It’s a whole new world out (yet again) there for yours truly.
From Therapeutic Drug Monitoring to Medical Ward Rounds with elderlies who can barely speak, next on to the unit with scarring heads, severed torsos and limbs, then to mini little screaming creatures, followed by understanding complexities of women (internally), then to the ever on-the-running emergency department and I am finally settled to the final department where I have been allocated for the specialists’ dispense for the next good year… the Anesthesia Department.
Critically ill or patients requiring long term pain-relief or active resuscitation. They all happen here. I need Anesthesia-101. Thank goodness with Datin Sivasakthi, the Head of Dept and the rest of the specialists who I have worked with so far, my brains have been put in good use. Not bad, not bad at all… *phew*
Now coming into the third week of orientating myself. So far, so good. Discussions have been made, views were exchanged, everyone who came into our Intensive Care Unit were very much cared for. Relying onto my trustee clinical pharmacology handbook only is quite le-impossibleh. Seriously, government hospitals should be provided some sorta fundings to get reliable papers and literature writings. Ok guys, may sound abit overworked, but if you guys have any good access to journals, i’ll appreciate them! thanks…
Errgghh… yes, say it with me “EEERRRGH!” Make it sound like someone’s constipating with a hardrock shit stuck at the ever width-limited arse-hole.
Life currently revolves around four of us… KY, Wern and Adrian. These are the family who kept me sane on my maddest days.
Workplace is getting so rotten it’s inhumanly bearable unless you are one who is used to growing up thinking every solution to problems is just by hiding your knee caps and necks. Otherwise, pray more than enough till the answer to all questions fall like rain… how bout in form of post-its.
Thanks guys and gals out there who sent me motivational messages to keep me up to perk. Woot! I love you peeps! Although… hmmm.. there was a random or two of get-well messages. Nevertheless, thanks for that too. I’m not sick, I’m just working with sick people. BOTH sides.
Somebody oughta tell me… How does an ugly person with no substance of knowledge get to boss people around? Either that, maybe this person with no substance and still bosses people, naturally loses the beauty in him/her that s/he turns ugly? Wait… probably the question was supposed to be “where”. At this point I do not understand how a meeting works without an agenda. At the place where I work, I also do not quite comprehend how when the head of department may have certain responsive disagreements to other departmental heads’ actions, s/he has to disregard the heads’ decisions and then use the subordinates to communicate with the heads. Does it make sense or is there no sense of respect at all?
Welcome to my current workplace… 2.3 years, counting down…
I have added another to the craft. I am my own masterpiece.
To Singapore I am this Friday for the International Wakeboard Competition. Anyone else?
Case 1
Imp: Meningitis, viral/bacterial
Clinical insufficiency: Pt refused lumbar puncture (LP) for infection diagnostic
Treatment:
1. IV Acyclovir 400mg TDS
2. IV Cefoperazone 2g BD
Pharmaceutical Care:
1. Tx w Acyclovir was initiated till day3; restarted again on Day5 (equivalently missed 4 doses). In any case, if resistant occur when patient’s vitals and health deteriorate, what will be the next Tx in line? What with the limited evidence to show that viral meningitis has a straightforward medication to treat, let it be Herpes Virus Simplex (HVS) infection to be treated now. This is clinically rational as patient had refused LP for further diagnosis.
- IF acyclovir 400mg TDS was unable to improve patient’s clinical signs, addition to (investigational) FBP and C&S negative results, FOSCARVIR (foscarnet) 40 mg/kg q12h (renal insufficiency pt) Equivalent to 40 mg/kg q8h.
- bedrest, hydration, monitor electrolytes
- Cefoperazone 2g bd continued for any prevention of risk for bacterial infection
- Both anti-infectives to be used for a period of 10 days
New rotation now… The paed’s my responsibility now. From the device counselings to the drug monitoring so they do not turn spotty, plain colours purple, green or grey or for some *cough* I can’t tell if they’ve even changed colours or not.
Been caught up with Anton, Auds, Dan and few others who have been forsaken :-/ Geez… We’re turning old. ‘Nuff said.
Baaack to work. Thought the paediatric ward is the funnest place. Thought these sorta places could bring out the inner child in me. Well, I have but learned well - not so fun if 24 out of 30 kids there are sick kids. Worse than anything if the other 6 are not ill but just SUPERhyperactive brothers/sisters of the sick kids.
Recap:
1) What happens if one kid looks like the other one running around? Try to identify who is the sick one. Geeeeez
2) What happens if a pharmacist like me tells the doctors that the epileptic kids need close monitoring of their medication? A screwed up kid. We’ll be concentrating so much in these kids’ drugs we forgot he is a kid whose got diabetes. Don’t come to me if you think you’re a kid who’s got spasms.
3) What do you do if a kid comes to your face and screams at your face too? I asked the mom take away the kid, he kicked her, sang to him, he screams louder… Screamed back at his face? He smiled and giggled. Wonders of the world. Very much unsolved mistery.
4) What happens if the specialist had to peel off some plaster/take tubings off the kid(s)? The kid cries… AND THEN the reinforcement of the other kids come. Everyone starts crying together-gether. “Woohooooo”
Ill kids drool. Kids cry in confusion. Kids scream in pain. Often, I see random kids drool, cry and scream for no particular pathological reason. Now I see what LB-Tim’s gone through…
It was the weekend ago that I have been to a workshop organized by the Seremban Hospital’s and Melaka’s Pharmacy Departments. dub dub dub yada yada yada. So till I was there, the objective of the whole workshop was how to create an ideal counter-patient service in the hospital pharmacies. So much had been spoken, so many typical and old-school words. *yawnz*
I realized…
People here seemed to put so much importance on the attire we display but forget alot of the service, manners or even professionalism as a … well, professional. Theoritically, should we be naked underneath the white coats, the health service we provide should be top-class or at least at the peak of our standard, no?
While simple problems should be solved first, funny how they want to make sure the aesthetics come first.
To prevent problems? Nah, one told me before, “Everything here should have a problem. So we are there to solve the problem mar…” *ponders ponders*
A senior once said to me, “you are young and full of energy. Therefore, you’ve so much drive to want to do loads of things to change. One day you’ll be like me, sit down and get used to everything.” Will I? *sheesh*
I’m a confused person since I came back. Cliche- Welcome to the real world. I know… I know… But I did work elsewhere before, haven’t I? Perhaps in four years time, I would want to see what’s others doing elsewhere. Bring it on, baby!
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