, but size 2, crikey, we're out of stock. Urgh. Nothing I can do about it but pass over to the OT that they will have to make use of size 2.5 alone. And because the anaest did not come to see the patient, he didn't know there was a loose teeth on the patient's lower gum. Sigh.
Today seems to be burning hot than usual because I stepped into OT many times and yet my back is sweating. OT is supposed to be freezing like being inside the freezer but we're all sweating, even my patient. His whole head is damp when I came to pick him up. Poor guy. All in all, things were hectic but slowly cooled down after 6.
Thursday, January 15, 2015
No Rooms
15th January (Thursday) - Today, it's one hectic day. The amount of discharge = the amount of admission. Even more, because not many patients are fit for discharge, and the people who wants admission are unreasonable. As I had said many times, they seemed to think we can just throw our patients out of bed and reel them in. Sorry to say, folks, but hospitals/ hotels/ restaurants, anywhere in the world in fact, has limited beds/ accommodation and seats. Please understand, people come in here because they are ill, and they aren't well enough yet to discharge. Yes, I know you have family members who are also ill, but please, for God's sake, give our patients the chance to recover. If we nurses can discharge the patients, we'll gladly do so, but it's the doctors'/profs' job to discharge patients. Certain areas we can't cross the line, and yet they still don't understand what's the meaning of the word LIMITED.
Okay, scratch that. Sometimes I think people are too thick-headed. Myself, included, but at least, come on, know the boundaries. I even brought a girl to a room which we don't even have time to clean fully (No time for housekeeping, we just chucked all the rubbish, turn the mattress over, set up a new fresh linen, top up with admission kit and gown). Just nice the cleaning lady was just about to clean the toilet and she went, "No, I don't want this room." For crying out loud, you think this is room service? That's the only room left. And it's not as though we didn't tidy up, we did, we cleaned it rather nicely instead of waiting for housekeeping, except for the toilet, I mean, you don't expect the nurses to be maids, right? (Yet another thing that patients will never understand, nurses ARE NOT maids) Sigh, why is it so hard to please people???
We ourselves are busy like hell too. Running after profs, procedures, sending patients up and down for scans, patients who insisted on being discharged, it's a non stop cycle. I myself followed one prof, the moment I'm done and wanted to write my report, bam, angio room called for the patient to be sent for a fistulogram. But my report... D: The TL is basically chasing me down, so alright alright, I grabbed the folders, served my patient his anti-hypertensive drug and whisked him off to below. Then just as I came back up, Doctor came to see his little babies. There's no need to ask which room is it. He only has two, so I just grabbed both folders and braced myself for the first one. The family are the whacky type, I say whacky in a polite way, but others call them much worse than that. I spent an hour sitting with him in the room as the grandmother and mother give themselves tons of headaches by asking in-depth questions. What's wrong with you people??? We are giving you the easy way but you are making things so difficult for yourselves. I still got the bruises that the kid gave me due to being kicked multiple times because he hates nurses. It has to be a one hit perfect observation, because the kid doesn't have patience. With the faulty oxymeter and the lousy sensor, that's impossible. Sorry kid. (Hence why I refused to study in post basic paediatric care, but also mainly I don't have tolerance for kids, only for babies)
After that, it was a rush of observations since no one wants to do. With all of our thermometers missing and left with only the crappy slow one, not many patients are happy about it. Well, what can you do? When I first entered there were four, then there were three, then two and finally, left the lousy one. All the fast ones had gone poof. Vanished into thin air.
After all of the crazy pandemonium, it was only near 1 after the TL had came back for her break that I rushed for mine. Not even thirty minutes are up and I rushed back in after wolfing down at top speed and I got called to bring a patient back up from pacemaker insertion. Sigh... No one else can do it cause everyone are too busy. So what to do? I dumped my container and bottle, grabbed the kidney dish full of supplies, and most importantly, ice pack and rushed down. Since I haven't even seen this patient before, I had to ask them for Prof So-and-So's patient. Oh, there she is. Ohhhh, my ice pack is too lousy, not even half an hour had passed and it's already not cold. Darn it, I knew I should've taken the large hunk of ice one instead of the lumpy one.
Once done, I did the usual post op observation and wrote my report at top speed. Then the CI (Not the one who is particular, another one) asked me to also monitor the heart reading. Wha-at? Where are we going to get those heart-reading machines like the HDU? Oh wait. I recalled we got that super Philip machine for close monitoring. I think we can use that, and the CI said yes, I can use it since it's for close monitoring. So after hopping up and down for the electrodes. I switched the machine and struggled to find a bedpan and measuring jug. Urgh, we are having severe shortage of bedpan liners and measuring jugs here. HELP!!!
Okay, scratch that. Sometimes I think people are too thick-headed. Myself, included, but at least, come on, know the boundaries. I even brought a girl to a room which we don't even have time to clean fully (No time for housekeeping, we just chucked all the rubbish, turn the mattress over, set up a new fresh linen, top up with admission kit and gown). Just nice the cleaning lady was just about to clean the toilet and she went, "No, I don't want this room." For crying out loud, you think this is room service? That's the only room left. And it's not as though we didn't tidy up, we did, we cleaned it rather nicely instead of waiting for housekeeping, except for the toilet, I mean, you don't expect the nurses to be maids, right? (Yet another thing that patients will never understand, nurses ARE NOT maids) Sigh, why is it so hard to please people???
