commitee....

I was “invited” to this patient safety committee as committee member few days ago. Well, “patient safety” has been a very important issue for the past few years….The hospital evaluation scheme(HES) has focus on this feature since the starting of the new evaluation scheme 2 years ago.

 

Well, a boring afternoon – most of the agenda need not to be discussed by whole bunch of member… It started by 12:30 noon and by 1:50pm I slipped and went to my OPD session. It dragged on till 2:40pm I heard.

 

But I was assigned to a specific issue – the past over record. Most of the past-over were done verbally in the past. Mostly MO to MO and sometime Specialist on call to Specialist on call. But now the HES required us to show record that past-over has been done. Well, more paper work again. The nursing director has told us that one of the big hospital is doing it over the  computer. There is this section in the intranet and MO will logged on and key in those patient that need to be “really” past over. The MO and specialist on call will than logged on to the net and tabbed on it meaning that they has seen the record.

 

Well, look like we need to do something similar…I will need to discussed with my cardiologist (still back in Penang and coming back today…he another invited committee member) and implement it within few weeks…

busy....

Nothing much happens after the assault incident. Busy as usual – the calls were bad, but I could still hang on. Then it was this 4 days continuous Mid-Autumn holidays, I had a break and a holiday far south. The weather was bad and I was wet most of the time. Back to work yesterday and I slept a solid 4 hrs without interruption.

 

I had 8 patients under my service now. 1 of them intubated and stranded in ICU, he is recovering from his pneumonia but I doubt he could be successfully weaned off from ventilator – he is too weak, albumin only 1.9….I am feeding him with some high cal/protein diet, hopefully he won’t ended up with trachestomy.

 

But my life is busy still – our cardiologist mother passed away last week and he is backed in Penang and will only come back on Saturday. I had to cover his OPD and this occupy some of my free time.

 

Next months, the earthquake drill will be on and they scrambled the drill into 3 days only. 4 pre-drill in 2 days ( AM+PM each) then 1 day for the Monkey show…

darkest day...

This was one of the darkest day for me.

I had a bad day intiailly – broken pipe in the house and was disturbing me…then that was this incident that happen during my call….

It was in the evening, there were this group of youngsters who came in to ED- the casualty was jumping. A 16 y/o girl with rt ankle swelling after a fall. She did not stand properly after a jump. Possible sprain I think. There was a crowd of patient then, a tall like young male who brought her in told me, “ lets take xray first …” His tone was not polite and I returned him, “ then what more exam did you want me to do – do you wanna teach me do thinks ?”. I was a little irritated by this guy – I haven’t examined her yet. I proceeded with the examination, then I ordered a xray. No fracture was noted and I chatted with the patient – she is staying in the hostel and the guy was the coach (national service man attached to school).

Since there was no fracture, I intended to discharge her - but as she was not adult yet(16y.o)...I need to inform her family -> at least tell them about her condition. The girl gave a mobile phone no. which belonged to her sister - but no one answer the phone. I asked her again, if she had any other contact no. she said she forgot - appearently another victim of parents divorce, or else she would give her father phone no. without me asking. I did not bother about ask but someone who look much older(early 20+) told me that he could contact teacher for me. He dialed a phone no. and passed me that phone -

 

teacher B : " now tell me what is the condition..."(still smiling tone)

Me:"well, no fracture and ......(explaination)...but I could not let her go yet, since she is under-aged I need to speak to her family"

teacher B :"I am very close to your boss(hospital director). just let her go..."

Me: "I cant, I need to do accordingly, and don't push me around in the name of my boss"(I was a little bit irritated)

teacher B :"you tried to give us a hard time.."(harsh tone")

Me:"No , I am just trying to do me job.."

teacher  B:"....(angry words..., tell me what is your name..., I am gonna come to you tomorrow.."

Me:" I am Dr XXX, I get off at noon...I did nothing wrong and you can come..."

 

The conversation ended as he was yelling and I just didn't like to hear it and passed it back to the senior person. Later I asked him if he could get the hostel supervisor and checked on her phone no. so I could call her parents - and that teacher called again and yelled some very bad words -again, I passed it back. I was so damn frustrated and the senior person told me that he is the trainne teacher and I asked him to sign a notification that he would responsible for her and let him brought the girl back to the school hostel.

 

About 1 hrs later, the teacher called again and this time, he told me he is definitely coming over to me and asked me to "wait" for me...I hanged up and called up my hospital director and told him about the situation - he told me to "watch my back". I didn't pay attention until the next day...at the moment - three person is involved - the coach(national service man attached to school) A, the trainee teacher C, the retired teacher B.

 

 

The A,B,C did come the next day(post call for me, I worked till noon) - and plus another 3 person, 1 is a currentl school teacher D, another 2 look like bully ( fat - fatter than me...)...They came and talked with my hospital director and service manager(he is the local who is somewhat influencial). But both of  them were not able to talk them out - I was busy in the ward then. Then my hospital director came and told me that he need me to go down - I actually told my hospital director that morning that I would face them - I started it and I should stop it...

