Allahuakbar, alhamdulillah....
Despite the news on Gaza ceasefire (which was good), here comes another big news. Things that I've awaited for has come. The results for placement are out!!!!
Today before work, I was a bit stressed, thinking that I'll be working in Green Zone.However when I reached the zone, I felt a bit relieved as it wasn't that busy. Ten minutes later, we heard the news about the placement. One by one started calling JKN. My news came later, at 4.20pm. Nah...they are sending me to district hospital.
Frustrated? Yes, as I was really hoping to get a good life in health clinic. Thankful? Yes, as finally I can leave ED HPP !! And I also get to go outside my hometown, live my own life and enjoy the excitement of balik kampung! Worry? Yes, thinking that I'll be working non stop till next Saturday, how am I going to survey for house/ room and prepare for my new life?
I am still in denial, I just couldn't believe it that I'm going there...I have not broken the news to my parents yet. They must be sad in a way that I no longer will be with them at home everyday. And I couldn't help much in taking care of my grandmother anymore.
Okay, tonight I went home late as usual. I was so determined to punch out at sharp 10 so that I could reach home by at least 10.20, unfortunately I was stucked with a patient. I had to discharge her...her blood results came back normal, and her sons kept asking me about her progress.She improved after some medications and 2 pints of normal saline. I really hope that she would be fine, please don't come back to ED with worsening of symptoms...I hope she recovers well. May Allah give back her health.
Saturday, November 24, 2012
Monday, November 19, 2012
Pray For Gaza
GAZA diserang lagi. Entah apa mahunya Israel laknatullah ini.Ada pendapat yang mengatakan bahawa kebangkitan Islam baru-baru ini menyebabkan Israel rasa tercabar dan mahu menunjuk-nunjukkan kuasanya kembali. Ada pula yang mengaitkan dengan kemenangan Barrack Obama.Wallahualam. Ini adalah isu kemanusiaan, bukan lagi isu keagamaan.Seluruh manusia dari segenap pelusuk dunia bangkit menyatakan bantahan terhadap keganasan zionis ini. Namun zionis kejam ini tidak pandang sebelah mata. Amerika yang kononnya berkuasa besar itu juga tidak dapat berbuat apa-apa.
Kempen boikot barangan Israel kembali popular, hakikatnya terlalu banyak barangan mereka untuk diboikot.Pandang kiri, pandang kanan, pandang depan dan belakang, semuanya barangan Israel belaka.Tepuk dada, tanyalah iman. Jika tak dapat boikot semua, dapat boikot sedikit pun dah membantu.
Kempen boikot barangan Israel kembali popular, hakikatnya terlalu banyak barangan mereka untuk diboikot.Pandang kiri, pandang kanan, pandang depan dan belakang, semuanya barangan Israel belaka.Tepuk dada, tanyalah iman. Jika tak dapat boikot semua, dapat boikot sedikit pun dah membantu.
Saturday, November 10, 2012
Rough Night
Last Thursday I worked night shift in blue zone. It was my first night shift as a medical officer. I was glad that it was only for one night, no more two nights during housemanship. I was the only MO working there with my only HO who was pregnant. Apparently the other MO who was supposed to cover blue and green zone interchangeably just came to my zone to say," you can do it. take your time to see patients", or counting the number of cards flowing in.
That night, patients poured in like nobody business. All of them decided to "visit ED" at night even though their illness started in the morning or even a few days before. Luckily the MA at triage counter was the nice one, who tolerated with us well.
I was already stucked with the first case I attended. A 35 year old lady with Hepatitis B, currently pregnant at 6 weeks, came in with PV brownish discharge. She had IUCD inserted before but positive for pregnancy.Her BP was lowish, around 98/56. Of course I would think of ectopic pregnancy!! I asked her many times whether the IUCD was removed and she denied! I quickly hydrated her and frantically looked for the scan machine. One was being used in red zone, the other one in yellow zone. Should I wait or should I transfer the patient to Yellow zone? I waited. Patient clinically stable with no abdominal pain.IVD ran fast.Finally I scanned her and confirmed by the "interchange MO". We saw IUGS. Still, it could be heterotopic pregnancy. Suddenly I encountered with a Gynae MO,oh, the red zone case was an ectopic pregnancy, going to OT really soon. I quickly presented the case to him, he scanned the patient and reconfirm the IUGS, unlikely ectopic but still need to monitor the BP. After she completed IVD, I recheck her BP and it picked up to 108/60, PR 80.Okay, unlikely ectopic. I explained to her everything only to hear her saying," sorry doctor, itu IUCD sudah kasi keluar dekat klinik dua hari lepas." What???