We ourselves are busy like hell too. Running after profs, procedures, sending patients up and down for scans, patients who insisted on being discharged, it's a non stop cycle. I myself followed one prof, the moment I'm done and wanted to write my report, bam, angio room called for the patient to be sent for a fistulogram. But my report... D: The TL is basically chasing me down, so alright alright, I grabbed the folders, served my patient his anti-hypertensive drug and whisked him off to below. Then just as I came back up, Doctor came to see his little babies. There's no need to ask which room is it. He only has two, so I just grabbed both folders and braced myself for the first one. The family are the whacky type, I say whacky in a polite way, but others call them much worse than that. I spent an hour sitting with him in the room as the grandmother and mother give themselves tons of headaches by asking in-depth questions. What's wrong with you people??? We are giving you the easy way but you are making things so difficult for yourselves. I still got the bruises that the kid gave me due to being kicked multiple times because he hates nurses. It has to be a one hit perfect observation, because the kid doesn't have patience. With the faulty oxymeter and the lousy sensor, that's impossible. Sorry kid. (Hence why I refused to study in post basic paediatric care, but also mainly I don't have tolerance for kids, only for babies)
After that, it was a rush of observations since no one wants to do. With all of our thermometers missing and left with only the crappy slow one, not many patients are happy about it. Well, what can you do? When I first entered there were four, then there were three, then two and finally, left the lousy one. All the fast ones had gone poof. Vanished into thin air.
After all of the crazy pandemonium, it was only near 1 after the TL had came back for her break that I rushed for mine. Not even thirty minutes are up and I rushed back in after wolfing down at top speed and I got called to bring a patient back up from pacemaker insertion. Sigh... No one else can do it cause everyone are too busy. So what to do? I dumped my container and bottle, grabbed the kidney dish full of supplies, and most importantly, ice pack and rushed down. Since I haven't even seen this patient before, I had to ask them for Prof So-and-So's patient. Oh, there she is. Ohhhh, my ice pack is too lousy, not even half an hour had passed and it's already not cold. Darn it, I knew I should've taken the large hunk of ice one instead of the lumpy one.
Once done, I did the usual post op observation and wrote my report at top speed. Then the CI (Not the one who is particular, another one) asked me to also monitor the heart reading. Wha-at? Where are we going to get those heart-reading machines like the HDU? Oh wait. I recalled we got that super Philip machine for close monitoring. I think we can use that, and the CI said yes, I can use it since it's for close monitoring. So after hopping up and down for the electrodes. I switched the machine and struggled to find a bedpan and measuring jug. Urgh, we are having severe shortage of bedpan liners and measuring jugs here. HELP!!!
Monday, January 12, 2015
Ungratefulness
12th January (Monday) - Ohhh, I can't take it anymore, I seriously can't take it anymore. I know I've been rambling about this for a while now but this one really takes the cake. The day started off like normal enough, I managed to get a few ladies walking about since it's already their 3rd post-op day. No more excuse for them to stay in bed, sorry. I managed to convince one to move about, and she did, she also managed to take her food well, so I finally off her drip at the last pint. At last, the past few days she had been asking me to remove it but she's only been taking Milo, which I said to her it's not enough. Taking one cup of Milo doesn't mean you're fit to get off the drip. But since today she took oats, bread and water, I'm happy enough to do so. Especially when she took a bowl of porridge for lunch. Good to see up and about. Now, if only I can get the other girl to walk...
Today I did an admission for an angio case. Once done, a baby came in. Then everyone was like, "Kiddo, your big brother's patient is here." Big brother? I don't remember having any prof being called my big brother. Oh, OH. OH HELL NO. I knew who it is. There's only one person who is my 'big bro' , and I don't recommend following him unless you are 120% sure you know what you are doing. Sigh, yep, he wants his blood again. Urgh, he's a paediatric genetic expert, so every specimen bottles he wants are super weird ones that you don't usually keep in the ward. DNA, chromosome, genetic...really weird ones that involves special bottles. Since I already followed him twice, I more or less got his style. So I was shoved to the front line. Alright then, who am I to complain? I took the old folder and read the specimen he needed, prepared the bottles and butterfly needle, with the tube holder. You see, he is the type that wants you to know what you are doing. If you don't know what you are doing, he'll chase you out, as he did to one girl whom I am with during my first time, when I was in my lowly 3rd month.
Big mistake. A senior girl did the admission, so I actually forgotten about the Emla cream with the urine specimen bag. Guess who get shot. ME. Always me. At leasr prof didn't explode like last time, but he advised me there's no need to wait for him, that whoever is doing the admission should straightaway apply the cream onto the child. FOR GOD'S SAKE, I WAS ATTENDING THE ANGIO PATIENT AT THAT TIME, AND YET I STILL GOT THE BLAME FOR NOT APPLYING THE CREAM!!! Fine, I'll admit, my fault for not checking up on the patient, being too intense on preparing the specimen bottles. I even syringed out Lignocaine by accident due to being stressed out and got a bullocking from the CI. It was an ACCIDENT, at least I didn't throw it into the tray. She asked me why did I bother syringing out the Lignocaine out of the bottle, and I told her patiently because when I already broke the bottle's seal, it's considered contaminated, so there's no point I leave it wasted in an open bottle. So I just syringed it out, kept it in a syringe and wrote the name on top so that no one will get it wrong. And the CI was going on and on about how I'm wasting the hospital money and saying that I should pay for it. Urgh. >< (punches self) I swear, this is the last time I'm being super nice to help them out. You try to be nice and kind to help people out and you end up getting yelled for every single thing that went wrong.
