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.

leave is so good :)

i love being on leave! :D

the feeling of waking up late in the morning, with the sunlight and fresh air hitting your face, without needing to rush to hospital at the unearthly hours of the day, being able to actually eat breakfast slowly and read the papers instead of scarfing down cold food, being able to walk around my neighbourhood and appreciate being in the sun, not having nurses call me for the most irritating things, not having to update families, not having to deal with irritated radiologists, not having to deal with attendings and residents, eating home food, spending time with my family and friends, ahhhh.

LIFE IS BLISS ON LEAVE :D

leave!!!

my leave starts in 1 week and i'm excited as anything about the prospect of waking up late and not reporting for work! :)
of course, there's exams to study for so it's not going to be that relaxing. but i only have myself to blame for signing up for more exams so i can't complain :\

on the brighter side? i'm headed across the oceans to visit my family again! :) i can't wait to hit the coasts and theme parks. the smell of freedom is so sweet - in 1 week! :)

servitude?

back to gynae wards - got to admit i'm relieved, i love obs but i feel more at home in gynae because it's so much easier!

more about my new ward in a bit when i'm more awake, had call last night and it was disastrous. patient expectations are rising higher and higher and we're just not able to deal with them.
i'm expected to drop everything and run to see premier patients for any minor problems, some of which are so utterly ridiculous!
eg. c/o pain but refuses to take painkillers
eg. c/o about the light in the room
eg. c/o about wind in abdomen but refuses meds

they just leave me with a really sour taste in my mouth when i'm expected to mollycoddle them. for goodness sakes!!!!

just yesterday on call, i had 2 cases from the same ward.
first:
lady post PFR/SSF, c/o severe pain "down there"
O/E: vulva not swollen, slightly tender to palpation. vaginal pack in situ
patient crying in pain and allergic to NSAIDS. so i order pethidine.
nurse runs around looking for the key to controlled drug cabinet.
meanwhile, husband comes out and shouts at me. reassure husband, run around looking for key too.
settle another patient, and am washing hands when husband comes out and shouts at me again because no one has seen patient in that 5 min.
hurry nurse up, finally gives jab 15 min after seeing patient.
spend next half hour holding patient's hand whilst she gaspes in pain and falls asleep from pethidine, all the while having to repeat explanation to family members who walk in and husband who shoots me pissed off/ suspicious looks.
demand to see attending who did surgery.

second:
patient post major op (cancer surgery), c/o pv bleeding 5 pads soaked POD 7.
speculum: copious HSF in vagina, evacuate as best as i can. no packing but placed on pad chart.
patient and husband appreciative

both cases left me with a great deal to think about:
1) post op pain is common. but we all have different pain thresholds. but you cannot expect meds to arrive STAT when you say there is pain!!!!!
if you want such wonderful service, pls go to a private doctor. i am but a mere cog in the wheels of the public hospitals, my dear patients.
shouting at me is not going to help hurry up the meds being served. also, you don't have to be so rude about it.

2) my dear patient, pls inform me earlier if you are having such a huge amount of discharge :( :( i was so worried!!!! thankfully it resolved.

3) i think we should treat all patients equally, subsidised or private. but i guess that's not possible

ok i'm not sure if i'm talking sense. had 1 hour of sleep last night, so been awake for about 36 hours other than that 1 hour of sleep. very tired.
more later (remind me about eye candy!!!!)

end of 2 months

i've reached the 2 month milestone of my first year of internship! that means my first posting is halfway through :D

and i'm surviving! i hope. hehe

so far it's not that bad. there are times when i just feel like running home away from the wards and not coming back, but i always force myself to stay.
and on call i feel like turning off my phone and staying in my call room to sleep but i force myself to answer the calls anyway, because well, i'm all the patients have isn't it?

then again, today i received cookies from a patient, i was SO SUPER TOUCHED :D
this patient is a doctor herself from another country, and i don't think i paid her particularly much attention, but i think she realised i was having a really tough time running 2 wards especially with a demanding resident. the gift cheered me up tonnes! :D

calls are coming thick and fast, once every 3/4 days for me right now. can't wait till my leave arrives!

last labour ward call i did- EXCITING STUFF :D
we'd 3 caesareans - 1 was almost a crash caesar because of a really bad decel on CTG. getting to scrub up 3 times that night was exhausting but a load of fun! :D plus the resident that night was one of my favourites, sweet and ever willing to teach despite her exhaustion. so i didn't mind waking up 1 hour earlier to pre-round the patients for her to make her work earlier, although i think it really wasn't very glamorous to fall asleep at the nursing counter. oh dear!

students in the wards now, i wish i could have time to teach them, but my current ward is so super busy that i barely have time for lunch, let alone to teach people! arghhhh.

well call cm again! need to sleep early.
but arghhh tour de france is on and i'm dying to watch! :(

sine curves

working life is like a sine curve (or a cosine curve, whichever rocks your socks).

i'm exhausted from running 2 wards by myself this last week, i get to work at 630 am and leave around 7 plus which not much chance to sit down in between save doing my millions of discharge summaries.
i know it's pretty easy to do my discharge summaries - there's a template! :D
but when i discharge close to 30 cases every morning (all must be done by 1130 am else the nurses get really really antsy and call me non-stop), on top of all the other things that need to be done in the wards like updating attendings/taking bloods/updating families/bringing CTGs down to be signed etc, it makes for one very stressed-out me.

at least one of my ward residents is this super nice lovely lady who doesn't need me to follow her around and is always patient.

i wish the same could be said of the guy resident in the other ward, who told me in no uncertain terms that he expects me to follow him around the whole morning to carry his files and scribble in them for his round. well, i don't mind doing that if i didn't have 2 wards to cover, thank you very much. he thinks i'm slacking off by not being there but the truth is, i'm still doing my NVD rounds in the other ward by the time he's finished with his rounds!
to top it off, he's quite a senior resident, moving on to the next level soon i think. so i feel really bad having to call him for anything i'm unsure of because he sounds rather disdainful. :\ just the other day i got scolded for making him come up to the ward to take consent from a patient - to be honest, in our guidebooks we're specifically told we can't take consent from patients in cases such as these, which is why i had to call him up. but he insists that i can take this consent and yelled at me and the nurses in the middle of the ward.

all these encounters with him have just left a really sour taste in my mouth whenever i see him, although if truth be told, i don't think he's that bad really. kind of naggy, but he's a good doctor i believe. i just wish that i wasn't running 2 wards so that i'd have time for all this!!!!

it's really crappified, this whole point about not having enough interns, and the workload distribution is rather uneven too. i think they've realised it because next month it's back to one person a ward, thankfully for whoever's coming up here.

then again, it's the last 2 days of hell running these 2 wards!!!! plus i'm on call tomorrow night too and with a not-so-friendly resident, booooo :(
wish me luck please!


but that doesn't mean there haven't been bright sparks throughout the days!
the nurses have been particularly nice, they help me as much as they can, and they tell me to leave early and that they'll call the on-call to do whatever comes after knock-off time because i think i'm really looking very haggard from all this stress (my friend was rather stunned when he saw me, said i looked very "mature". URGHHHHH). but that doesn't change the fact that mornings are really really bad, and getting several PPHs in the ward doesn't help to decrease my stress levels at all. oh well.

the other nice thing was meeting my previous attending in the lift with several CTGs to sign off, he just grabbed the whole bunch and signed them off for me! HOW NICE IS THAT????? i was so super touched! :D

good days and bad days, it's like a sine curve.
looking forward to leave like nothing before.
wish me luck!