A friend's day..

OMG!!

I SO NEED A HOLIDAY!!

I went for a self-detoxification + social gathering + quick date in KL last Friday. Luckily I was on 8-3 shift that day, otherwise I wouldnt be able to catch my flight.

Finally, Eka got married, to another doctor of Hosp. Selayang. Caya la! Also, I met up with my Galwegian colleagues, including Sazrina yang dah lama giler x jumpa. She has a kid now, a 5 months old girl named Raihana.. (ella..ella...ella....ey, ey, ey). A little catching up done..

Roque: absconded from her 2-years Medical scheme in Cork
Amira: completed SHO contract in UCHG
Nuna: Paeds HO, Hosp Kuala Pilah
Maedy: Tagging O&G HO, Hosp. Klang (hehehe)
Naa: Anaes MO, HUSM
Saz: Paeds HO, Hosp Seremban
Eka: Ortho HO, Hosp Selayang
Aini: Medical SHO, Roscommon Hosp
Shima: Medical MO, Hosp Alor Setar

Juga dapat jumpa ngan "pacik" si Pulut..ehehehe..And my pacik as well :P

Yani, Mira, Pulut, Lyana, Me, Kak Pia, Nuna, Naa, Roque

Us and the Newlyweds.. but Mira si berkaca hitam seems more prominent!

The bride is hiding...

....from the incoming groom

Maedy made it (she was tagging on that day!), with Aida and Kak Pia

Kak Ina with her youngest kiddo

Mangsa keadaan ... hehe

flu scare

Another lady succumbed to her death yesterday.

A severe pneumoniae due to H1N1 influenza.

The flu scare hasnt been that nice on the ED staff. Obviously, we're understaff. And its a joke when those SN/JM in nursery were whining about how THEY are understaff..

Statistically, the whole of Kuching will attend to nearly 700 cases of fever/cough/sore throat per day. Thankfully, the polyclinics will see up till 5pm(and their records would be up to 400 patients/day). After 5pm, patients will be diverted to us, the mild cases go to the fever clinic (a temporary clinic set up at the gynae OPD), and those categorised as mod-severe will be re-routed to ED. So, yesterday, the fever clinic staff saw about 100+ patients, and we saw the rest, as the fever clinic closed at midnight.

So, its no wonder if I havent got better cause everyday after I saw these patients, I'll get sick all over again.

Diagnosing URTI itself is kacang, but I spent most of my 'consultation' time reassuring the patients or their parents. After all, the hardest thing to convince the patients is that the H1N1 flu is just like any other flu is in a person's life...except it KILLS...

Of course after a better plan to categorise patients, we dont see those stupid cases where patient came to ED just because someone asked him/her too i.e asymptomatic patient who was simply a student of a college with suspected cases.. And of course, patient spent less time waiting outside ED to see us. And we dont have to argue with those rude patients who would simply barged in and demanded to see us earlier because he cant wait and follow his turn like other patients..

Tough. And boss said this will go on for at least another 3 months. And the hot season is coming to town, and Ramadhan's approaching as well. Hmmm...

Last advice, take care of yourself people. The best cure for all this is self quarantine. And drink plenty of water... ciao.

worse week ever

The worst week ever.

Felt like digging a hole and bury myself in it.

I had a bad bout of fever this week. Terrible chills and bad cough spasms. Only few days ago, my temp went up to 39 degree. And I literally knocked out on Thursday, after my night duty. The last 2 days, I've been coughing up blood, and my chest is severely tender from all the coughing. I lost 2 kilos, I cant eat because I felt nauseous and I vomited most of what I ate. And still I had to go to work. And I really hate it if patients (or their parents) came to ED complaining of simple fever and we're too slow to attend to them... because I felt mush worse and I still had to go to work! Stupid people! Just go to the polyclinic la!!!! Kenapa nak buang masa kat ED???

The MOs here sucks. They're malignant, backstabber (even with each other) and racist. Sikit2 nak marah. Even when its not my fault, aku jugak yang kena. Seriyesly, benci betol!! So what if people have been saying ED shift work is 'heaven'?? I just hate it.. I prefer waking up early, and go to work at the same time as others and balik pukul 5..

I hate the MOs.. I hate the MOs..... I hate the MOs....

And finally, having a colleague who persistently saying he has a crush on me, while knowing that I have a boyfriend is another bad thing this week. I already felt down from the flu and the workload and the MO thingy, I dont need another to make me completely down..

mixed feeling

I felt pity towards this guy yesterday. He's mental retarded patient and has been on antipsychotics for quite some time. And today his elderly father brought him in because he had suicidal intention secondary to severe backache..yeah no joke..
This 39 y/o guy suffers from tardive dyskinesia and tardive akathisia (yes, I still remember my psych days..after all, Prof did said I'll do well in Psych, which I didnt..ahaha). I guess it'll still be OK if he has this writhing arms movements, but to suffers for chronic back arching for 3 months?? He was moving all the time, he cant sit or lie down, because not only his hands kept unvoluntarily moving but he cant straighten his back (opistothonus)..