After taking the patient back from angio, I didn't had time to write and hand over when 'big bro' came back again, due to the parents requesting a delay since their child was sleeping. So what to do? The TL ordered me stop temporarily and go attend to him. With the trolley ready, I went with another colleague. Following him you need a partner to hold the baby, drawsheet, the required specimen bottles, what are they for (He will always ask you, and if you can't answer, out you go.) and you had to be quick on your feet. Thank God I wasn't screaming my head off for this round, but he did asked me to be FAST FAST FAST. No delaying.
Overall, since we are already used to him, the whole thing took 30 minutes, since the baby was also very silent, and not struggling. Shame that we had to use open drip method since he's too small for the butterfly vacutainer. Once done, I settled my angio patient and remaining patients and end my shift.
Today I did an admission for an angio case. Once done, a baby came in. Then everyone was like, "Kiddo, your big brother's patient is here." Big brother? I don't remember having any prof being called my big brother. Oh, OH. OH HELL NO. I knew who it is. There's only one person who is my 'big bro' , and I don't recommend following him unless you are 120% sure you know what you are doing. Sigh, yep, he wants his blood again. Urgh, he's a paediatric genetic expert, so every specimen bottles he wants are super weird ones that you don't usually keep in the ward. DNA, chromosome, genetic...really weird ones that involves special bottles. Since I already followed him twice, I more or less got his style. So I was shoved to the front line. Alright then, who am I to complain? I took the old folder and read the specimen he needed, prepared the bottles and butterfly needle, with the tube holder. You see, he is the type that wants you to know what you are doing. If you don't know what you are doing, he'll chase you out, as he did to one girl whom I am with during my first time, when I was in my lowly 3rd month.
Big mistake. A senior girl did the admission, so I actually forgotten about the Emla cream with the urine specimen bag. Guess who get shot. ME. Always me. At leasr prof didn't explode like last time, but he advised me there's no need to wait for him, that whoever is doing the admission should straightaway apply the cream onto the child. FOR GOD'S SAKE, I WAS ATTENDING THE ANGIO PATIENT AT THAT TIME, AND YET I STILL GOT THE BLAME FOR NOT APPLYING THE CREAM!!! Fine, I'll admit, my fault for not checking up on the patient, being too intense on preparing the specimen bottles. I even syringed out Lignocaine by accident due to being stressed out and got a bullocking from the CI. It was an ACCIDENT, at least I didn't throw it into the tray. She asked me why did I bother syringing out the Lignocaine out of the bottle, and I told her patiently because when I already broke the bottle's seal, it's considered contaminated, so there's no point I leave it wasted in an open bottle. So I just syringed it out, kept it in a syringe and wrote the name on top so that no one will get it wrong. And the CI was going on and on about how I'm wasting the hospital money and saying that I should pay for it. Urgh. >< (punches self) I swear, this is the last time I'm being super nice to help them out. You try to be nice and kind to help people out and you end up getting yelled for every single thing that went wrong.
After taking the patient back from angio, I didn't had time to write and hand over when 'big bro' came back again, due to the parents requesting a delay since their child was sleeping. So what to do? The TL ordered me stop temporarily and go attend to him. With the trolley ready, I went with another colleague. Following him you need a partner to hold the baby, drawsheet, the required specimen bottles, what are they for (He will always ask you, and if you can't answer, out you go.) and you had to be quick on your feet. Thank God I wasn't screaming my head off for this round, but he did asked me to be FAST FAST FAST. No delaying.
Overall, since we are already used to him, the whole thing took 30 minutes, since the baby was also very silent, and not struggling. Shame that we had to use open drip method since he's too small for the butterfly vacutainer. Once done, I settled my angio patient and remaining patients and end my shift.
Saturday, January 10, 2015
Relapse
10th January (Saturday) - Okay, today I'm half-dead, report taking made me a little blur, but I did took the report on auto-pilot. Bed-making, some patients asleep, request to do later. 4 operating cases, majority obs and gynae. Throw in a child and neuro case and we are all set.
No, we actually got nothing against the patients. but seriously, there are some who are just plain lazy, waving an airy hand, "Oh, it's okay, you can change it later." Especially one patient who often parties up til the break of dawn (Figuratively speaking). She often wakes up at the end of our morning shift, then expects us to change her bed linen. Now look, it's not that we don't want to change your linen. You have to understand, prof often comes around lunchtimes, which means certain times like from 12 - 2 are usually peak hours for the profs to come, which means we will be super busy. Sometimes we just wished patients can be understanding, you know.
Okay, I rushed some admissions for late-comers who are due for operation in thirty minutes. Once settled, I rushed to attend another patient who has a leaking branulla. Ohhh, please don't let it be a leak, if it leaks, and it's a baby, I cannot imagine the baby wants to go through another round of poking. Uh-uh. Not on my watch. Armed with Heparin Saline, I unwound the bandage and partly took out the plaster surrounding the branulla. Nooooo. It's not leaking. Eh, something came loose as I tried to twist the tubing out. Oh, it's not a leak, It's the T-piece connector being loose. I fixed it up and then tried to twist the tubing so that I could flush--- Ahm, urgh, HOLY COW, WHO TIGHTENED THE TUBING?!!! It's hard to get it out. The mother took pity on me and armed with two chest clamps, I grabbed one, the mother grabbed another, and between us, we managed to twist the tubing open by turning opposite directions. Praise the Lord. And the baby was so quiet, singing along to The Wheel On The Bus. Glad someone's having fun.
