quick update

thus ends my 1st week in the labour ward! i have done 3 episiotomies, delivered a baby, seen an IUD (saddest thing ever), seen a cord prolapse, endured loads of shittiness and made friends with the residents.

the 2 residents on my side are SUPER NICE :D i am so thankful to them! esp when i bung the iv cannulae (we have to set 18 G ones, arghhh), they will willingly do it for me. super nice :D

got to go to the OR to assist in a caesar, SO EXCITING. the senior resident laughed at me when i jumped as they ripped the membranes and the liquor gushed all over my hand. hahahaha. clearly i have not assisted in a caesar before! but it was SO EXCITING, esp when i had to "cpr" the abdomen to push the baby out! :D of course, i ended of with blood all over my shoes and pants. arghhh. thankfully i'm not washing them though :P

i think i love deliveries, nothing beats them!!! :D

have finished my 3 calls in 6 days, that was exhausting and i hope i dont' have another set coming up that fast :\ esp since i had a patient with a stroke on the call and i had to call a neurologist from another hospital about the patient, which was hell because i had to call the other hospital 5 times before getting a human being to talk to me. ARGH. plus there were 2 AMA discharges on my call, one at 8 pm, and one at 2 am. so i had to type all the whole discharge summary!!! :\ oh gosh. but i think it's still better than having the patient desat on me as per my sunday call. eeks.

remind me to write about the cord prolapse another day!

i hate calls :(

had my 2nd call on thursday in the labour ward this time round, i barely survived! :\

(for your info: a call is when you work all day and then go on "call" at night, so that the rest of the team can sleep in peace. in short, you (and the others on call) are left holding the fort at the hospital till daybreak when the rest arrive at the hospital again, ready and refreshed to begin a new day! my weekday calls are from 430 pm to 8 am, weekend from 730 am to 1230 pm the next day, depending.)

labour ward is so so tough, i barely know enough to scribe in the case notes and the loud ticking away of the CTG machine makes it really hard for me to hear what the residents are saying when reporting their VE/CTG findings. plus the masks we're all wearing means i can't lipread to save my life either. :\
thankfully, this being a medical profession, means that the senior doctors are usually a bit more understanding once they find out i wear hearing aids! :) the only thing i need to learn now is to start pointing out that i do wear hearing aids. sigh.

did my first episiotomy repair (with lots of begging to get another resident to come supervise me, he isn't a very nice fellow but i didn't have a choice- those on my side were all in the OR for a crash caesar :\) thankfully it went quite well, wasn't a very big tear. so that's well and good! :D
managed to do it quite quick, must say that the pelvic trainer session we had was super useful!!!! :D

both the senior residents were super nice and patient with me and my slowness, they patiently dragged the tables outside the rooms and yelled their orders into my ears while attempting to teach me. plus my JRs were fabulous, doing the plugs i failed without complaining much and showing me how to do cord blood pHs.

i felt so bad!!!! :\ esp when i failed 8 out of the 10 plugs i set :( i keep bunging the veins, i really really need more practice. thank God my friend, G, was on call with me, so i could ask her for some help here and there.
it was even worse when she had to go to the OR to help with a crash caesar and i was the only one left in the ward of 24 beds :\ tonnes of paperwork, harried midwives and nurses, scared/irritated/pained/grouchy/demanding patients to see! oh my.

the midwives were fantastic, they asked me to dilute all the penicillins and hang up the drips before i slept at 445 so i wouldn't have to wake up at 5 plus to give all the drips, they'd do it themselves. SO NICE. when they heard i needed to do deliveries, they instantly pulled me into a room to observe a delivery that was ongoing (unfortunately, i had to leave early to go do paperwork for a crash caesar. arghhhhh). but i was so touched :D

G and i were so depressed on call, we started a countdown timer to the end of call! we wanted to watch american idol, but sadly, we had work to do just as it started :( oh well.

it was my last day in the same day admits clinic and the ward, i was honestly rather sad to go! :\ the ward nurses have been super nice to me :D today a patient had a hamper of fruit delivered to the ward, and the nurses wanted to give us some fruit, but S and i agreed they'd done far more than us, so we had a banana each. hehe :D so cute, i love the nurses. and there wasn't much work to do on the last day as well :D

took off at 245 post-call, fell asleep while standing on the train, waiting for the bus, riding the escalator down - so dangerous! in the end i cabbed home from the train station as it was pouring and i was so tired. ooph.

having 3 calls in the next 6 days, hope i survive without making major mistakes!

first call

thus ends my first call - on a sunday, no less!