The other patient was a 19 year old man who presented with fever, constitutional symptoms, history of having high WBC and family history of leukaemia.He came late at night because he had no transport to come earlier. It was already 11.30pm when I saw him.I had to investigate him thoroughly only to find out that he had peritonsillar abscess.His WBC was 24. Luckily our registrar asked the red zone HO who had no case at that time to refer the case to ENT. Unluckily, the ENT MO oncall was the junior one, who just left ED. He didn't want to admit the patient but insisted on asking the patient to come to ENT clinic at 8 am later.Pity the patient, if he went back, he might have trouble with transportation again to return to the hospital. Yet at least he wasn't having leukaemia.
A father to a 6 year old girl approached me two times, asking me to see his daughter first as she was having severe abdominal pain - as the man said "sakit sampai berguling-guling". I told him that I would see her right after the current patient who was also in pain after an MVA. Okay, I should have went out and look at the child, perhaps if the pain was so severe, I should have ushered her to green 1 straight. Suddenly the MA came, so I asked him, " ada ke budak yang sakit sampai berguling-guling kat waiting area tu?" He helped me find out and informed me that the child was in pain but not sampai berguling-guling (obviously, would you do some acrobatic stunts at public?), I told him to upgrade the patient to green 1 even though I knew that green 1 was suddenly busy at that hour. The interchange MO heard us and reluctant to accept the case but I insisted, at least if she was not attended stat, she would be in an area where everybody could see her.So, the child was brought into green 1. I saw her later on, sitting on chair comfortably, perhaps after given some pain relief. As I was super busy, I forgot to ask about her diagnosis...
A 38 year old man kept pulling the curtain in blue zone and claimed that he was having severe pain. His right hand was on his hip, I thought he was having some renal colic. He insisted on us giving pain relief and see him later but I told him that I could not treat him without knowing what illness is he having. That time it was already nearly 4 am. I couldn't care more, but to continue seeing patients who came before him.Later on, my HO attended him.His main complaint was right sided lower rib pain after bouts of coughing.He claimed he had history of left rib fracture before after a chronic cough and was treated at Adventist Hospital (really???).He also told us that he already came in the morning and was seen by a Cardio MO.Fine, I asked my HO to give analgesia and sent him for CXR. I went to trace his card just to find out that he was diagnosed as non-ischaemic dilated cardiomyopathy, previously defaulted follow up at private hospital, requested for AOR discharge from the cardio MO and now returned back for another complaint.Obviously he had some problems. Problematic patient. CXR showed no rib fracture, we reassured him and discharged him.
What a rough night !
That night, patients poured in like nobody business. All of them decided to "visit ED" at night even though their illness started in the morning or even a few days before. Luckily the MA at triage counter was the nice one, who tolerated with us well.
I was already stucked with the first case I attended. A 35 year old lady with Hepatitis B, currently pregnant at 6 weeks, came in with PV brownish discharge. She had IUCD inserted before but positive for pregnancy.Her BP was lowish, around 98/56. Of course I would think of ectopic pregnancy!! I asked her many times whether the IUCD was removed and she denied! I quickly hydrated her and frantically looked for the scan machine. One was being used in red zone, the other one in yellow zone. Should I wait or should I transfer the patient to Yellow zone? I waited. Patient clinically stable with no abdominal pain.IVD ran fast.Finally I scanned her and confirmed by the "interchange MO". We saw IUGS. Still, it could be heterotopic pregnancy. Suddenly I encountered with a Gynae MO,oh, the red zone case was an ectopic pregnancy, going to OT really soon. I quickly presented the case to him, he scanned the patient and reconfirm the IUGS, unlikely ectopic but still need to monitor the BP. After she completed IVD, I recheck her BP and it picked up to 108/60, PR 80.Okay, unlikely ectopic. I explained to her everything only to hear her saying," sorry doctor, itu IUCD sudah kasi keluar dekat klinik dua hari lepas." What???
The other patient was a 19 year old man who presented with fever, constitutional symptoms, history of having high WBC and family history of leukaemia.He came late at night because he had no transport to come earlier. It was already 11.30pm when I saw him.I had to investigate him thoroughly only to find out that he had peritonsillar abscess.His WBC was 24. Luckily our registrar asked the red zone HO who had no case at that time to refer the case to ENT. Unluckily, the ENT MO oncall was the junior one, who just left ED. He didn't want to admit the patient but insisted on asking the patient to come to ENT clinic at 8 am later.Pity the patient, if he went back, he might have trouble with transportation again to return to the hospital. Yet at least he wasn't having leukaemia.
