Back To Kindergarten

Back home early today.. Not feeling very well.. Feeling absolutely pissed at the head nurse at D4.. She made me feel like I was back at kindergarten..

During our ward round this morning, Dr. KFK asked me to find the dosage of IV Ceftazidime and the frequency of administration for a renally impaired patient and that I did.. I found that ceftazidime should be given EOD to a prient with the CrCl of <10 mL/min and at a dosage of 500mg.

Tried finding alternatives for that.. Guessing it would be for G-ve bacteria, IV Ceftriaxone maybe? Asked Dr.G.. He said, yeah, IV Ceftriaxone could be used.. So I went off to find info on IV Ceftriaxone for renally impaired patients.. Found out that no adjustments are necessary..

Anyways, while I was away finding info at C3 where Fei and her drug info were, D4’s head nurse called Satellite A pharmacy to complain about me being AWOL! According to Mala, the Sr. had raised her voice saying that I went off without telling her and that when she asked questions, I kept quiet and just smiled…

No.1, NOBODY was dying so I’ve no idea why she was so frantically looking for me when I was away for 10 MINUTES and was at the next building! And secondly, she NEVER asked me anything and hello.. Since when am I ever QUIET??

All that happened was Dr. KFK was looking for me, walking fast towards the back of the ward, when I was next to her all the time and I didn’t bother to shout “Hey, I’m here!” or wave my hands in the air to catch her attention! And the sr was like.. “Aiyo, kenapa tak cakap apa-apa?” Easy.. She wouldn’t have heard me if I didn’t raise my voice!

Anyways, Dr. KFK later told me that it was to cover for Burkholderia pseudomallei, the bacteria that causes meliodosis.. So the choices were only between Imipenem and Ceftazidime but the former covers a broader spectrum of bacteria.

Later, I went off again, this time to come home since my time-off had been approved orally.. Told Mala to call May if anything.. Went to ward supply to get my stuff and to fill in the time-off form only to receive a call from Mala telling me that D4’s head nurse was once again complaining that I went AWOL!

Like WTH! Does she expect me to inform her of where I go everytime I leave the ward?? Am I suppose to notify her whenever I go to other wards for bedside counselling?? Do I need to tell her when I’m off to get discharge medications for patients?? It’s like she’s expecting me to ask for permission to go wee-wee! F**k that b**ch!

I’ve this weird feeling she’s gonna complain about me to the KPF.. And she’s totally gonna add her own spices to which would be my poison! Sigh.. Just my luck I guess.. If I were to stay back in HSA and if I get to be a ward pharmacist, I hope I won’t be in charge of the worst medical ward known to pharmacy!

When Night Turns Into Day

Currently doing my night shift at A&E pharmacy.. Today is my 4th day of my 5-day night shift.. One more night to go and I’m back to working normal office hours i.e. 8AM – 5PM rather than 10PM – 8AM.. Thank God! So glad there’s internet here..

Though my biological clock has been altered, somehow, my brain still isn’t working.. It’s like there’s this mechanism thingy that tells my brain to stop working after midnight.. Apparently, most of the doctors on-call here have the same problem.. Judging from the prescriptions they write.. Antibiotics for viral fever, high dose prednisolone for too long a duration, etc..

The worst thing is, no matter how many times you tell them that this or that should be this much or should be taken for this length of time, they’d say ok, change the next few prescriptions then go back to prescribing wrongly..

I made some mistakes myself.. Worst being wrongly commenting on a TDM paracetamol poisoning case to which I found out myself the following night.. And had to make everything right the following morning.. A mistake I would have never done during normal office hours.. At 3AM, anything can happen..

Lotsa patients come to A&E after 1AM everyday.. Mostly for illnesses or medical problems of little to no urgency.. Dispensing PCM, actifed, piriton, benadryl and antibiotics is practically routine.. It’s basically the same medications over and over again..

The most mistakes doctors at A&E make have to do with patients under the age of 12. Most of the dosages given are too high for their age or their weight.. Wrong frequency for antibiotics, MVT syrup, and pushing it for promethazine.. It’s scary to think we might cause harm to these kids or worse.. Just like that kid who was prescribed with T.PCM 1GM QID.. Passed away after the 3rd dose.. Normal dosage for adults but for kids, fatal..

And like I said, no matter how many times we tell them, they still continue to make the same mistake.. Again, it’s because the brain just refuses to work coz it knows it’s time to sleep.. We usually tapper down the dose if it’s too high but with reference, of course..

Wards seem to love to indent after 10PM although they know they could borrow some stock from other wards before they properly indent from the pharmacy during office hours.. A&E pharmacy doesn’t house all drugs available in the hospital.. So sometimes, we’d have to go to ward supply to get the medications to be supplied to the wards.. Now that’s scary…

Imagine walking all alone along a long, not-so-well lit, empty corridor, to get to a big, dark, secluded room with padlocks which take ages to be unlocked and which always seems so eerie and somehow makes your hair stand on ends when you enter it in the wee hours of the night.. Don’t forget… I’m talking about a hospital… *Shudder*

Gosh, I hate night shifts.. I’m really glad this is my final week of night shift throughout my whole PRP year.. Don’t think I can stand it anymore.. Moreover, I haven’t been having enough sleep for the past few days because of the construction going on upstairs of my apartment and with all the phone calls I’ve been receiving while I’m sleeping.. It’s really taking a toll on my mind and body.. Been having migraine for sometime now coz of my lack of sleep..

Anyways, I guess that’s all for now.. Sorry I haven’t been updating my blog for sometime.. Been terribly busy with work and all.. Will be going to Penang next week to celebrate my birthday with Kelvin.. Also meeting up with Jason and May.. Hopefully I’ll have some nice pics to post up then..

Till next time.. Ciaoz!