Ong went on his US trip to visit her daughter again…my shift was supposed to be better as we had a new colleague joining us…however I was no less better – still 8 night shift ( mon -2 but sat +2)…darn and 2 more Sunday day shift, all I could do was cursed….
Well, our new colleague is an orthopedic surgeon, ex-hong kong citizen turn US citizen, Taiwan medical grad. Some introduced him to our boss. Prior to his arrival, boss had described him having 6 months of ED experience. Lem and I had exchanged opinion about this guy and we agreed that we were last of the breed…. And we were right…
Our new colleague(CM) first shift was a night shift and Lem had requested him to report earlier. Boss had led him around and after a tour in the ED, boss had brought him to ICU for me to brief him. During the briefing, I had noticed 2 controversial point …
Point 1 – He do know how to insert a central line He had indirect admit that he doesn’t… when I told him that for shock patient, a central line would be needed prior to start the dopamine drip. He had asked , “ so do the surgical aide insert the CVP ?” well, a question indirectly informed us that I hope someone insert it for me… I told him NO and the doctor would need to do it…
Point 2- he is good at intubation Before I sent boss and him off, I told him that we don’t have any relaxin(succinylcholine)in the ICU, propofol(diprivan) would be the first choice as it had some muscle relaxant effect. Boss had asked him, “ do you know relaxin/succinylcholine.?” He answered in a confident tone – Back in XXX hospital, we used to use it …. Well, in the ED only 3 persons use relaxin prior to intubation – boss, me and the anesthetist … darn dangerous drug as the patient would not be breathing by himself if the drug is given…. I used it occasionally as I don’t want to break someone teeth and I am prepared to do a tracheostomy / cricothyroidectomy if I can’t tube the patient…. Well, seems we found our 4th man, I told myself… I happily went home that day as it had been a long time I hadn’t sleep in own bed on a Monday night…
The next day, I came and I asked the ICU night shift leader how was the shift… she shaken her head and told me that she didn’t want to comment any…I told her that if it is something regarding the CM, she ought to give us some feedback so we could prevent any further damage….. She finally agreed to voice out… they had 3 intubation last night. The first one was a TB patient in the ward with sudden onset of hemoptysis.The patient had suffocated and CM had took a long time intubated the patient . The 2nd one was an ED patient who was noted with OHCA(out of hospital cardiac arrest). He had tried 3 times intubating the patient and finally gave up and asked our surgical aide to do so... our surgical aide intubated the patient on his first trial(his last intubation was 10+ yrs ago…). The 3rd one was an ICU patient which fused the ICU night shift leader’s patient…he was unsure of the ETT position kept retracting the ETT (until 18cm) and the even asked the nurses to confirmed the position for him…
I shook my head when I heard that – I remembered our deputy superintendent asked us to “make way” and “let go” of our shift for CM (so that he could work 260+hrs /months and make a handsome living…) …
Later on…he started to show his “weakness” – he was unable to locate a femoral vein during CVP insertion , cannot insert a chest tube…and he doesn’t act like a surgeon… he had prepared a suture set by clamping a needle on a mosquito clamp (supposed to be a needle holder) and passed it over to Lem; Lem almost pricked himself when he tried to suture…….He had lacked the skills to work in an ED – ETT intubation, CVP insertiong, Chest tube insertion…..he mastered none is not familiar with any of them…intern grade to be exact…
He had diagnosed a appendicitis which had pain over right middle quadrant- a definitely laughter as he is almost board certified general surgeon....
He had prescribed baktar 1# bid to UTI patient…
Lots of spelling mistake – suptum, corase crackle…
what do we have ? an intern ?
For the past few weeks – he had stepped almost on all of the medical attending… everyone had complaint to boss… boss had come to us and asked us to lead/guide him… but I doubt we could, if he stays , the ED staff would be the most beneficiary from it as shifts would be shared , however, it is difficult to teach someone who just watch TVB drama in the 175 whenever there is no patient…..I would have read up a lot if I am at his level……god, he getting the same paid per hour as I do...
attitude decide everything... you might lack of knowledege, lack of skill but with a correct and positive attitude, everything would be fine...