3 months man.. I wish to die myself la kalau macam tu..seksa woo..

On the other note, a colleague asked me out yesterday. Pandai dia usya.. While both of us were doing our bloods, he suddenly asked me, had I got engaged or not..Of course I'm not engaged yet la.. And suddenly after we've finished handing over to the next shift's people, he came over to me and asked me to a movie. Well, bluntly speaking, dah lama aku tak diusya orang. HAHAHAH. So my stupid answer to reject him was, I dont really watch movies, biasa layan privated CD only.. :P

And finally last night, mum showed me something that made me laughed so hard. This is a page from Dudin's Sivik's project..

zoning in the green

1st day in A&E today..
Since I started quite at the end of the week, I'd only to tag till this Sunday, and start my shift duty by next week..

Anyway, I started in green zone, where cases are mostly GP-based.. I felt like a GP myself...
No Grey's Anatomy or ER's feeling yet.. definitely not Scrubs... (how I wish it's like Scrubs err..minus Dr Cox..)

Some MOs are OK, some teaches, some gossip and complaining too much, some let me do what I want, because they heard I'm a final poster ... which I dont want to simply do cause my managements might be wrong..

And yeah, a lot of referral as well.. which is an eye-opener for me.. Not that I'd never referred before..but at least I can finally put names to faces (esp those Medical MOs). Oh ya, referred one case to the Surgical MO yang separa lelaki itu, kes hernia. Punya la banyak tanya, nasib baik aku tembak betol..ahahaha... aku dah cuak bila dia tanya nama over the phone..

"so, patient ckp tak reduce since bila, coz I nak tau kalau strangulated or obstructed dah kire emergency.."
"err, since 6 pm yesterday."
"ada BO flatus tak?"
"ha ah, ada BO satu kali today."
"so, what do you think, irreducible ke, strangulated ke, obstructed ke?"
"irreducible"
"kenapa?"
"patient stable, not in shock and no symptoms of bowel obstruction."
"Ok, nanti saya turun jumpa. U apa nama?"
" dot dot dot. Terima kasih.."

Seriyesly, aku lupa tanya since bila tak reduce, yg aku tau pacik tu ckp satu hari. Dan lupa nak tanya dia ada BO/flatus ke tak. Aku juz tanya ada vomit ke tak.. Nasib baik, memang betol, pacik tu start rasa tak reduce kol 5.30pm, dan ada BO pagi tu...wahahahahah...naseb baik...kalo tak mati aku kene tamparan wanita MO surgical tu!!

Jangan buat lagi....jangan buat lagi...................... thorough history!!!! thorough PE!!!!!!!!

And the worse thing about A&E is, the SN are totally unhelpful, they have only one glucometer yg dipegang oleh one SN (so you have to look for her if you want to use it), and you cant even find the termometer (and I'm bringing mine to work tomorrow!)...

Anyway, the bomb was on me early this morning, when I met the head of HOs, Dr W. utk lapor diri. She thought I was with the army (under ATM), coz she saw I'd only to do 1 year HO-ship here. Of course, I'd to tell her that its my last posting, and then she asked me, whats my plan after that..

Well, I did say I wanted to try few months as HO here and there in Med/Surg/Ortho.. since what I did in Ireland is totally different from here..

And she insisted they're all the same..

Yeah... the idea was this. They are lack of A&E's MO, couple of them are pregnies and delivering soon, and she wants me to stay as an A&E MO if that's the case...

Which I dont want to.. cause I'm quite stupid and I cant handle too much stress... ahahaha, bole ka?

Ciao

Today I said goodbyes to few dearest patients (and their mums) of mine..

To Zevier. The 4 mths old boy, who came in with meningitis and then intubated by me (in front of Dr B..uhuhu..pressure...). He's still inpatient, and the mother is now counting days for him to complete his antibiotics. From an unconscious kid, to an irritable kid with a huge fontanelle and now to a more active, smiling kid... I can say he improved a lot. Now and then,the mother will approach me requesting a wonder drug for lactation... she and few other mums.. Made me feel like a drug dealer la pulak...

To Mohd Afiq. The 3 mths old boy, who currently admitted for pneumoniae. Previously a prem baby at 25week, with weight of only 750gm. The one who had been in nursery for 2 months. And has spent nearly 3 weeks in convalescent unit. So, I became quite a good friend with the mother, who'll see me review her kid and other kids (esp I/O Rina and Suriana... these three babies basically has the same birthday.. the first to go home was Suriana's then Mohd Afiq followed by Rina's) and who will whistling away while poking their kids for RBT. Yep, the mother will say, "hah, vampire dah datang" or "takpe besar nanti kita cucuk dia pulak".. hehehe...