Issue : We are all out of Ondasetron for most of our patients, but thank God again, it's not important, but we were told to stand by with the Kytrils. Seriously, I don't know how prof can just do more than 10 cases continuously without stopping, with all the last minute cases being added in. As all my patients like to tell me, "He's a man with many ladies chasing him." That's what makes him so good in his job. :D
So yeah, with all the mad rush of sending patients down to OT. the place itself was also like a marketplace. I haven't checked one of my patients fully and they were already pushing my patient out. Give me a chance to check my patient's wound please. What if it's bleeding or something like one case I took last time, where we had to use so many gauze to staunch the bleeding? Good thing my patient is alright otherwise there will be BIG trouble.
Most of the old patients came back today, so in a way, it's like a reunion, but in a way, it's also sad. Whenever I see a patient discharge, I pray hard that they don't come back again for admission. It's not nice, you know, to see your patient going from weak to strong, and then back to weak again, like my old patient, who went for a CABG, and now he had came back for a chest tube insertion. Oh dear.
Not so good part, my nose suddenly went too sensitive that I ended up wearing masks a lot, and coughing out and blowing out a lot of greenish phlegm and mucus. My voice didn't sound too good too, but I checked my temperature: 36.4 C. No fever, but I'm still weak. Well my nose and throat ever be fully cured???
No, we actually got nothing against the patients. but seriously, there are some who are just plain lazy, waving an airy hand, "Oh, it's okay, you can change it later." Especially one patient who often parties up til the break of dawn (Figuratively speaking). She often wakes up at the end of our morning shift, then expects us to change her bed linen. Now look, it's not that we don't want to change your linen. You have to understand, prof often comes around lunchtimes, which means certain times like from 12 - 2 are usually peak hours for the profs to come, which means we will be super busy. Sometimes we just wished patients can be understanding, you know.
Okay, I rushed some admissions for late-comers who are due for operation in thirty minutes. Once settled, I rushed to attend another patient who has a leaking branulla. Ohhh, please don't let it be a leak, if it leaks, and it's a baby, I cannot imagine the baby wants to go through another round of poking. Uh-uh. Not on my watch. Armed with Heparin Saline, I unwound the bandage and partly took out the plaster surrounding the branulla. Nooooo. It's not leaking. Eh, something came loose as I tried to twist the tubing out. Oh, it's not a leak, It's the T-piece connector being loose. I fixed it up and then tried to twist the tubing so that I could flush--- Ahm, urgh, HOLY COW, WHO TIGHTENED THE TUBING?!!! It's hard to get it out. The mother took pity on me and armed with two chest clamps, I grabbed one, the mother grabbed another, and between us, we managed to twist the tubing open by turning opposite directions. Praise the Lord. And the baby was so quiet, singing along to The Wheel On The Bus. Glad someone's having fun.
Issue : We are all out of Ondasetron for most of our patients, but thank God again, it's not important, but we were told to stand by with the Kytrils. Seriously, I don't know how prof can just do more than 10 cases continuously without stopping, with all the last minute cases being added in. As all my patients like to tell me, "He's a man with many ladies chasing him." That's what makes him so good in his job. :D
So yeah, with all the mad rush of sending patients down to OT. the place itself was also like a marketplace. I haven't checked one of my patients fully and they were already pushing my patient out. Give me a chance to check my patient's wound please. What if it's bleeding or something like one case I took last time, where we had to use so many gauze to staunch the bleeding? Good thing my patient is alright otherwise there will be BIG trouble.
Most of the old patients came back today, so in a way, it's like a reunion, but in a way, it's also sad. Whenever I see a patient discharge, I pray hard that they don't come back again for admission. It's not nice, you know, to see your patient going from weak to strong, and then back to weak again, like my old patient, who went for a CABG, and now he had came back for a chest tube insertion. Oh dear.
Not so good part, my nose suddenly went too sensitive that I ended up wearing masks a lot, and coughing out and blowing out a lot of greenish phlegm and mucus. My voice didn't sound too good too, but I checked my temperature: 36.4 C. No fever, but I'm still weak. Well my nose and throat ever be fully cured???
Friday, January 9, 2015
Tension High
9th January (Friday) - I knew today we're going to get incoming admissions, because yesterday was too silent. Unless you count me having a soft whispery voice and unable to shout or yell, with the occasional phlegm and my ears pressure seems uncoordinated due to a lot of popping when I'm blowing my nose, oh, and the part where OT caused me a lot of stress. Yes, I know it's already past eight, the time where we all will be begging, please don't send patient up before nine... But what can you do if you are still on? I got a call to take down a patient, no, not complaining. I grabbed what I needed (Kidney dish. spatulas, gauze, gloves, alcohol swabs, hypafix) and dashed down. Ah, okay, there's my patient. slightly KO-ed, as all who underwent GA.
I took over from the OT staff. Ooookay. Some weird lettering, but I can see bronchoscopy, excision of mass and tumour clearly. Alright, but wait. She skipped the HPE part. I quickly asked her about the specimen and she went, "Oh, yeah. HPE sent." Close call. She passed over the rest. I'm surprised that Dr A never wrote his cardex. He doesn't seem like the kind of person who would leave things hanging. So the girl told me to give Panadol if the patient moans in pain. If Panadol doesn't work, to call Dr A. Oh, okay.