My hospital director told me in a heavy tone,"I cant stopped them and they had promised me that not to use force if you faced them." I grinned and told myself - no force use my ass, they definitely would try to assault me. I was prepared - nope, not to retaliate of coz, to be bashed. This kinda people woukd not rest if no force is use - I would not fight back - but would try to cut the injury to minimal.

 

I met them, and greeted politely and apologized stat - but B was not satisfy - he said apologized is not enough and told me that he would like a room and have a talk. While me walk toward the room - one of the 2 bully charged toward me and kicked me on my rt knee. A small kick and I fell on the instant ( just like those football player who was tackle...) and sat on the floor and pretend looked painfully.... Well, no one came forward to gave me another tackle( actually our service manager restrained them from further attack). Even I am prepared for the asasult, I still felt very bad, not the pain but just the feeling ... I then get up and walked into a room with them - B started to yelled and claimed that I am unethical and some bad words - I apologized and them seem not that satify - and I was fed up and told them - I said if not enough, then I kneed la...and they stopped me from doing that and go away..

 

It was a bad experience for me - I was assaulted and I had to played like a person who had done a lot of wrong things. But, I had all the evidence, I had a medical report, I had a recording of the yelling and now is my chance to call the ball. But I won't use it - maybe later. Police report or complaining to the school might irritate them and further jeopardized the hospital....as the chinese proverb : you experienced one incident and you gained more wisdom - I am cool now, I might need to be more polite and don't "bashed" patient/family with words.. But, I would still insist on speaking to the family for under-aged patient...

PS:

1.the school is the local high school.....

2. I really like to report to the police about this KNNACB retired teacher(he was the former school PT head.) but to create such trouble to my boss in the future[legal suit, as he was the witness as well] - I will think infinite time before I do it...

3.Curse that KNNAOCB  teacher trainee and NSM coach - they should have call the current PT head instead of that retired Old ASS kisser/Fucker.

 

working in the house ?

Back to work after a 3 days off...I did a short round for my patient on Sunday and settle some of the problems, so I need to a minor catchup only. I enjoyed weekend and off but when you come back to work, need to catch up on my patient condition. It is a stress if lots of admission. I got only 5 patients under my service at the moment. And the best part working in this hospital is I could assess the hospital management system from my house remotely. I could assess almost everything(even the xray/CTs), minus the TPR sheet of course. But I just couldn't work as SOHO no matter how good is the system, is against the law to order anything without seeing the patient.....

 Well...is a stress to place patient under my service, not only need to responsible to the patient but also answer to their family...so far I have met no malignant family...

I has started to don a lab coat nowadys - too many things to carry along: steths, sanford, penlight .... However instead of the usualy long one for attending physician, I use the short one (mostly worn by medical officer/resident). I just couldn't bear the heat - the long ones are mostly thick one, the short one has think and thin version. Luckily it is autumn now...I sweat less...

tired

Calls were bad lately - even when the ED was cool, I was bothered by the ward from time to time.. my last call was worse, I came to work in the evening instead of noon - boss when to Canada to settle his daughter's college matter and I took over his ED shift. It was still a 24 hrs job but I started at 6pm. It lots of different from 12-12 shift, you just can't simply sleep first to prepare youself for call starting from 6pm. So I was darn tired after this 24 hrs shift. I slept by 10pm yesterday when I reached home.
I still felt tired today and I can't rest properly tomorrow after my shift - my LCD TV would be installed by noon tomorrow and when I reached home - I would need to re-arranged the TV table and those cable from TiVo, DVD player, X-box......

Actually it is a tiring month - my work is disturbed by this earth quake disaster exercise - 2 weeks from now. Disaster medicine was one of my interest and when my deputy pengarah asked me about attend it, I gladly complied. I hope to learn some from this exercise. Next year, I will be sitting for the disaster medicine specialist exam - it is not an official specialty recognized by the local govt- but I considered it as a personal interest..

drill...

This months will be more busier than last months…

 

I got to attend a earth quake disaster drill organized by the local county authority…The drill will be attended by the county chief so it is considered as one of the large “show”. There will be 4 predrill and final show will be 3 weeks from today. I am one of the 3 medical officer who will be in-charged of the sick bay….Well, more working hours this months.

 

 

 

This part of Taiwan is considered as one of the least earth quake region. However months ago, the was a big earth quake which had a magnitude of 6.0+ on the Richter scale. Only a few casualties but it made the local govt. panic. So a “show” is put up.

 

 

 

I had been to similar show before – not that realistic. I don’t see how it could improved the medical shortage around this area. The nearest DMAT is 100km away from the point. I think it will be wise if the a local DMAT could be set up. But again – doctor shortage is the key element.

 

 

 

Well.. more report on such event – the 1^st pre-drill is scheduled on this Friday….