A father to a 6 year old girl approached me two times, asking me to see his daughter first as she was having severe abdominal pain - as the man said "sakit sampai berguling-guling". I told him that I would see her right after the current patient who was also in pain after an MVA. Okay, I should have went out and look at the child, perhaps if the pain was so severe, I should have ushered her to green 1 straight. Suddenly the MA came, so I asked him, " ada ke budak yang sakit sampai berguling-guling kat waiting area tu?" He helped me find out and informed me that the child was in pain but not sampai berguling-guling (obviously, would you do some acrobatic stunts at public?), I told him to upgrade the patient to green 1 even though I knew that green 1 was suddenly busy at that hour. The interchange MO heard us and reluctant to accept the case but I insisted, at least if she was not attended stat, she would be in an area where everybody could see her.So, the child was brought into green 1. I saw her later on, sitting on chair comfortably, perhaps after given some pain relief. As I was super busy, I forgot to ask about her diagnosis...
A 38 year old man kept pulling the curtain in blue zone and claimed that he was having severe pain. His right hand was on his hip, I thought he was having some renal colic. He insisted on us giving pain relief and see him later but I told him that I could not treat him without knowing what illness is he having. That time it was already nearly 4 am. I couldn't care more, but to continue seeing patients who came before him.Later on, my HO attended him.His main complaint was right sided lower rib pain after bouts of coughing.He claimed he had history of left rib fracture before after a chronic cough and was treated at Adventist Hospital (really???).He also told us that he already came in the morning and was seen by a Cardio MO.Fine, I asked my HO to give analgesia and sent him for CXR. I went to trace his card just to find out that he was diagnosed as non-ischaemic dilated cardiomyopathy, previously defaulted follow up at private hospital, requested for AOR discharge from the cardio MO and now returned back for another complaint.Obviously he had some problems. Problematic patient. CXR showed no rib fracture, we reassured him and discharged him.
What a rough night !
Sunday, November 04, 2012
Day 2
Alhamdulillah, ended my day 2 of life as a medical officer. I survived 2 years of housemanship and stepped up onto the next level. However, I am still stuck in the department till they have a meeting on the placement, which is sometime in the next two weeks.
Being a medical officer,you bear more responsibilities, but you also enjoyed some other privilages such as less working hours, less night shift and less patients to be seen.
I still think that our HOD should open her eyes more widely on her registrars and senior MOs. What kind of registrar who does not want to make decision after a case has been discussed with him, and still asked the MO to decide? There is no point of him being around when he even doesnt want to take responsibility? He always wanders around or just sit on a chair and gives instructions, or even worse, he talks about someone else look for hours!!
I do not think I can tolerate this any longer. These are not right!
Today a young man committed suicide by jumping off from neurosurgical ward on second floor. This guy was admitted earlier for minor intracranial bleed after an accident. Apparently his girlfriend came and broke up with him. Perhaps he was so frustrated and upset with his condition, he decided to end his life. Shattered spleen...he was still alive when they intubated him in red zone...but God knows better...his ex girfriend should feel guilty for what she had done, she could have waited till he recovers before breaking up with him.
I cant wait for the transfer, may Allah grant my wish to go to health clinic...
Being a medical officer,you bear more responsibilities, but you also enjoyed some other privilages such as less working hours, less night shift and less patients to be seen.
I still think that our HOD should open her eyes more widely on her registrars and senior MOs. What kind of registrar who does not want to make decision after a case has been discussed with him, and still asked the MO to decide? There is no point of him being around when he even doesnt want to take responsibility? He always wanders around or just sit on a chair and gives instructions, or even worse, he talks about someone else look for hours!!
I do not think I can tolerate this any longer. These are not right!
Today a young man committed suicide by jumping off from neurosurgical ward on second floor. This guy was admitted earlier for minor intracranial bleed after an accident. Apparently his girlfriend came and broke up with him. Perhaps he was so frustrated and upset with his condition, he decided to end his life. Shattered spleen...he was still alive when they intubated him in red zone...but God knows better...his ex girfriend should feel guilty for what she had done, she could have waited till he recovers before breaking up with him.
I cant wait for the transfer, may Allah grant my wish to go to health clinic...
posted from Bloggeroid
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