sleep, or lack thereof

night calls are every intern's nightmare.

(a call is when you work the day from 7 am to 5 pm, start call at 5 pm, work through the night till 8 am next morning when call ends, then carry on with day work till 5 pm again. if you're lucky you get a post-call and get to leave around 12 plus at noon)

6 months into my intern year, i must admit that i'm more used to calls now, but that doesn't mean i like them any more.

of course, there are exceptions to any rule, and i have to say that i really really loved labour ward calls, esp when there are caesars aplenty!!!! :D nothing i love better than going in for a caesar :D :D :D time seems to fly when i'm in the OG OT

i used to think A&E calls for ortho weren't too bad - until monday night.
when my resident called me in a panic 15 min before my call was officially supposed to start, i knew things were bad. what i didn't realised was HOW bad.

when i hauled my arse down to the A&E, there was an entire STACK of cases waiting to be seen in the ortho room. oh dear!!!! (the usual is about 3 to 4 cases, maximum!)
and there were 3 patients waiting to be admitted - means i had to clerk them in the A&E or run back to the ward to admit them - and the ward is very very far away!

the worst was doing a blood culture in the A&E - no sterile gloves, no culture set. just swab the area 10 times with alcohol swabs and do a no-touch technique and pray like anything that it won't be contaminated. EEKS!

thank goodness for my very enthusiastic students, who's energy gave aging me a boost through the night. they were chirpy and perky and well, everything i was not. hahaha. they even kindly bought me a drink! :D yeyy!
but really, seeing their energy gave me a boost. i remember how enthusiastic i was back then. every plug to set, every blood to draw, every backslab to prepare, was like a diamond. i craved the clinical aspect of medicine like bees to pollen (not honey hahaha!).
getting to play doctor as a student was the BEST THING EVER! hehe.
now, sadly, i am getting old and jaded. every new case that comes in, i just try to clerk it as passably as possible, every plug i set, just needs to work, every blood i draw just needs to be enough. the less work, the better!
so really, i do owe alot to my students - their enthusiasm helped me pass the night! :D finally packed them off to sleep at 515 am. goodness!

my poor resident and i didn't have time for dinner, we worked non-stop from 5 pm to 530 am. when we both finally sat down at 530 am, i fell asleep whilst she called my senior resident for some advice regarding the admissions. oh dear.
must have looked an awful sight sleeping in the ED! :\
too nauseated to eat breakfast and lunch the next day, left hospital at 2 pm and crashed at home promptly.

but call is over! next one on sunday- ward call. EURGHHHHHHHH!!!!

failed

exam results are out, and i am not amongst the list of those who passed.
but i'm alright, i know i didn't study as hard as i should have, and this result is entirely my own doing. i will make sure i study a lot harder the next time round! :)

survived my passive calls so far, v happy :D
passives are awful calls. you get a million calls for post-op reviews, you take endless bloods, you see all the patients that cannot sleep/itchy toes/cannot pee/cannot BO/bleeding/chest pain/SOB/dizziness/nausea/pain pain pain/ etccc.
ARGHHHHHHH.
medicine is not my strong suit, clearly!
diagnosed a patient with nosocomial pneumonia my last call, but didn't start tazocin as nurses had just given augmentin 1 hour ago. wrote in casenotes to start tazo cm, and passed over to the ward HO next morning, but the attending refused to do anything for patient as patient appears well. OH DEARIE ME :( :( :(
i can only hope that the patient pulls through! :\ will go back and have a look at him another day.

dealt with a VVVVIP patient (some foreign politician's relative, prof's personal private patient), that my resident was ordered to clerk personally and take bloods from. hahaha.
thankfully she was very nice :)
the funniest thing was when my resident tourniqued her hand, stared at it in horror and told me: "i haven't taken blood in a damn long time", right in front of the patient! OH DEARIE ME.
thankfully patient does not understand english. HAHAHAHA!
luckily i set her plug, so all was well and good :D

my lovely senior resident overheard me whining to another intern about how crappy life in ortho is, and said:" still complaining??" hahahaha oops!

more rants about private and subsidised care later on!

world of traction

1 month into my job, and i still haven't learnt to set up traction yet. HAHA.
thankfully my nurses are so fabulous and will set it up without asking me to help - it must be pretty clear that i am clueless!

seems that most people in ortho are nice! :) albeit totally clueless on how to manage patients other than surgically. hmmm. i have given up trying to stop the avalanche of referrals we write on a daily basis asking other disciplines to "please come and see the patient", now i just write them jadedly without asking if they are really needed. :\
each day, i can send about 5 referral letters! oh dear :(

but i must say, those who review my patients are so SUPER NICE and patient with me. they have hardly scolded me, and they are so kindly and i feel so inspired after talking to some of them :)

my greatest thrill thus far was having a pregnant trauma patient! :) i was utterly comfortable managing her. whee! :) but no, i don't wish for more pregnant women to come to me. hehe

renal patients are my greatest nightmare. they have oedematous hands, horrible veins, and AVFs that malfunction so easily. :( :( :( they are usually broke from years of dialysis, grumpy from being poked so many times, and are so immunocompromised and so unwell that they make surgery a nightmare. which equates to - my nightmare because the surgeons will leave that to me. :\ OH DEARIE ME :( :( :(

but that's not to say that the orthopods are horrid people! they are VERY good at what they do. my lovely resident even bought me dinner on call and another let me go up to sleep, saying he could handle all the work. OHHHH LOVE :)

seems like one of the senior residents in another hospital is looking for that special someone! i heard he announced to the whole OT in the middle of an op "I AM SINGLE AND AVAILABLE" very loudly, and when nobody said anything, he went on to say "WHY NO TAKERS!!!!"
HAHAHAHAHAHAHA!
and in that same hospital - a bunch of orthopods also call themselves: the backslab boys!
oh my goodness oh my goodness hahahaha!

