隐藏着的歧视

医务人员，本来就得本着医者父母心，众生皆平等的态度去面对每个病人。
可是难免，
看到瘾君子病重出现在急诊，
还一副不肯合作的模样，
就想脱口说：“怎么样，不要就走啊！谁管你死活！大把病人在等啊！”
心想也算了，
拿不到爱心出来，
也不应该歧视！

每个人背后都有故事，
不是吗？

新官上任

大老板今天第一天上班， 有种非同凡响的气势， 干脆，清楚，仔细， 最重要是， 我也觉得自己获益良多。 我的九个星期就这样混混噩噩地过了。 只觉得忙忙碌碌， 没学到什么。 最后一个星期， 终于有道曙光出现， 但可惜我也即将离开。

扑克脸

我的扑克扑克脸

世界很小
医疗界更小

永远不知道
何时山水有相逢

保持良好关系
才是上策
才是生存之道

多不堪的人
尤其是上司或同事
还是得忍
还是得扑克扑克脸

年轻

当病人说你看起来像十六岁，
心里会暗爽一下。

然后会想病人可能在隐喻我不可靠。

管他，
我的确还是新鲜人，菜鸟。

然后又继续暗爽 :D

I don't think there is a fracture!

Around 9pm,
a Friday night.
I was holding my groceries in my hands and loitering in Coles Supermarket.
Mobile phone rang.

Reg: How's things going on the ward after I left?
Me: Good, not much happening.
Reg: Did you check the xrays report of Mrs X?
Me: Oh no, I forgot...
Reg: *silence*
Me: (Try to be convincing) But she can weight bear with no pain, I think the chance of her having a fracture is really low...
Reg: Ya...that's true.
Me: I will check the result from home....(OS: You are the reg, why do u agree with me?!)

Yes, my fault for not checking the result. But your over-ordering X-ray without proper examination first is not much better...

My 101 years old patient

Wow, 101!
But can you tell me why you need to rehab a 101 years old lady?
To go back to her pre-morbid functional status?

Isn't this a bit too much?

I am not discriminating elderly but seriously, at the age of 101, won't you think you have lived enough? With pneumonia, pulmonary oedema, rapid AF, NSTEMI, bowel ca, fractures...
Possibly the most torturing thing is that you see family members younger than you passing away.
Why would you come to rehab?
Wont you like to stay at home in your own bed?
Or rather I should say, why did u get sent to rehab?!


*grrrrrrrrrrrrrrrrh*

Killing me softly with rehab

If you ask me what I like the most about my rehab rotation,
The answer is always: I dont need to answer any pages.

Anything else I like about rehab?
Probably those cute elderly.

Anything else?
Maybe the Malaysian aunty nurses.

More?
No.

The rest?
#@*%!$*#!!!!!

一个有教育性的玩笑

刚完成了我的weekend shift。
老天算对我不薄，我的周末并没有疯狂的工作量。
发生了一件至今仍令我深思的玩笑。

On our way from ED to the ward,
registrar: how's your day?
me: It's been good. I am just clearing the jobs on the white board. I feel obliged to clear those jobs and I don't like them piling up.
registar: You are a perfectionist, like me.
me: yea...it just feels good.

Walked past said whiteboard, no jobs...*feel awesome*

Sat down and played with my iPhone.

Oh, I need to write up the blood slip for patient X for tomorrow. So I walked out.
Caught a glimpse of said white board.

"Bed 1: failed supp. Pls do manual disimpaction." (i.e. clear the stools from the backpassage using a finger)

It's 9.15pm, and I have nothing else to do and just waiting to handover at 9.30pm.

So I told the reg what was on the board and getting quite excited to do my second manual disimpaction throughout my internship so far.

My reg cracked a joke:
Make sure you order an abdo xray after you do it.
Me: Why? Is that a must? (No one told me before...)
reg: look at your bony finger, it can cause a perforation...No, I am just kidding. You don't need an xray.

Ok...we had a laugh and I was ready to go.

Reg continued to say:
Are you really going to do that?
Me: yea...this will be my last job for tonight *happy* then i can handover. *walking away*
Reg: are you serious? you really going to do it? *walked with me towards the white board and RUB THE JOB AWAY*
Me: *confused* what?

Reg: I wrote that on the board! It's a joke!
Me: *feel a bit embarrased*

Then I had a 5 minutes talk from the reg about not doing what's written on the board blindly and the importance of escalating treatment.

Reg: Nurses dont always know how to escalate treatment but you do. That was a glycerine suppository. You can escalate to an enema.

有一种恍然大悟的感觉，
像被点通任督二脉。
是我们东方人的教育方式的问题吗？
我们崇尚听话，顺从，勤劳。
就是少了那么一点的变通思维。
长大后踏入社会，
受人钱财，替人消灾，
不懂变通，就会让自己觉得工作吃不消。

如果那天没有被开这个玩笑，
或许我还得继续撞墙个三五年才会学到这个道理吧！

休息是为了走更长远的路

休假了三天
接踵而来的是连续八天的工作

在家里打扫整理 乐也
上网看天下 乐也
穷追港剧 乐也

比起
pager不断地响
护士不断地烦
没时间吃饭的日子
实在有天渊之别

自问没什么大志
不奢望悠闲自在
只希望安然无恙 平安大吉

我的长远的路

今朝有酒今朝醉
今朝有觉今朝睡

睡饱了就有力气战胜自己
再不愿也得跨步走 ：）

适不适合外科？

1）无奈早上七点开工，辽辽无期的放工时间。
2）分身术得比任何人厉害，穿梭于病房，手术室，门诊，会议。
3）外科巡房速度比火箭快，一个实习生必须拥有千手观音的外在条件加哪吒的风火轮，边用龙卷风快速度写字，边看病人的observation，urine output, drain output，你忙得出烟，你的大老板只是跟病人挥挥手说一切很好，然后拍拍屁股就一阵风走掉去另一个病人的床。然后一切重演。
4）你会在稍有空暇时觉得你老板除了会开刀之外，什么都不会，像个废人，然后你会开始鄙视他。当他请你喝咖啡时，你就会觉得这是你应得的。不会存有感激之心。
5）没有时间吃午餐。
6）病人流量很大，进进出出，太多paperwork。
7）会觉得很对不起病人，因为你没有时间好好问候，问诊，检验。你纪录的一切都是你的老板跟你说的。

