Dead threat.....

It was another weekend call…no ones like to do weekend call, it was not only the feeling that everyone is on vacation and I am the only one who is so dumb to be working, but the feeling of tiresome. The so call weekend calls are unlike the normal shift. The whole hospital is left to less than 1/3 of the usual man power. The working cannie had to run here and there to manage patient that he hardly knew and to explained the condition to so family that sometimes were so malignant you that you hope you had never chosen this profession....  But a  Sunday call with a dead threat ?  really one hell of a call of the life time...

I had 2 weekend call this month… both covered Sunday morning. Ong had gone for his 3 weeks break. I had to do back to back call(Sun-Mon) with a 10 hrs break. Last one to be exact and I am not going to do it in the future. I had a confirmed from my ex-colleague that the board certified ED physician is coming over from her side. A controversial person who is going to take over as head of department. I just don’t bother who I am working under. But the shift is what I concerned. I am going back to my “no weekend” policy as the management had promised me. It had become worst from occasionally one to permanent and later increase to 2….I want a restructure of my working plan and pay as well if new rules is going to be implemented in the future. I just don’t want to be the joker getting 40% less than other working under the same environment. But still one more Sunday shift to go...

Well, anyway, I saw this lady during the busiest hour in the evening. She is a case of newly diagnosed congestive heart failure who had been non-compliance to her medication. I had to admit her as she had noted with orthopnea. After the explanation and consent of patient for being admitted, I turned my back and walk toward my desk.  “what you think you are doing, how could you be so rough on seeing the patient”. I stopped and tried to find the person. I saw a young male in his 20s staring at me. I walked toward him and asked him what had I done. Apparently he was the son to the lady, I had told me that I had explained clearly to the patient and asked him if he wanted a further explanation. However he seems to be under some drug influence and kept focusing on my roughness, he even throw the word,”this is my only mother and you should have treated her properly, do you believe, I can make you a dead man right now…”,

 

he just add another finger to my dead threat count....

 I looked into his eyes and said to myself, “ KNN, do you believe I can dislocate you shoulder and blind you eyes within a glimpse, MFK SOB…”, be patient and control your temper is what I was thought, but unless he make the first move, I would give him a pass...

I was a little pissed off and so do those patient and families who was crowding the ED. I continue with my job seeing the endless patient. Later when the patient was on her way to the ward, the patient and her husband had apologized to me about their son attitude. I told them that no to worry as I am not really angry with them…. Later in the night when I managed another patient in the ward, the nurses had to me that the malicious son had even asked money from the patient…I shook my head when I heard the news, no wander he wanted me to treat his mother “well” so that he could dig cash out from her – Axx fxxking jerk who can even feed himself  

the almighty....

Well, as I thought my shifting of database was flawless, but actually I was wrong….

I came to work in evening and no one complaint to me…but later some of the nurses had started to tell me that the some of the order had “disappeared”… I had this idea instant flashed through my mind – failure of upgrading , those disappeared order must have been written to the old database….well, I did a tour from one ward to another and noted half of the program were not properly upgraded….spent sometimes and told myself that will be it….

 

Well, today morning, one of the nurse practitioner trainee had told me that the sorting of medical record was out…there were not in proper order, mixed to be exact…

apparently the “copy and paste” to the new harddisk had caused the disruption – a shock for me as I knew sorting a listbox is not an easy task. So, need to find a script that sort the collection before I write the name into the listbox….

 

 

I had to “google” again and after 1+ hrs of hard work, I finally got a solution…darn easy one… thanz again to Al Mighty GOOGLE…I had it fixed 30 mins before I go off…

 

Guerrilla warfare....

I had this 14 years old boy who was brought into ED by his father around 2am complaining about fever. He was seen in local clinic and discharged with antipyretics (TID dose). He had taken his last antipyretic more than 8 hrs ago. I examined the patient and the preliminary diagnosis was influenza as he had most of the cardinal sign.

I offered a suppository voltaren and explained that it was the dosing interval that cause the fever to recurred. The father after hearing my explanation had ask me, “Is that it ?”. Well, since he wanted to go further, I had told me that – why not an IV , the child is really dehydrated. But still the father repeat the question, “is that is?”. Some irritation but I knew what he wants – he wants an injection – no way of giving any aspergic…. Ketoprofen ? IM is to painful for a child, not my style of punishing a rude father by hurting his child…. So here come the guerrilla tactics of mine – I offered him a influenza rapid test… few months ago, the department of health had stopped providing free rapid test- patient have to pay for it…. NT400 it is… When I told the father – he show a queer look after knowing the NT400 charge… After pausing a moment, he had agreed with the test and I saw his disturbance and forget about the injection...

