Tuesday, September 30, 2014

Undisguised Dislike?

30th September (Tuesday) - I thought today is going to be a little bit relaxed compared to yesterday but no. Today is worse. Let's just say if that senior becomes a TL, my life becomes a nightmare. Last time everyone was on her side because of the break issue. She sent me to break early so I went about 9, taking only a small packet of nasi lemak with anchovy and banana leaf as my brunch. Once done, I went back to do my usual work, feeding. Then, helping out in some admissions. Oh the TL, I really think she's dislikes me. God knows. When I first met her she seems okay, if taking her work seriously. But after working with her when she's the TL for a few days, I think she really dislikes me. When I'm busy doing something, she'll just yank me aside and order me to do something. Since last time I didn't want to go to break early, she got the whole big bosses ganging up on me and I got into big trouble. So, to avoid another drama, I just grabbed the thermometer, stethoscope (It's a baby), I was looking for the SPO2 probe but unfortunately, after running around the entire ward, I got nothing. So I just went over to the baby, took the vital signs and the orientation to the ward and ditto. Then I have to take the baby's weight, but the mother insisted on carrying the baby, so I did the dumbest thing and allowed her into our store where the baby weighing scale is located. Then I got a warning from the Sister to ALWAYS carry the baby myself instead of letting the mother carry. God, that was a big mistake.
And I got to handle two teenage boys on my side, both under the same prof, same diagnosis (dengue fever), and they are both good friends, just different room. Sigh. While I was handling one of the other boys, the prof came in and asked me to follow him. After rushing like a mad woman to prepare the branulla line, with a few slight mistakes of the needle, we managed to get it. Oh, and I followed for about 2 hours plus, from 12 to 2. So I have to rush my report and get all the samples ready and labelled right. Thank the Lord he's a nice prof, when he gets mad, he just raise his voice, but he won't lose his temper.
Oh, this month's salary just came in, and I got a day off tomorrow. Good, I'm gonna need it. I really hope that staff won't be the TL in my shift for a while. Otherwise my mood will drop rock bottom. ==

Monday, September 29, 2014

Doom & Gloom

29th September (Monday) - With only a minute left to spare, I dashed in just in the nick of time to grab my report. I noticed they mentioned one of the patient for discharge. When I took a look, I was like, "Huh? This patient is critical, how can he be discharged?" Turns out it wasn't a discharge as in, grab your things and hightail it out of here. It's because the patient passed away. Yes, he passed away at about 5.45 am. Total shock. I met this patient before when I was at downstairs. I even took him for a wheelchair ride to the billing department to make payment. Although he doesn't remember me, he was pretty much okay. Few days ago, he was joking with me about his suspenders (Or to put it in Minho's term, runnie-undies) since he point blank refused to put on sarong. I kinda get him cause I don't like wearing sarong either. (Pardon the Maze Runner pun, I love the books, especially Minho. Can't wait for the next book in 2015)
Okay, then there's the running back and forth with the linens and shower, then it's time to give my favourite uncle his feeding. Oh yes. Uncle's feeding is often done by me, so he also knows what time I'll be coming in to give him. He then told me he's going to have a PEG insertion to save cost, which is on this Wednesday. Awww, I'll be having an off day so I won't be there to see him off as he goes for the op.
The prof whom I once helped in pleural tapping... He got a patient admitted in the ward. Coincidently, I was the one doing the admission, so he asked me to prepare setting a line. He's one of the nicer profs, so after preparing my tray, I brought it over to him for inspection, he nodded and said, "Good, but you don't need the vacu-containers. I won't be taking blood, just the line will do." So once ready, I assisted the prof, easy enough, it was a success, and although his writing were like squiggles, I double confirm his orders. Simple, and my report is happily done. Although in between I have to do tons of bits and that due to the seniors being occupied.
Oh, and I ran into a really odd patient. You ever heard of these types of patients? The one who demands for singles or VIP rooms? They're the type that wants to admit for operation, but because they couldn't get their room, they went, "If you don't have a room, then I won't do the procedure." Sigh, these people really think they are living in a hotel suite. Well, their problem... We give them a room, but they refuse it because they don't want double or four bedded. Jeesh.
Remember the patient whom I removed sutures? She seems alright because she's fully discharged. It was just bad luck. Anyhow, I attended another one of his patient and he ordered me to off CBD. Well, once I got out from the patient's room, he's gone. I asked the senior nurse who had followed him and she said, "No, he didn't say anything. Check the notes." The only he wrote was DRIP OFF, not CBD OFF. To double confirm, I grabbed the folder and chaed after him after we made a call to downstairs. When I got down, I asked the counter nurse and they were like, "He was just here! Hurry girl! He's at the front!" I run and thank the Lord, he's still there, although the lift's just moving up, and he's on the phone. I quickly run to him and said, "Prof, just to double confirm. CBD to off?" He just waved a hand and nodded. So, lucky me. I juat off the CBD with the senior's guidance and resume back to my happy working day.
Poor patient though. I think room 5 is jinxed. The previous old man who stayed there also passed. Cause of death : Hypovolemic shock, CA pancreas. RIP :(