When I got back, I checked through my medication cardex first. Oh for goodness sake. The girl got it wrong. Dr A already wrote all of the painkillers in black and white. The one who did not wrote was Prof B, who ordered 3 doses of antibiotics with the anti-vomiting drug. == I quickly stuck stickers onto my nursing notes, and got another shock. No, not kidding. My patient's labels were swapped with another patient's, both are under the same Prof. Oh COME ON, I know they are probably busy but please, please, please, a Malay young lady label with a middle aged Chinese man label, there's a BIG difference. Thank God I checked the whole folder beforehand. Yes, it's my patient's folder, but the labels are wrong. I have to toss it aside and print out a new fresh set of labels. Sigh. What a waste. As I was closing my folder, I noticed something funny in the front. What's this? A vial with an unused medication, seal unbroken. HELLO??? It's a very good thing I did not thrash the folder around. What if the vial breaks? And then who's going to answer to Prof B tomorrow???
The next day we definitely have sponging. Only one. The elderly lady whom my friend sent down with the young lady I sent. It's kinda obvious. She's the only one with a major surgery, my young lady just had an excision of the neck, not very major. I did sponging for her with another girl, and I knew it, she kept talking to me non-stop in Cantonese/ Hokkien, even though I repeatedly told her in broken Cantonese, I don't speak the language, nor do I understand fully, only basic simple words.But she still insisted on talking to me. Sigh, I tried to answer her as little as possible, hoping for her to understand that I can't entertain her much. She didn't get it, but I toned down a lot.
It's my second time taking a patient back from angio, but this time, I'm well prepared. Grab the kidney dish (and others) and off we go. So after making sure I'm going to the right place (Don't want to end up running around the South Tower like last time), I went to find my patient. There's only three patients there. Two men and one lady. I know my patient is a man, but which one? I haven't seen his face before, so I went over to the girl at the counter and asked for my patient. She smiled at me and said he's the one on the farthest left. To make sure I'm not taking the wrong patient, I went over to the patient and asked for his ID band----
Oh, no band. O.O A-Ara...
I asked the patient his name and he said, yes, he's the patient. I was basically going around, "Where's the ID band?" Then the girl laughed and said, "We had to cut it off because it was on his right." Ohhh, Okay, at least thank God it was the right patient. So I grabbed the folder, brought back my patient and did the routine post-angio observation. Whew.
Besides running up and down in doctor's rounds, admissions, assisting in dressings and observations, I did one final task before the end of my shift. Assisting a prof in removing the TR band. God knows why he wants to remove it so fast, I was basically ripping off packets after packets of sterile gauzes and handing them to prof due to the amount of blood pouring out from the radial site. Not to mention the surgical swabs I was tearing open after another. Then he asked me to get adrenaline from the pharmacy. I told him timidly we need a prescription, since adrenaline is not something that we keep in the ward. He basically waved me away and said, "Just get me one ampoule, I'll write the prescription later!" What could I do but ran like crazy and asked the pharmacy for the adrenaline. Lucky they were understanding and handed me one, and I ran back with the precious ampoule in hand. I dropped it in the tray, tossed out a 3cc syringe and prof stopped me. "Wait, don't open it unless I tell you to." Alright. So I stand by with the plasters and bandages then when the bleeding finally stopped thanks to prof applying a lot of pressure, I got my plaster ready and we taped it hard. Then I did the bandaging while prof went to settle the charges. After settling the branulla, I chuck all the blood stained gauze, gloves, torn packets into the clinical waste bin, wrote my report at top speed, grabbed a charging list, jotted down all the equipments, grabbed prof's charges, and on my way out, I dropped by the billing and ended my shift officially. Wow, what a day.
I took over from the OT staff. Ooookay. Some weird lettering, but I can see bronchoscopy, excision of mass and tumour clearly. Alright, but wait. She skipped the HPE part. I quickly asked her about the specimen and she went, "Oh, yeah. HPE sent." Close call. She passed over the rest. I'm surprised that Dr A never wrote his cardex. He doesn't seem like the kind of person who would leave things hanging. So the girl told me to give Panadol if the patient moans in pain. If Panadol doesn't work, to call Dr A. Oh, okay.
When I got back, I checked through my medication cardex first. Oh for goodness sake. The girl got it wrong. Dr A already wrote all of the painkillers in black and white. The one who did not wrote was Prof B, who ordered 3 doses of antibiotics with the anti-vomiting drug. == I quickly stuck stickers onto my nursing notes, and got another shock. No, not kidding. My patient's labels were swapped with another patient's, both are under the same Prof. Oh COME ON, I know they are probably busy but please, please, please, a Malay young lady label with a middle aged Chinese man label, there's a BIG difference. Thank God I checked the whole folder beforehand. Yes, it's my patient's folder, but the labels are wrong. I have to toss it aside and print out a new fresh set of labels. Sigh. What a waste. As I was closing my folder, I noticed something funny in the front. What's this? A vial with an unused medication, seal unbroken. HELLO??? It's a very good thing I did not thrash the folder around. What if the vial breaks? And then who's going to answer to Prof B tomorrow???
The next day we definitely have sponging. Only one. The elderly lady whom my friend sent down with the young lady I sent. It's kinda obvious. She's the only one with a major surgery, my young lady just had an excision of the neck, not very major. I did sponging for her with another girl, and I knew it, she kept talking to me non-stop in Cantonese/ Hokkien, even though I repeatedly told her in broken Cantonese, I don't speak the language, nor do I understand fully, only basic simple words.But she still insisted on talking to me. Sigh, I tried to answer her as little as possible, hoping for her to understand that I can't entertain her much. She didn't get it, but I toned down a lot.