thankfully, my good call luck seems to be holding! :D must really give thanks that every plug and blood i took (except one, and even my JR couldn't set that!) was really easily done and most were on the first try! :D was still feeling extremely demoralised after thurs where i failed every single one but this is proof that there is a God out there for He must really have heard my pleas :D

but then again, to put things in perspective - i was on my feet from 730 am to 640 pm, the only sitting down was doing discharges. :\
i only got to eat "lunch" at 9 pm - i am so slow at doing stuff! :( thankfully the nurses were all v nice and understanding as to why i was so lousy and useless and they were telling me to stop being so frazzled and to take my time. hahaha i love nurses!!!! :D

my phone stopped ringing around 9 pm, and i managed to bathe and squeeze in about 4 hours of sleep overall in between running to see a new patient with CA cervix (and also HIV positive, super scary drawing bloods, i double-gloved and tried to use as few needles as possible!) who's Hb was 4.6 - had to call for emergency bloods and monitor her closely, and another septic patient with an intra-abdominal abscess for urgent CT scan (there was no end of fighting between the nurses and the radiologist - the nurses insisted she was to be NBM but the radiologist insisted on oral contrast - so i solved it by calling the attending in charge, who was super nice and even sounded appreciative that i called to update him. whew!) :D

went off post-call at 330 pm, my dad had to text me to tell me to go home! thankfully my friend protected me from the nurses by saying i was post-call and forcibly shooing me out of the ward so they wouldn't ask me to do anymore work. very very thankful for that.

so i survived my first call in the peripheral wards, next call is come thursday in the labour ward! hopefully i get to see a couple of deliveries and i get to learn episiotomy repair :D

day 4

surgical masks are the best things ever!

well, maybe not, but compared to suffocating behind the n95, i have no complains about wearing a puny surgical mask, at least i get to breathe :D

thought i would feel better after celebrating my birthday yesterday (a mid-week pick me up!), but no, i'm just as tired today :(



covered my friend's ward today since she was post-call, that just means that i ran the usual ward i'm in by myself!



today was a really crap day at bloods, i failed every single blood and plug i had, it's really depressing. i think mentally i was defeated before i even tried drawing the last blood! :(

thankfully thankfully thankfully, when i called the junior resident (JR), he came bustling down right away and helped me clear tonnes of the work in the ward, he's so super fast!!! i think knowing what to do helps you do it fast, and the experience really helps.



i felt so lousy next to him, but he kindly reassured me that it was normal and he started out like that too, and that at the end of 1 year i'd be like him. :D

i hope so too, i hope so too!!!! keeping my fingers crossed :)



anwyay work wise today wasn't so bad, because we had intern teaching session (that my ward partner and i fell asleep during, such is the heavy work of our ward that we're super tired out). rather embarrassing that we were sleeping in front of the nurse manager :\ i hope she didn't think we were insulting her, we were really just tired out :(



it's really hard to get away from the ward, we tried to leave but the nurses just kept asking us to do things, and it's hard to turn them down as well cos you feel guilty. :\



i had this patient who came in for a minor op, supposed to be home by evening, but nooooo, she bled and bled and bled when we removed the ribbon gauze. the JR was rather shocked too, i think, because it wasn't expected at all. in the end, 3 JRs and 1 senior resident came down to review her whilst i ran around doing other things. my knees are black from kneeling by the patient's bedsides for various things! but that's the least of my complaints haha.



the saddest thing today was this young lady who came in for an abortion, because of foetal anomaly. she was alright all through my taking consent, attempting to draw blood (and failing rather miserably!), but when i inserted the cervagem, she started crying. it wasn't from the pain, but from the sadness. i felt so so bad for her. they're sending the foetus for post-mortem and doing an extensive workup on her as well, but i think it's really quite traumatic and she really wanted this baby i think. you could see the sadness in her eyes, somehow. her husband was really lovely, being supportive and everything, but i could see his sorrow as well.

sometimes life isn't fair, and i think this couple would really have made quite a good pair of parents. the lady really reminds me of one of my friends. i hope they find peace, somehow

it's only day 3!

in my friend's words, " DAMN SHAG".

we're all drop dead tired after day 3 - at least on days 1 and 2 you had adrenaline to keep you going but on day 3 it's really bad cos everything hits you at one go - the lack of rest, the stress, the expectations that you should know enough of what's going on, the work piling up etc.

my job has suddenly expanded, seems that my intern buddy neglected to tell me quite a few things about day surgery!!! so it resulted in the junior resident being rather unhappy with me, thinking i was shirking my duties. :\ took me rather alot of groveling and apologising profusely on that point! i can't really blame her :\
but at least she was nice enough to teach me what i should do, and when i had to call her for help later on she answered quite happily (i guess since i'm relieving her of her job, hahaha)

today was hectic, rushed through same day admits clinic and went upstairs to help my friend out, and on walking into the ward, the nurses grabbed me and showed me what they wanted me to do - the WHOLE COUNTER was filled with files! :( :( :(
as if that wasn't enough, they then plonked 5 files into my hands and said these needed to be discharged by noon. and i got there at 10 plus! :\
plus the other intern was dealing with a dangerously ill patient so it was up to me to get the work done :\
had to send an emergency SOS out to all my friends, and i am SO SUPER GRATEFUL to those who came to help me out! :D :D :D I LOVE YOU ALL, REALLY REALLY REALLY!!!
between the 3 of them, they cleared the discharges, updated the attendings, dealth with a pleural effusion and calmed the nurses whilst i clerked the new cases and set plugs.

but well, the 2 of us in the ward eventually only had lunch at 330 pm :( :( at least we got lunch so i can't really complain i guess! still, it's not joke drinking less than 500 ml of water the whole day.