A Peaceful Sunday

28th September (Sunday) - 2 more days to cha-ching cha-ching. Just have to survive. Alright. Here we go. I often work Sunday noon shifts, but someday I'll get a Sunday morning. Someday. So I was taken to another ward but thank goodness, not many patients today. But this ward sure have tons of cases, ranging from infected heel with vacuum dressing, phaco with macular holes, Gidelman syndrome... New stuff right? I had to do a little Google search on the definition of Gidelman syndrome. When I found out, I felt super sorry for the patient who is only in her 20's. Thank goodness she have a very good husband who is willing to support her.
Ever seen phlebectomy? I used to think it was a major surgery but it's a procedure, to put it in simple terms, it's draining out the 'bad blood' (excessive blood) in the body and then throwing it away, or in some cases, if the blood is still alright, to give it to the blood bank to filter it. The patient is a regular so she actually know more than us, even the prof. She instructed the prof how to poke her veins, and thank goodness I had the chance to see the procedure. The prof use a large needle, commonly used to donate blood, and poke it right into her vein. If all goes well, the blood goes draining into the bag like the Vulsava slide at Lagoon. It's just a pity the prof accidently jerked the needle that it went running and we only got a quarter full. Aww. What a shame. I even ran to get autolagus bags just to try getting her blood, unfortunately, no matter how many time the prof pricked her, he just can't get enough blood anymore. Only the first one was the jackpot. He was going to use the butterfly needle to prick her but the patient was like, "Oh nooooooo. Please don't, prof. I got a plan B." And the prof was like, "Plan B?" And she went, "I go back home, let my veins grow nice and bouncy, then you can prick me again, okay prof?" And the prof was like, "Are you okay with coming back again on Friday?" Nevertheless, he allowed her to go, although he did mentioned that there are two places that you can get good blood supply. The neck and groin vein. Both are super good places for blood taking, mainly because pressure there are high. The patient was like, "WHAT?! Noooooo." Severed neck and punctured groin vein can shoot up to about 3 metres, right up to your house ceiling. True fact, but don't try it at home please.
Then we have a fussy patient. Well, okay, she's not really fussy, but she treats nurse with no respect. She treats us like, well, maids, or hotel room service. It really makes you pissed. These are the list of things she'll ask us to do:

- Take out the rubbish for her. (She'll put them all these large bags outside the door and expect us to pick them up.)
- Bring food for her. (What she orders, she expects US to serve, not the caterer staff.)
- Cleaning the toilet and floors. (When she spills or drops something, she expects US to clean it, not the housekeeping.)
- Hospital is a hotel (She stays in a single room, but her whole family is cramped in that little room. Little kids sitting on mats, relatives squeezing themselves onto the recliner and bed and chairs. Everyone carrying bags as large as a one month travelling suitcase. I mean no disrespect but come on, we are NOT a hotel.)

Makes you mad, doesn't it? A nurse being reduced to nothing more than a maid. Sometimes, I really wonder, what's the point of studying so hard for a diploma in a professional job when you are being treated like slaves? I once read a book by a Malaysian professor and he said that nurses, especially here, are often treated with no respect. Well, I guess I'll have to agree with him on that one.
Then I met a really nice gentleman, in his 50's to 60's coming in a day early because of his insurance. It was a little pickle but thankfully we sorted it out, although he'll have to go to admission the next day since they already finished working (Half-day today) for the day. I took a look at his home leave consent and found out that he wrote it in a very polite and humble way, and he even said, "Please give me a double room, there's no need for single or VIPs." Curiosity getting the better of me, I took a peek at his biodata and he's a manager... Wow. Such a humble guy and casually dressed, he doesn't look like a manager type. I guess there are some nice managers out there if you know where to look for them. All in all, it was a very nice day. I'm working a lot of morning this week. Wish me luck.

