Friday, March 12, 2010

Am i 'hot' or what?

The Tuesday that just passed, i was doing Queen call...and boss was on call too....before i go on further, i would like to clarify the term 'hot' used in the title...being 'hot' during your call is nothing remotely close to being a hot babe (i'm not that perasan ok)....if you have 'hot' calls means your calls are crazy busy....

Anyway, i'm actually too worn out to elaborate on the details...but i had 4 UGIB referrals, 5 obstructive jaundice referrals, a few appendices, a carbuncle and 3 peripheral referrals (just to highlight the 'few')...thank God my referrals only came after i finished clinic....and lunch...hehe...boss told big boss and he was like "HAH!!! how can you get so many UGIB and obstructive jaundice in a day??!!!" that coming from big boss kinda stamped the 'hot' on my calls...

But i don't think it's just me...boss should take some responsibility since he was on call as well...he's also super 'hot'...so i suppose our combination is explosive, hehe...while i was busy seeing those UGIB, boss actually came with big boss to casualty...dang! quite paiseh....but thankfully boss diverted 2 of the UGIB to medical...so i only managed to sleep about 3 hours plus during that call...

I'm post call today....yesterday's call was with lady boss...and it wasn't too bad...we had a laparotomy after clinic...before we managed to have lunch with the whole surgery gang...then it was quiet till night...had an appendicectomy which i waited for 2 hours before we could actually start the operation....halfway through the op, the HO on call in male ward called to inform me a patient passed away....he was DIL/DNR...so no resuscitation done...

After the op i went up just to check on another uncle whose lungs were quite bad due to hospital acquired pneumonia...that was about 2am...i found him drowning in his own secretions, without his oxygen mask on his face and his saturation was 77% on air....and the HO was sleeping, and the nurses were busy on Facebook...would anyone blame me for burning with anger at such negligence? if i didn't come to check on the uncle, he might have died of hypoxia by the time the nurses passover at 7am and then only noticed to be dead....such unacceptable work ethics....

I was coaxing the uncle to wear his oxygen mask...and doing vigorous chest physio and suction for him...i had to ask the HO to help me...and the nurses didn't even bother to help...i tried every measure to help him but his saturation only picked up to about 95%....so in the end i referred him for ICU admission coz i knew he was gonna die if he was left in the ward....and i wasn't about to let another patient die during my call...

By this morning when i saw uncle in ICU, he was already intubated and developed VT and his blood pressure was low, requiring inotrope....and i only had 2 hours of sleep...of course today was another adventure on its own...i called the patients for tomorrow's locum OT one last time just to confirm their admission...i've done that earlier and all patients confirmed that they were coming...but then when i called one of the old uncle, i found out that he was admitted for complete heart block last Friday and had a pacemaker inserted...i was like, SHIT!!!!

So i called boss and he told me to cancel the case and find another patient to replace him...so i drove like a maniac to the clinic coz there was mortality meeting at 1030am and i had to present case reports...thank God boss came to help look for potential patients...it was really not easy to get someone to go for op last minute...but we finally managed to get a patient....so i thought crisis settled...and the rest of the day was quite uneventful....

After HO teaching, we went back to SMC to do pm round...and we found out that one of the patient for op tomorrow was still on clopidogrel...no one asked her to stop it at least 10 days before her op date...i almost died...things couldn't get any worse...so i had to re-print the OT list to avoid cancellation on our stats...and thank God boss managed to find another patient to put on the list... sigh, how much bad luck can befall a person in a day huh? but really thank God we managed to settle all the hassle and blunders...but all these 'disasters' must really make me look bad in front of boss...

Oh well, i'm just too tired to care...i need to rest...tomorrow another 5 hours of OT...let's hope no more disaster tomorrow....

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