had a good chat with a patient today whilst setting a plug and asking about her decision for a PCN (percutaneous nephrostomy). she's so sweet! :) it's things like this that really make me happy, patient care is right up there.

on the sad side, saw an aborted foetus :( :( my friend and i were curious so we opened the box, and OMG, i was so so sad after i saw it. it was tiny, about a hand's size, if curled in foetal position it could probably fit into a large palm. it was all red and jelly like, but you could see the ribs, the clavicles, the ears, the perfectly formed fingers and toes, the white jelly of the umbilical cord. it was a perfect baby :( :( :(
it's at times like this i wish i was an objector to abortions, but i've thought it over alot and asked a few people on this, including my family. and i think i'll stick to non-objector for now, but we'll see how it goes in the future.

on the other bad side, my exams in september have been cancelled due to swine flu :( :( :( oh well!

post first day of work

i am so tired i feel like dropping to the ground. having spent 11 hours running around cluelessly in an N95 mask breathing in carbon dioxide doesn't really help much either.

i suppose that's why i dropped off to dreamland on the way home and missed my stop! :(

first day wasn't that bad, i was high on adrenaline and fear, managed to turn up at the hospital at 7 am only to find myself locked out of day surgery and spent a good 10 min wandering around before getting a call from the nurse wondering if i was coming! after explaining that well, i was rather lost, she came out to get me very nicely. OOPS.

had all of ONE patient whom my boss efficiently clerked and bustled up to the OT before i even realised what was going on! :\ oh no i hope i know what to do tomorrow else i will be placing my fat neck on the chopping block. urlp.

after that i was scurried up to a ward to help out and i was even more clueless - i did my first cervagem insertion, my first doptone, my first consent taking and blood transfusion and giving iv antibiotics all by myself (with loads and loads of help from the nurses!!!!). OMG.

my friend and i were so stressed out and we only got to eat lunch at 3 pm (which is good, compared to what i hear from my other friends - eating a sandwhich in the lift on the way to exit rounds, having nothing to eat or drink till 9 pm at night, HORRORS).

but i'm thankful for the work, i could be out of a job right now and desperately looking for one. i could be one of my classmates who failed. i could be someone who never made it to medical school. so i am deeply thankful that though slave work this may be, i am here.

alright now i have said the requisite deep stuff (hahahaha) i shall now talk about some stupider stuff.

1. the bloody n95 mask is like a face sauna and gives me a heat rash. plus it removes all my painstaking applied makeup!!!! :( i am most unhappy with the last point, obviously. haha

2. i am possibly the dumbest intern ever, when a patient's potassium levels came back as 3.2 (normal is 3.5 to 5), i said, OH LEAVE IT. and all the nurses promptly crowded around me in shock and horror and ordered me to write down and order for mist KCl. oops. so being the good girl i am (hahaha), i did so meekly.

3. on reaching the canteen, all of us interns promptly held up our n95 masks and fanned ourselves for air! so funny. one small kid was staring at us very intently, i can't tell if he was horrified or amused.

4. all the former interns (stopped from moving onto the next rotation thanks to H1N1), promptly disappeared at some point in the day and were uncontactable. hrmmm. i suspect they all went out for either lunch or karaoke!!!!! tskkkk. but who's to blame them? ;)

5. when you're as dumb/blur/clueless as i am, the nurses are really really your best friends :)
I LOVE NURSES!!!!!

first day!

it's my OFFICIAL first day of work toms!

i'm so stressed i can't sleep, and the adrenaline is racing like crazy.

i'll be starting out in day surgery filling out forms and clerking same day admissions. thankfully all non-urgent electives have been cancelled!

wish me luck and prayers, please!

hullo and swine flu?

first post here! :)

thus begins my working life come monday morning.

my tiny island has been hit hard, not by swine flu itself but by precautionary measures.
we've learnt our lesson from the SARS 5 years ago, and now all measures are being ramped up slowly but surely.

we're now operating on an Orange Alert level, up from the Yellow Alert we previously had.
that means, come monday, i'll be wearing N95 masks and full protective gear in the wards.

my juniors have been told in no uncertain terms to cancel their overseas electives and to return home ASAP and be self-quarantined for 7 to 14 days or risk disciplinary action.
other juniors have all been barred from the wards till further notice.

my seniors (the current batch of interns) have been told they'll stay in the same postings, there will be no changeover to their next rotation until further notice. (this has made them very unhappy)

all visitors to hospitals are now screened for fevers and made to write down contact numbers, and are limited to 2 per patient.

it's all very scary and rather over my head, i'm just trying to keep on my feet here and hopefully i'll survive this! :\

i don't know what will happen, but hopefully i'll be able to blog as it moves on. SARS before i entered medical school, swine flu after i graduate! what a batch we have.

we were mask fitted for draeger masks on thursday, because USA supplies our N95 masks and they're keeping all stock for themselves right now. thankfully draeger fits me better so i can't complain.

but oh my, i really really hate wearing the masks!!! the sweat, the discomfort. the immense difficulty i face trying to hear people (i usually partially lip read to help me understand!). it's all made for very tough times.

hope you all are safe elsewhere in the world!!!!