Friday, September 26, 2014

Crazy Drama

26th September (Friday) - Hello, I'm back. Sorry for the long absence. Mainly it's because my internet is not up and running. Connection limited and etc etc, but no matter, I shall update you on my latest feats. First, have you ever heard of a syringe larger than 20cc? Don't be surprised. Not many people know much about it. Well, you don't actually see it much. You use it mainly for feeding, if not, for continuous pain relieve for cancer patients. But you don't see it often...again. What if it's used for giving a super large jab? *evil laugh*
Then we got tons of children coming in. Oh, dear Lord, one cries = all cries. And nowadays parents seem to rely on Mr. Google a lot. Well, on that day I actually attended a 2 hour on how to care for PICC lines. Who would've thought PICC lines are so useful? Just imagine. A well taken care of PICC line can last up to 3 months, to a year max. Wow, I know 3 months is a sort of standard since I do know patients who kept their PICC for 3 months, but a year is cost saving. One word : awesome. Although it requires total care from both sides. Okay, back to the kiddies, they are all demanding. And being with them, well, I have to spent 30 minutes in each patient's room just to get vital signs. Usually I ended up waiting for a long time to get the SPO2 probe to detect the baby's teeny weeny fingers or toes, then have to pin them down to get the reading, then have to bear their screaming and crying of "bloody murder" since they all had bad experiences with nurses who had given them tons of 'pricking' to get a branulla line.
Okay, fast forward to today. Alrighty. I had my chance for a STO, drain and SPC removal. 3 in 1 procedure. Seems simple? Guess again. I asked a senior nurse to observe since being here in 1 month does not qualify you to to do things alone, especially when I'm not familiar with skills. Okay, I got the Redivac drain and SPC out safe and sound. When it came to STO, dear God, the moment I opened the first stitch on the abdomen, pus mixed with blood oozed non stop. Seriously. No matter how much I try pressing the wound to stop the oozing, or I don't press it, it still keeps oozing. Good Lord, the senior nurse told me to stay put as she try getting the prof and sorry to say, no matter how many time we called, he did not pick up his dang phone. We called his phone, the Daycare, the clinic, the government side. Sigh. The lady ended up being in constant pain and kept screaming for painkillers. Sigh, why can't things ever go smooth??? :(

Wednesday, September 17, 2014

Sinking Down To Disaster

17th September (Wednesday) - Morning shift once more, and then I'll be having a day off. My mood wasn't good because of a certain someone. She always condemn me for being fat, fat, fat, fat. Every single day is always, "You're so fat and ugly. You should be thin like those stick models." Well, sorry for not being stick thin. Sorry for trying to cut back in eating then forcing me to eat a lot. Last time my patients won't even let me carry them cause I was such a scrawny kid who looks like I can drop at any moment, but with the right amount of food I managed to gain some weight that makes me look healthier than before that gives patient faith in me. Sigh, I used to have eating disorders for a while and got tons of gastric problems, so painful til one time I nearly passed out. Whatever, enough of my eating disorder problems.
So today I had the honour to take uncle for a shower, so off I go, dressed out in full apron to protect my clothes from being damp and gloves. So I gave uncle a good shower, form top to bottom, wash his hair, wash his back, make sure he brush his teeth, and made sure he smelled like strawberries. Mmm... Uncle always smells like strawberries thanks to his Body Shop strawberry shower gel and strawberry cream butter. Uncle then showed me a book that he's planning to publish on the 21st (No, he's not an author, he's a publisher) by showing me the rough concept of the book. The cover and the loosely bound book by threads, but the original one will be a hard cover with proper photo jackets and all. I'm sure it'll turn out wonderful.
Then with the usual feeding, I went to break quite late. But even before lunch, my mood was spoiled by s staff nurse, she doesn't work in the ward, but in the clinic. Holy, I swear, if it wasn't for the training I received for three years, I might end up screaming at her. Seriously, I've been doing some procedures for these past few weeks on my own and she actually have the cheek to say that my college sucks, oh yes. Who wouldn't get pissed? And I've only been here for a month, and she has been here for a long time, of course it's natural for her to be good at things. Come on, it's like comparing a rabbit and a tiger.
*mutter, mutter* It's one thing for the ward nurses to push me, but not a clinic staff. Grrrr. I get it that there are senior staff nurses who bully new doctors, senior staff nurses bullying new staff, but a clinic staff bullying a ward staff is OUT of the question. Or maybe it's just my thought. I'm going to avoid her now that I know her.