alright alright enough of this nonsense. haha!

of bones and rods

in a fit of fatigue, crossness and irritation (that is wholly induced by my new rotation and my current workmate), i told my senior residen, "I HATE ORTHO!!!!" before i could stop myself.
OOPS. that was a real "open mouth insert foot" moment.

thankfully i recovered enough to remove my big fat foot and apologise profusely, but he'd already burst into amused laughter by then. SO SUPER NICE :D

i'm grateful he's going to be my resident on call when i slog through my first ortho call (HORRORS)! can't ask for a nicer person :D

the world of bones and rods is a world i am wholly unaccustomed too, and i find myself missing the world of women and babies terribly insanely much so. i miss caesars, i miss epi repairs, i miss VEs, i miss CTGs (so much easier to read than ECGs!), i miss ultrasound pelvis, i miss alot of things. i miss the nurses, the residents, the administrative things. and the PLUGS, ohhhhh, THE PLUGS!!!!

but that's not to say ortho is entirely hateful. the nurses here are fabulous (mostly!) and really do try. the workload can be very light and i get to eat lunch!
days are early but i don't have to do 630 am rounds :)

on the bad side? i am this toilet bowl, as all interns are - we suck up all the shit that is flushed down, and there can really be alot alot of shit.
i need to remind myself that orthopods are VERY GOOD at what they do. and not at anything else, unfortunately! :\

getting scolded by other departments is a daily affair - seems like everyone is too scared to scold the attendings so they end up scolding you instead. ah well.

presenting at trauma rounds cm, trying to grow a thicker skin because i'm sure to get scolded so bad. hopefully i emerge tear free! :D

exams!

here we go again! new start, new exam toms. freaking out. the questions are so hard, i had no time to study for this, and i'm sure to fail. oh well.

have left OB/GYN for new rotation to ortho, am having OB/GYN withdrawal symptoms so bad :(

exams aieeee

AIEEEEE exam fever! this time, i am most certain to fail because i haven't had the blessed time to study at all. :\ sigh. oh well at least i can always resit this!

moving on to another posting soon, i don't want to leave :( i love OB/GYN and i'm used to the working culture here already!

have managed to swap most of my ward calls away for labour ward ones this month, i heart labour ward to bits even if it means that i'm not getting any sleep at all. i love it even more when there are many many term caesars so i get to go in and assist!!! nothing beats fundal-ing and pushing the baby out and hearing the first cry! :D

of course, seeing a preterm twin delivery was nothing short of thrilling and sad. the babies are so tiny and pathetic looking, i was standing at the side, watching, yelling in my head, "CRY, BABY!!!! CRY CRY CRY!!!!" as my attending carefully lifted the baby's buttocks out of the uterus.

seeing primary PPH was also exciting, but in a bad way :\ i was squishing the uterus with both hands as my resident sewed it frantically trying to minimise the bleeding. uhhhh.

and finally, my first code blue! damn scary and exciting, and my patient too. thankfully she turned out alright. i must say though, i guess pharmacists don't really understand the importance of code blue. the one i called urgently had no clue what code blue was and was asking all kinds of inane questions, until i gave up and started yelling that my patient was going to die unless she could quickly give me an empirical dosage. but i guess can't really blame them, they have no idea what code blue is.

admin matters are pissing me of, like group and matches being only valid for 3 measly days. so i have to keep poking this poor lady every 3 days for a new group and match (because she has PP major and is only 32 weeks). she's been left with bruises along all her arms! :\

medical students - i've had a few follow me, and i realise that they really really slow you down alot. and some need alot of attention, which i don't like. and some are really pushy and demand to do things, others are very mousy and wait to be offered things. arghhhhhhh. but when i think of how hard it was as a medical student, i try my very best to slow down and teach a bit, to involve them as much as i possibly can, but ohhhh, they really test my patience sometimes!

i love OB/GYN! :D
now for the exam :\ oh well. at least it'll be an experience :\

i'm home! :)

(something's wrong with blogger loading on my computer - can't see anything so i'm just typing and hoping for the best!)

finally home after an eternity!
endured an 11 hour flight, then 10 hours in transit, only to find my flight home was cancelled and i'd to stay the night whilst waiting for the flight out next morning.
was downright depressed, but i made it home in the end! :)

i have to say, there's nothing like coming home, and clearing customs super fast sure helps!

exams upcoming, think i'm certain to fail as haven't had time to study at all, but at least it'll give me some much needed experience in the exams.

and i've gone and joined twitter - it's really interesting to follow people and see what comes of it! :)

back to work tomorrow, not looking forward to it at all. sigh.