我的结论是我不适合外科。

苏打绿陪我过的日子

每个星期五傍晚，
我会象个游子，
赶搭最后一趟火车回家。

沿路是夕阳，大片的草原和结群的牛羊。
三个小时，
听着苏打绿的歌，很有感觉。
就这样，不断地重复了七个星期。
青峰的声音太引人入胜了。
他们的音乐甚至已经取代了周董在我心中的位置。

眼见下乡服务已经快告一段落。
没有了三个小时的车程，
换来了更忙碌的外科，
我还会有时间聆听他们的歌吗？





比较喜欢台语版本 ：）

IV cannulasss

I finally have some positive experience with IV cannulation after few years of practicing.

I still remember my first few ones, they were easy veins but just couldn't get in or at least have to try a few times. Practice really makes things I wont say perfect but at least much better.

I have got a patient telling me my cannulation is less painful than the one done by the nurse (and the nurse couldn't get it in :P).
Another patient told me today "it's a pleasure" even though he ended up not needing the cannula. So I poked him for nothing but he was not upset.
One patient didn't realise I was done with the cannulation.
I managed to cannulate a seizing patient in a MET call.

They were not difficult ones and they have got palpable veins. The really hard ones I still missed or didn't know where to start.

I could now say I am better than when I was in 5th year.

It's great to have some satisfaction from the work and some positive reinforcement too :)

Endless ward jobs

Things have been quite good on the ward until yesterday.

I really felt that everyone wants a piece of me. Drug charts, IV cannulas, referral letters, calls from GPs, calls to GPs, calls to patient family, calls from patient family, chase results, review patients with new complaints, deteriorating patients,admissions, last but not least, talking to an agitated patient with hx of IV drug use that we are not giving him any endone at 6pm whilst I was supposed to be finished at 4.30pm.

It's nearly impossible to get out of the ward, things come up 1 after another or at the same time. I understand that if the nurses dont catch me, they will have to page the cover doctor in ED and if ED is busy, no one will respond to them quickly. The nurse in charge was very nice though. She said if I have any problem claiming overtime, she will speak for me.

How I wish I have "3 heads 6 arms"...but I am lucky that I do have a really helpful registrar who shares some of my workload.

Without me realising, it's already Wednesday! Weekend is coming :D Hang in there!!!

I am the New Rotamah Intern

The ward that I am looking after, Rotamah ward has medical, surgical, paeds and obstetric patients. I have 5-6 GP consultants coming in the morning to do ward rounds. Seriously, they all look almost the same...and I just cant remember their names, not to mention which patient is under their care. It took me 2 days to finally create my own patient list so that I get to update my list everyday like any other metropolitan intern :P But the GPs are way too efficient, probably because they are used to do all the clerical stuff by themselves (write progress notes, discharge summaries, medication charts, pathology and radiology slips) because they used to have only 2 interns covering the whole hospital wards, this year we have 4. I bet they are going to get spoilt by me...wahaha!

The nurses of my ward introduced me to other people, "Have you met YS? She is our new intern. We have our own intern now!" I guess I should be happy that I am owned by Rotamah? But they are really nice people, and they are very experienced, can do almost everything, except for signing the drug chart :P And thats what I am here for :)

Besides Rotamah, I also cover the dialysis and oncology units. I will get paged when they need a doctor to write up medications or to review patient who is not quite right.

When I get asked questions that I don't know, I always call for senior help :) I think this is probably the most useful bit that medical school taught me.

I spend more time writing drug charts, discharge prescriptions, discharge summaries, looking up results...than talking to or examining my patients. It's sad, but a doctor told me before, an intern is someone who can perform clerical jobs with a medical head. I can't agree more! Hopefully, after I have picked up all the skills of doing clerical work, I will have more time to spend with my patients :)

My Flat 3

Arrived at Bairnsdale today, settling in my on site intern flat.

I am using the desktop provided...can't type chinese character.

Ah well... can't complain. I have my own bathroom, kitchen and living room. The internet connection is good, at least i dont have to wait for YouTube video to load :)

The TV is broadcasting news but I don't watch, I just want some noise in the background.

Cooked my first meal i.e. pasta with fried egg.

Accidentally came across this singaporean series called The Oath on YouTube...seems quite interesting.

Another orientation day tomorrow:)

Good night Bairnsdale :)

实习医生生涯开跑

预备....
“砰”！

五年的医学生涯结束，
现在我们才真正开始起跑。

我的起点有点特殊，在维多利亚的一个乡镇。
Bairnsdale是个人口大概十二千人美丽小镇，
有海口，沙滩，湖，旅游业蓬勃。

大学第二年曾经到过那里的医院学习过短短的两个星期。
没料到三年后真的会去那里服务十周。

特殊的并不是什么好事，
而是最近那家医院起了大风波，
董事部裁了一名长期在那里服务的consultant，引起其他医务人员不满，相继有几名资深医生和护士长辞职。
资深医生离职，对于我们的影响甚大，
院方向我们这一群八只黄毛丫头保证，
他们会有其他医院的资深医生暂时代职，
以确保我们得到充足的监督和引导。

但实际情况是怎样，
那就得到哪儿才知道了！