To Lenny. The 10 mths old girl, who came in with AGE then developed a pneumoniae and subsequently a SVT. the one that failed to thrive because she was only fed condensed milk by the mother.. who's family a hardcore poor. The kid who I am struggling to get aid assistance from the JKM... which was bullshit-ly difficult..

And finally, to Mohd Haziq. The 1 month old kid, with syndromic facies who developed a nosocomial pneumoniae after he was admitted and now had to depend on the ventilator. Yup, tried extubating him yesterday, but he was gasping away like a dying fish, so we had to intubate him again..sigh.. He's cute little thing, and yah, the mother is one of the mothers yang selalu mintak "ubat tambah susu"..

So, after saying goodbyes to them, kasik Lenny and Zevier duit angpau dan susu, aku pun blah dari ward tu. Terasa sebak ada gak, coz I do hope all 4 of them to go home well.

Hey, despite what I hate about Paeds, I really enjoy this rotation because I love having these great bonds with kids.. Now, dont get me wrong, I'm not Jacko...

Under My...

And I thought it'll be hell till the end..

Tomorrow is my last day working in Paeds. Yey!

Frankly speaking, the last 4 weeks in Isol wasnt so bad. I got to work with the nice MOs, and had managed to escape the DayCare. The MOs I've worked with in Isol are great people who I can joked and laughed with. Bukan macam kat ward lain..hehe..I'd only few oncalls since starting Isol, and the workload in Isol aint that bad. Thats a plus as well... Furthermore, I've been upgraded to ICU HO, so, I only had to cover the 4 patients in ICU... which was a cool thing, coz the cases there are much more interesting..and twisted...

Cuma:

Sangat hampa dengan the new taggers. Especially those graduated from UM. Punya la tinggi my expectations of them, tapi sayangnya, they are just theoritically knowlegeable (yes, I can hear them blabber about the lysis syndrome among themselves, while I'm struggling to finish all the Plan D's). When it comes to real work, they kept whining and complaining and sighing. Its shit la because: you're a HO, you do the jobs. The MOs talk and think and give orders.

Menghampakan coz these UM graduates refuse to see the acute cases. During the rounds they just kept silent and dont even bother to write in the casenotes. One discharge summary takes ages. Lepas tu boleh komplen sebab terpaksa buat kerja orang lain. Hello??!! Aku penah buat discharge patient nursery yang duduk 2,3 bulan la...imagine brapa jilid casenotes kene baca... After abis round, they will either do discharges or trace results. Tak volunteer pun nak buat blood or refer case or getting a CT/MRI/appointment. Again, you're a HO, not a clerk or kak PPK. They can trace blood result and do discharges la..

Yang bengang, I know tagging is hard. But tolonglah, if postcall people can struggle to keep their eyes open and their hands moving buat keje, you should be able to... Mengantuk tak yah cakap la, but be part of the team la..tolong la buat keje. Time tagging plak,bukan nak tolong amik darah ke, clerk case ke. Ini boleh pegi lunch sampai satu jam, lepas tu duduk kat kaunter, buat bodo. Tak pun review patients sendiri sampai berjam2. Takde pekdahnya.. Ada sorang tu pulak, mencebik bila suruh clerk case. Fine, aku tau jam dah dekat kol 11pm masa tu, tagging dah nak habis... tapi, kalau keje ikut masa, sila jadik cikgu la. Loceng bunyi je terus bole cakap "class dismissed". Aku ingat lagi, masa kat O&G, aku dan KP terbabas day tag sampai pukul 2am sebab banyak giler patient. Dan pagi esoknya pula, terpaksa start tagging balik kol 7. BRAPA JAM JE DAPAT TIDO????

Hah.. ini graduate UM? Buat geli hati ada la.. Maybe because they thought they're from top class Uni, diorang ingat diorang bole act like this. Yeah rite.. bole blah..

Hari tu Chan cakap,bila dia dah start keje, baru dia sedar, bukan ilmu yang menentukan semuanya. Semuanya terletak pada motivasi nak keje and niat nak tolong orang. Jadik doktor bukan senang adik2 oi. Toksah la nak gembira sangat kalau dapat buat Medic, atau kene hantar oversea or masuk Uni high class buat Medic. Semua orang bole blaja buat Medic, tapi tak semua boleh survive jadik doktor. Yang berhenti jadik doktor during tagging tu pun budak UM jugak...

Ada komen?

Ke ada budak UM nak baling batu kat aku...

Sorila, buat masa ni, dari pemerhatian aku... Budak USM, Unimas, MMC, PMC/Ireland dan 2 ekor budak IMU itu lebih baik mutu kerjanya... budak Rusia/Ukraine tak yah cakaplah..memang lambat sket sebab diorang punya silibus lain giler ngan budak Msia...