Tuesday, September 16, 2014

Slow Paced Day

16th September (Tuesday) - Happy Malaysia Day, and yep, I'm working, in the morning. I rushed into work with 7 minutes to spare, but turns out I was quite early, compared to the others whom came in at 7 sharp. The night shift girls went, "What? You all came in just in time because it's a holiday?" Then we got down to business, report, ditto. Then the night girls wished us a happy working day and we are off to bed-making and showers. Spongings... Most of the patients are already okay compared to the first post op day, so most of them are able to walk and shower. Some were even kind enough not to disturb us as they said they can ask their family to assist while we attend to other matters. And most of them are also being discharged so they are walking around to  help themselves. Some were concerned for us that we are working in the holidays but as I mentioned to one patient, "If there's no one, then who's going to take care of you and the other patients?"
So there are Redivac bottles to change and the occasional minor dressing to change, the only thing that's keeping us busy are the discharges. Not much admissions, but tons of discharges. And when I checked the system, tons of discharges just kept coming in. I know everyone is keen to go home, but we only got 2 people working in billing, and discharges kept piling up.
So there's not much, besides the feeding that I often do. Oh, and patients gave us tons of crackers and fruits in case we were starving. Guess that's one thing I don't have to worry about whenever I'm out of food, except I'm a picky eater.
The only good thing that comes out of it is I get to claim a PH for working today. :)

Monday, September 15, 2014

Full Speed Ahead

15th September (Monday) - Hello and I'm in noon shift again. To start things off, at first things were a little slow, but then it became fast. First, I was assigned to be a runner. And there are only two seniors with four juniors, including me. This is because tomorrow is a public holiday, so there are many who took leave; in the morning there were 2 MCs, so So after sending the uncle to the gym for physio, I rushed to help off a CBD. It was my first time but I know the process. Prepare a pair of gloves, a syringe and a yellow bag and you are all set. Put the CBD into the yellow bag, aspirate the balloon with the syringe and slowly pull the whole thing out. Of course, since the patient is a child, she screamed and screamed, but when thee tube finally came out, she kept quiet. The good news is 15 minutes after I removed the CBD, she's able to void in the toilet. Well, that's a relief. The thing that I'm worried about is that she wasn't able to pass urine once I pulled out the catheter, otherwise she'll have to get another tube inserted and it'll be traumatizing.
Then, I was just about to sit down for my 15 minutes break, and the senior was sorry to disturb me because it was already 5 pm and I needed to fetch uncle back from the gym. Since there's nobody to fetch him, I just put my meal aside and went to get him. Since the usual way I used is locked, I have to make a big run to the gym, lucky I followed the first round earlier on or I wouldn't be able to find my way. When I got there, there's only one person left, the physiotherapist and she was waiting for me. I rushed over and she asked me, "How many people does it take to carry him?" And I answered, "Four." She then asked me why four, and I said one to support the front, the back, and two on either side. She then said she tried making uncle to stand, but he somehow ended up a little bow-legged. Even so, he's now riding the bicycle to train his legs to walk again. So, after a few miss and turns, I found my way back to the ward, and immediately start sponging him with some of the staff, using a new cream that his wife bought for him. A strawberry cream that looks like yoghurt and smells super nice, like strawberry smoothie or strawberry ice cream. Once applied on uncle's skin, he smelled exactly like strawberries. Good thing I fed him early too, cause his wife and children and friends came to visit him.
Then, a patient called because she needed someone to change her Redivac bottle, you know the thing as well as I do now, double clamp, unscrew, new bottle, reverse the process. And another lady called because her dressing was soaked. This one, all you have to do is cut the gauze into halves (not fully), and then slot each one of them up and down on the tubing, and secure the whole thing with an Op-site. Then it's back to feeding the uncle and call it a day. Whew.