It's my second time taking a patient back from angio, but this time, I'm well prepared. Grab the kidney dish (and others) and off we go. So after making sure I'm going to the right place (Don't want to end up running around the South Tower like last time), I went to find my patient. There's only three patients there. Two men and one lady. I know my patient is a man, but which one? I haven't seen his face before, so I went over to the girl at the counter and asked for my patient. She smiled at me and said he's the one on the farthest left. To make sure I'm not taking the wrong patient, I went over to the patient and asked for his ID band----
Oh, no band. O.O A-Ara...
I asked the patient his name and he said, yes, he's the patient. I was basically going around, "Where's the ID band?" Then the girl laughed and said, "We had to cut it off because it was on his right." Ohhh, Okay, at least thank God it was the right patient. So I grabbed the folder, brought back my patient and did the routine post-angio observation. Whew.
Besides running up and down in doctor's rounds, admissions, assisting in dressings and observations, I did one final task before the end of my shift. Assisting a prof in removing the TR band. God knows why he wants to remove it so fast, I was basically ripping off packets after packets of sterile gauzes and handing them to prof due to the amount of blood pouring out from the radial site. Not to mention the surgical swabs I was tearing open after another. Then he asked me to get adrenaline from the pharmacy. I told him timidly we need a prescription, since adrenaline is not something that we keep in the ward. He basically waved me away and said, "Just get me one ampoule, I'll write the prescription later!" What could I do but ran like crazy and asked the pharmacy for the adrenaline. Lucky they were understanding and handed me one, and I ran back with the precious ampoule in hand. I dropped it in the tray, tossed out a 3cc syringe and prof stopped me. "Wait, don't open it unless I tell you to." Alright. So I stand by with the plasters and bandages then when the bleeding finally stopped thanks to prof applying a lot of pressure, I got my plaster ready and we taped it hard. Then I did the bandaging while prof went to settle the charges. After settling the branulla, I chuck all the blood stained gauze, gloves, torn packets into the clinical waste bin, wrote my report at top speed, grabbed a charging list, jotted down all the equipments, grabbed prof's charges, and on my way out, I dropped by the billing and ended my shift officially. Wow, what a day.
Wednesday, January 7, 2015
No Voice
7th January (Wednesday) - Aaaack, aaahh, eeeeeeee, ooooooo, na-da. Nope, no voice. Darn it, is my URTI that bad? I don't have fever, my nose isn't running much anymore, but I get a really bad sore throat til my voice is nothing but a whisper. I can talk, but only in whispers, and sometimes my voice will just fade. Which means no establishing rapport with patients for today.
Seeing me struggle with my throat, everyone attempted to give me advice. How sore throats are cured with cold diet, like ice cream, 100 plus. The MO on the other hand, said I should take juice rich in Vitamin C, and something hot like soup or broth, even asking me to gargle and take honey, I did all of the above except the cold diet part. I though sore throat means having a lot of phlegm in your throat and the only way to get it out is to use hot stuff, like Milo, coffee, tea, soup. I never expected cold diet, but the senior girls told me to get cold diet, because my throat is slightly swollen and painful. Cold diet like ice cream actually helps to reduce the swelling and pain. But when I asked my Dad, he shouted that I shouldn't listen to them because they are not doctors. I don't know. Both sides are actually right in a way. Cold diet is pleasing to the throat, and it does help reduce swelling, as evidenced by my patients who had underwent throat or nose surgeries. Hot diet actually does help to reduce the phlegm accumulated in the throat, which is why chicken soup is always the best remedy.
In the end, I took warm porridge mixed with Marmite, mini Chipsmore and a Milo packet. Shouldn't be any harm, except I am still unable to taste anything. For the past 3 days, I had absolutely no appetite at all. Mainly, when you had sore throat with thick phlegm and mucus clogging all over your throat and nose, food is the last thing on your mind.
A staff took concern of me and asked me why I never took MC. I mentioned it before, if I took a last minute MC when I'm supposed to be on duty means that I'm taking an 'illegal MC', according to some people. This is already my fifth month, and I cannot afford any screw ups. Because anything I do, it'll be whisked away into the file and I wouldn't even see it until my next evaluation.
No voice aside, I managed to give proper care to the patients. Topping up hydration for chemos, blood transfusion, taking patient back form OT, yep, no trouble at all. I maybe unable to speak, but that's what papers are for. :)
Seeing me struggle with my throat, everyone attempted to give me advice. How sore throats are cured with cold diet, like ice cream, 100 plus. The MO on the other hand, said I should take juice rich in Vitamin C, and something hot like soup or broth, even asking me to gargle and take honey, I did all of the above except the cold diet part. I though sore throat means having a lot of phlegm in your throat and the only way to get it out is to use hot stuff, like Milo, coffee, tea, soup. I never expected cold diet, but the senior girls told me to get cold diet, because my throat is slightly swollen and painful. Cold diet like ice cream actually helps to reduce the swelling and pain. But when I asked my Dad, he shouted that I shouldn't listen to them because they are not doctors. I don't know. Both sides are actually right in a way. Cold diet is pleasing to the throat, and it does help reduce swelling, as evidenced by my patients who had underwent throat or nose surgeries. Hot diet actually does help to reduce the phlegm accumulated in the throat, which is why chicken soup is always the best remedy.
In the end, I took warm porridge mixed with Marmite, mini Chipsmore and a Milo packet. Shouldn't be any harm, except I am still unable to taste anything. For the past 3 days, I had absolutely no appetite at all. Mainly, when you had sore throat with thick phlegm and mucus clogging all over your throat and nose, food is the last thing on your mind.
