Wednesday, January 31, 2007

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medical staff casualty?

wonder what i will tell you?
As i always told you, medical ward or world is a war zone. Especially in medical ward because too many patient .Thanks partially to casualty dr and our beloved demanding patient.
Today ,i will tell you the real story in my ward for my call for past 2 weeks. It happens at 11pm. During the excitement of resustcitate a Diabetis patient with sudden onset of Shortness of breath or altered behaviour. I saw one familiar feature, my ex staff nurse in nephro ward came in as patient with uniform . After my excitement of saving patient, patient survive.
I went to see her and clark her. she is a 32 year old staff nurse(responsible one), present with sudden onset of weakness on left upper and lower limb. It happen after she got results from lab via phone.Sudden in onset and no previous weakness.No family history of stroke. only significant history is pregnancy induced pregnancy on last pregnancy.Guess what she got? She got stroke. Ct scan no changes and no haemorrhage. The only good thing she got as a staff is a fast CT but she still in third class ward at extension bed.this is the true story happens in penang GH. Working hard and gt nothing special. I called it medical casualty.
Why? You got illness during working. Who said medical ward is not a war zone.
second case happen on my another call , during the on call on 2 am , a 42 year old Staff nurse at 2 am came with stroke. Ct brain is normal with hypertension and diabitis. She was treated approriately.
Sometimes, i think back . Actually doing call is like sacrifice our life (medical personnel) to save other people life. What we got?Medical casualty ? needle prick, stroke,cut during op,blood splashed during procedure.
What we got ? minimal amount of pay. 10 Rm per hour. stroke. Maybe HIV or Hep B or other illness. Getting complaint.A minimal thank you(rare one to get).
So who said medical world is not war zone.

Maybe one day during call, i may got IHD or stroke. Who knows?

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busy ward=bad first line dr.

i am recently doing a lot of call due to a lot of dr going off. I found out one thing in this hospital and other hospital. The ward full of patient or not is depends on the first line doctor(casualty dr). If casualty dr did not do their proper clerking and assessment. THEY will end up in medical ward or surgical ward. SOon patient will sit on chair waiting to be clarked.
For example , a few junior dr in casualty will ask patient which area they are from and got any fever or not. If patient from dengue area and fever, sent fbc.Guess what , the next minute ,patient will be in medical ward with diagnosis ? dengue. it is because low wbc without low plt and high hematocrite. They won't ask pt to come for repeat fbc but will just admit. Guess what, ward is full of ? dengue.Notify and get the highest among the nation.
poisoning is one of the favourite also. A old chinese lady with poor BM language complaint of abdominal pain and use minyak angin to apply on abdomen and head. Guess what , admit to our ward for salycilate poisoning. On our history deny od taking any 'minyak angin' .Reassure again telling truth we won't report police. End up she scolded us insane.
This is the tip of iceberg of what happening .the good and manageable medical ward all depends on the good processing dr in front line(casualty).

Friday, January 12, 2007

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Wednesday, January 10, 2007

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cheap service=bad service, Young dr=bad dr. Old=good?

currently after working in Pg for past two year plus . I found one hard facts to Penang people. Penang people actually not so like GH. A lot of middle income peple think penang GH service is screwed. here is the conversation i overheard when i took one of my family member to take medication.
mr A waiting at one of specialist clinis said : Aiyo, so long waiting .dr seems to be sleeping.
mr b:ya lo, I come since six am . Now it's still not my turn. Don't know where all the dr dying!
mr A: I think they got round or emergency
mr B irritated and say : How siau(hokiien dirty word)! tat tat pai lai pun wu lang si a ma?(everytime also got people dying when i went to clinic?)Lim pek baru lai si ko goi chi pai!(I only come four month once)
Mr A: si ha ne kuan e . (it's like that). Tat tat pai wa ki lo kun chu pun wu rang si e(everytime i went to ward also got people dying)
mr B: ha mi su er a ne kuan.(why like that)
Mr A:na ru kua(na you see).Pointing at the houseman and young mo. Tat tat re ha ne siau len ma yi si lang lo(everyone so young simply treat patient and kill pt)
mr B: wa un kamka a ne kuan. Ru kua su jin bo lang si ee. (i also think like that. Private no people dying one.)si rim be bo rui a bo wun mai rai(i dont have money if not i also don't want ot come.)
conversation ends here because already reach one of the people turn.

This is the real conversation i heard in penang GH. We, the government dr getting cheap salary and government giving cheap service actually is not appreciated by many pg pt. A lot of penang residents still think cheap=bad service. Young=bad dr.

Their reasoning is cheap service sure give cheap drug and not the quality drug.

this is the real story happen in pg GH everyday.
If pt wait too long , they got angry . We see too fast,they got irritated because we don't see probably.

No invasive or expensive procedure like MRI or CT, they are not happy because their friend at private hosp with this type of complaint got this type of investigation.

Im conclusion.GH dr is underpaid, overwork! Yet is the third class dr!

Cheers to all the Pg GH dr, keep ourself as third class dr (in pt eye)even with first class service !