The test had come back positive of B 30 mins later, I informed the father and discussed about the use of Tamiflu with him. I strongly advised him not to use it and he concurred with my suggestion. I had put the child on a adequate dose of parecetamol with proper dosing. Prn Mefenamec acid was prescribed as I knew it would be difficult to suppress the fever.

 

Well, sometimes you would need to treat the family; confronting them would only increase their disbelief and only to show that you care the patient more than he does, you have their trust to treat the needed…..so much for the guerrilla tactics…

 

Stepping down

 

I had a talk with my dep supt (Admin) lately…. He told me he will be stepping down. I was not shock as he had been saying for sometimes… he is a man of honor and he tried to do things the right way. He reminds me a person – my ex SJAM Area Sergeant Major – a strict person who give you an impression he is a military man. He followed the rules and regulation strictly and set a good example for me. He inspired me during my cadet day and I wanted to trace his steps.....  I was lucky enough to wear the crown over my right wrist later on, although for a short duration but I was proud to hold such rank...

 

I don’t know what are the causes leading to his stepping down (not resign, as he is a valuable person to let go,  he is proficience not only in admin but he has the skill of negotiating with the Bureau of Health insurance). I did not ask what was the reason, there is no politic here in this hospital so it is definitely  related to his character. I did a intelligent guess about his successor and I got an indirect confirmation(not a nod or shake of coz..)from him. A short sided person who focus on “balance” will be taken over… Well, nothing much to say nor shout, Life go on – need to coup with it ….

Moving the Database

Finally move my database of prescription order and POMR from the “open”, “non-secure”, “anyone could assess and delete” server’s hard disk to the NAS…

More secure to most of the user of coz, still prone to attack by hacker grade user but I doubt anyone in the hospital have the ability to do so…

Well, it took me a few hours of replacing the path and upgrading the core program. Hopefully it would be the last time I moved. The database had growth from 200k to 2.5G in the past 2 years. The MIS dept had given me a space of 250G which can hold for 10 years…so far so good, it had been 3 hrs since the upgrade and no complaint from any user “yet”!!

 

Next step would be the integration of triage score to the HISMAX system. Later, if we had to join the e-medical record program I would have to password protect the path….long way to go and I don’t know if I would be staying for that long….

Surviving Hell Week....

 

It was one of the strenuous weeks in my life… survive though, but with some minor neurological impairment – memory impairment… I tend to forget thing/matter – e.g. I forgot where I placed my hand phone after getting out from the toilet…

I really forgot what was the principle or concept when I agreed to the roster Lem prepared… 24-12-24-24-14-24-24 (black colour = hrs/shift, red = rest hours)

… 4 nights shift in a week… I had done 5 night shift in

a row but that was 12 hrs shift and only covered the ED. However this time, it was different; not the shift, but my age… almost 40 and still struggling with night shift. I told myself should have gone to the recruit seminar organized by the lion city ministry of health….

 

In the future, no more than 3 shift in a week, I claimed…3 months of MMOH pay done in one week, really not that kinda money I should earn around this age…

 

Anyway I celebrated my 39 years birthday this week… job is still unstable as CM is leaving and someone is coming in and taking over the job of head of ED. Well, maybe time for a change for me, as I had discussed with Lem about my future… maybe I would go for sub-specialty training earlier than I expected.

I am still recovering from my memory impairment, I figure this is the worst insult my brain could tolerate… one more jab and that is it – moron I would be….

one thousand years old falcon....

 

 my birthday coming up next week….Those 2 kiddo were darn happy as it was toy shopping day. One of the non-traditional rule in our family – buy toys only on special occasion such as birthday. So my birthday is coming and it is time for them to buy toys…Xian had been through the “pick up anything you want” phase and he is very cautious and considering while buying toys. He wanted to pick up a magic performance set and Yun had no idea. Since next week will be "HELL WEEK" for me (3x night shift) and I would be working on my birthday - We decided to do an early shopping....

 

We went to Toyrus and Xian changed his mind and wanted a lego model airplane. He wanted a blue one but it was not available and he picked up a trash truck instead. Yun forfeited her option and wanted a round in the book store. I bought a picture finding game for them and something caught my attention while we were touring along the Lego section. I saw the midi size “millennium falcon”.

 

About 6 months ago, I saw the “Ultimate collector edition” – Millennium Falcon in store and it cost RM800….I almost bought it but had successfully suppress the urge. However it was the price which had attracted me – it was RM200 initially and now it is selling for RM120….Well, that was it…..

However I did not get the luxury of building it as Yun and Xian had offered to help me…Well, at least I could “zoom” around with it…