A staff took concern of me and asked me why I never took MC. I mentioned it before, if I took a last minute MC when I'm supposed to be on duty means that I'm taking an 'illegal MC', according to some people. This is already my fifth month, and I cannot afford any screw ups. Because anything I do, it'll be whisked away into the file and I wouldn't even see it until my next evaluation.
No voice aside, I managed to give proper care to the patients. Topping up hydration for chemos, blood transfusion, taking patient back form OT, yep, no trouble at all. I maybe unable to speak, but that's what papers are for. :)
Monday, January 5, 2015
No MC
5th January (Monday) - ACHOO!!! Sniff. sniff... Hack, cough, haaaack.... HACK!!!
Urgh, just my luck to strike the jackpot. The reason I haven't been updating the past three days was because of my sore throat. My nose had been running for the past few days but that hasn't stopped me form going to work, even though I feel like dropping dead like a fly. But today was worse. From a minor running nose to a little cough til the point where I couldn't cough out my phlegm and my voice became so hoarse til I cannot talk. Urgh, I didn't expect it to become so severe til the CI asked me to go NOW to the MO at the clinic. I was all set of going to the government side since I didn't brought anything except for 10 dollars, which isn't going to help me get far.But they asked me to get the GL form and the Sister was kind enough to sign for me on the spot so that I can quickly fax it to HR in an emergency.
I waited for 30 minutes foe the transportation to arrive. Darn it, I wanted to walk, it could've been much faster. but no one wanted me to walk. So I waited. Urgh, I was about to call my ward and tell them I'm walking when the van finally pulled up and I asked the driver whether he's going to the clinic and he went, "Huh? You were suppose to go there? But no one called me."
WHAT???? He only came by pure luck. Had it been normal circumstances, I might have to wait an hour. !!!! Nevertheless, with me dropping half dropping dead form the cough I'm having, he asked me to get on board and with the girl he brought, he rushed me over. During the brief journey, he asked what happened to me. I merely told him about my condition and he went, "That's sad, Your ward is having these as well, right?" Well, of course. From the past two days, there were staffs running around with runny nose and cough. As mentioned earlier, I seemed to have struck the jackpot. I reached the MO, and after checking my throat, she said it was just a virus infection, thanks to everybody who are having it. She merely called it an URTI (Upper Respiratory Tract Infection) virus. Well, okay. Thank goodness it was nothing serious. And yeah, I don't have a fever (I've been checking my temperature at home, no fever at all.). She merely advised me to take Scott Emulsions, Vitamin C, fruit juices, and fluids, always fluids. Warm water is the best. Since my throat isn't swollen, much, there's no need for antibiotics but some flu medication and the menthol salt that I previously used to get the phlegm out.
She then asked me whether I want MC or want to go back to work, I already spent 3 hours working and I refused to burn it all away. It's not as though I can't work, I can, I just cannot talk much. But following doctors, helping patients and whatnot, why not? So she merely gave me a time slip and advised me, "If your immune system is really that bad, I would suggest you wear a mask no whenever you are working." It's a good thing I'm not working tomorrow, so she didn't have to use any MCs. I didn't want the seniors complaining how I took an "illegal MC" like last time. It's bad enough I got an 'attitude problem', I don't need my reputation to go crashing down.
I got back, handed my time slip over to the Sister, and she advised me to take care of my health. Once the clock struck 2, I informed the TL that I have to leave and she let me off. So, now I'm resting in bed, taking all those awful medications, and on and off, drinking plain water. Mom tried to coax some food into me but I don't even have the appetite to eat. Everything I take, there's no taste at all. Sorry Mom. I think I shall go and make snowballs now (Scrunched up tissues). Man, I hate being sick.
Urgh, just my luck to strike the jackpot. The reason I haven't been updating the past three days was because of my sore throat. My nose had been running for the past few days but that hasn't stopped me form going to work, even though I feel like dropping dead like a fly. But today was worse. From a minor running nose to a little cough til the point where I couldn't cough out my phlegm and my voice became so hoarse til I cannot talk. Urgh, I didn't expect it to become so severe til the CI asked me to go NOW to the MO at the clinic. I was all set of going to the government side since I didn't brought anything except for 10 dollars, which isn't going to help me get far.But they asked me to get the GL form and the Sister was kind enough to sign for me on the spot so that I can quickly fax it to HR in an emergency.
I waited for 30 minutes foe the transportation to arrive. Darn it, I wanted to walk, it could've been much faster. but no one wanted me to walk. So I waited. Urgh, I was about to call my ward and tell them I'm walking when the van finally pulled up and I asked the driver whether he's going to the clinic and he went, "Huh? You were suppose to go there? But no one called me."
WHAT???? He only came by pure luck. Had it been normal circumstances, I might have to wait an hour. !!!! Nevertheless, with me dropping half dropping dead form the cough I'm having, he asked me to get on board and with the girl he brought, he rushed me over. During the brief journey, he asked what happened to me. I merely told him about my condition and he went, "That's sad, Your ward is having these as well, right?" Well, of course. From the past two days, there were staffs running around with runny nose and cough. As mentioned earlier, I seemed to have struck the jackpot. I reached the MO, and after checking my throat, she said it was just a virus infection, thanks to everybody who are having it. She merely called it an URTI (Upper Respiratory Tract Infection) virus. Well, okay. Thank goodness it was nothing serious. And yeah, I don't have a fever (I've been checking my temperature at home, no fever at all.). She merely advised me to take Scott Emulsions, Vitamin C, fruit juices, and fluids, always fluids. Warm water is the best. Since my throat isn't swollen, much, there's no need for antibiotics but some flu medication and the menthol salt that I previously used to get the phlegm out.
She then asked me whether I want MC or want to go back to work, I already spent 3 hours working and I refused to burn it all away. It's not as though I can't work, I can, I just cannot talk much. But following doctors, helping patients and whatnot, why not? So she merely gave me a time slip and advised me, "If your immune system is really that bad, I would suggest you wear a mask no whenever you are working." It's a good thing I'm not working tomorrow, so she didn't have to use any MCs. I didn't want the seniors complaining how I took an "illegal MC" like last time. It's bad enough I got an 'attitude problem', I don't need my reputation to go crashing down.
I got back, handed my time slip over to the Sister, and she advised me to take care of my health. Once the clock struck 2, I informed the TL that I have to leave and she let me off. So, now I'm resting in bed, taking all those awful medications, and on and off, drinking plain water. Mom tried to coax some food into me but I don't even have the appetite to eat. Everything I take, there's no taste at all. Sorry Mom. I think I shall go and make snowballs now (Scrunched up tissues). Man, I hate being sick.
Friday, January 2, 2015
Movie Exaggeration
2nd January (Friday) - Hello, and here comes the new year. :D My day off of spending time with my family is over and it's back to working life. Of course, with all the floods going on, school reopening has been postponed to the week after next. The usual patients are there, together with three new ones. But I'm sure we can handle it.
New Year treats were laden all over the table. Weird chocolates whose brands I never heard of, some crackers, chocolates, shell coated Smarties lookalikes,, lollipops and jelly beans. Oh, I love jelly beans so much ever since I ate some Bertie Botts Every Flavour Beans sample together with a Chocolate Frog sample I got last time when Harry Potter first hit the cinemas, that was a very long time ago. Argh, I can't help myself, I took a few, as sweet as I remembered, although I'm definitely going to regret it once my waistline increases. D:
The first day I came back, one of my colleagues asked me to take over following the anaest, well, okay, sure thing. I'm happy to do so. When I got in, I didn't realize it's going to take forever to get out. First of all, the patient, she's super paranoid. Second, she's a lawyer. Third, I say she watches too much thrillers. She kept asking a lot of irrelevant questions and stuff, here's a list:
New Year treats were laden all over the table. Weird chocolates whose brands I never heard of, some crackers, chocolates, shell coated Smarties lookalikes,, lollipops and jelly beans. Oh, I love jelly beans so much ever since I ate some Bertie Botts Every Flavour Beans sample together with a Chocolate Frog sample I got last time when Harry Potter first hit the cinemas, that was a very long time ago. Argh, I can't help myself, I took a few, as sweet as I remembered, although I'm definitely going to regret it once my waistline increases. D:
The first day I came back, one of my colleagues asked me to take over following the anaest, well, okay, sure thing. I'm happy to do so. When I got in, I didn't realize it's going to take forever to get out. First of all, the patient, she's super paranoid. Second, she's a lawyer. Third, I say she watches too much thrillers. She kept asking a lot of irrelevant questions and stuff, here's a list:
- Who's the doctor going to be in charge?
- Is the same anaest going to be there?
- What kind of painkillers are you going to give me? I want the names.
- Will you please be gentle with me?
- No, I don't want a needle now! Can't you do it once I'm fully sedated?
- You all, please, treat me GENTLE okay? I bruise easily.
- I'm so pale. Is it my diagnosis causing me this?
- Why can't you give me a 100% guarantee?
- I hate needles. Do dead bodies jump out from the body bags? Cause I like watching CSI you know. And I saw how they cut and dice and the corpses jump.
- Do I really have to do an ECG? It hurts, doesn't it?
- Why do I need all the TED stockings? Can't I just not wear it?
Clearly, I think CSI had really made her got the whole wrong idea. Personally, I don't watch shows like CSI, ER, all those crime scene shows where they do autopsies, I'm more of a Grimm person, where things are related to paranormals. I know, I used to watch CSI as well on AXN, even a few bits of medical line related shows, and Law & Order, but CSI tends to exaggerate. I often winced and shut my eyes as they do autopsies and all the gruesome bits. I hate those kinds of shows. They exaggerate. Besides, the reason why things often exaggerate is to sell the series. It's okay to watch it for entertainment, but don't take it too seriously. Sigh. I love Grimm, but you don't see me shrieking that dead bodies came back to life or something. (Wouldn't I be screwed? xD)
Among all of the lawyers I had treated, she's the most weird one. Even we medical staffs never ask into such details. The main things we do ask : Risks, the complications, will it affect out daily living functions? I swear to God, I spent an hour plus together with the anaest in her room to the point that it's only until 4 that I did a quick round of my patients. Thank God they are the same patients so they are used to seeing my face.
After that things were rather slow, only hourly observations, routine observations, intravenous drips and attending to patients' requests were the only thing that kept me going. But in between, I had also finally managed to complete the chapter which had taken me so long to complete. Oh yeah, something is going my way. :D
When I mentioned the lawyer drama with my dad, he gave a snort and said, "I told you lawyers aren't good people." Sigh, I will never get the lawyer thing with my dad. I mean, I got friends who are lawyers, and I met several lawyer patients, and they are all nice, even alright patients. One day, I think I'm going to pry the story out of him, about why he's so against lawyers.
Thursday, January 1, 2015
Happy New Year :D
Chronicles of Blitz Artwork. For more details, please check out my DeviantArt. Have a blessed 2015.
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