i am me

i've been fortunate enough to have been on pretty good calls lately.
there are usually 2 house officers on call at any one time. an active and a passive.
an active house officer would usually be the ones to take in all the new cases that are brought up from the emergency department. they'd clerk the new cases, run all the necessary tests and investigations and then subsequently absorb the new patients into their own day teams.
the passive house officer on the other hand would be the one that does all the 'housekeeping' duties during the night. such said housekeeping duties would be setting new IV plugs on patients that don't have any or for those that have pulled them out, taking bloods after the phlebotomists have gone home, inking up new medications and administering first doses of antibiotics to patients who need them.

for those on call, there are certain things that they do to try and ward off any bad calls. for instance, on my first week on the job, an older house officer told me that the only thing that said officer would consume was mee siam...so that all the cases would 'siam' (move/go/get pushed) away. another very superstitious thing they'd follow was that no one should wear red underwear for risk of getting a patient that would bleed out. eating ayam penyet, pau or drinking watermelon juice are a few other things that they refrain from doing. ayam penyet - patient getting squashed/killed. pau - a patient will get wrapped up (think shroud) or the list of new patients will pau (explode in high numbers)

OMG! HOW RIDICULOUS LA!!!!
i can safely say that i've worn PINK underwear, drunk PINK guava juice and have eaten SPAGHETTI (red) on my calls and (cross my fingers) i haven't gotten a bad call as of yet.
eh..pink is like in the same colour family as red la.
haven't tested out the ayam penyet and pau theory yet. but they SWORE that previous house officers that DID eat those items REALLY did get HORRIBLE calls.
i wonder how much truth is in it.
should i tempt fate? hmmm...

anyway..passive calls are usually quite doable unless you get stuck with nurses with brains the size of peas. i'd usually get through all my changes and set up all sorts of plugs and give all sorts of meds by let's say 12ish almost 1. by then i'm knackered to the point of imcomprehensible belief. i'd be scowling and shuffling my feet getting up to the wards, i'd be grunting and honestly i'd be quite rude. so usually by this time, after getting all the changes done, i'd go back to the oncall room where a bed awaits and climb under the sheets with a very very very big sigh of relief. just as i'm about to dose off,

*ring ring ring ring ring*

me: hello.
nurse: hello doktoor.
me: yes.
nurse: i'm kaling prum waard twleb see.
me: and.
nurse: mai paishent in bed pifty tree, Hb draap to ten point fibe.
me: what was it previously? (alert and ready to go if patient needs me)
nurse: oh...haang onn, *shuffling paper sounds* oh..it waas ten point nine. jast kaling to note.
me:..... (hangs up phone)

clearly there wasn't a significant drop. especially not to warrant a call to me. it's these nurses that really make me wanna strangle them.

but not all nurses are that lousy. there are some that really won't bother me until it's very important. ah...now that's when they're an asset to have.

and it's not really all about the nurses calling to wake me up to note about patient's blood or biochemistry results. sometimes they do call for important things like when a patient suddenly becomes delirious.

*ring ring ring ring ring*
me: hello.
nurse: hello doctor, sorry to bother you. but my patient in ward 12d bed 89 pulled out his IV plug and is now delirious. he's also trying to pull out his urinary catheter. i have restrained him and pulled him out to the corridor so as not to wake up the other patients. do you mind coming over to just review him and maybe give him a sedative? i've gotten all the meds ready.
me: ok i'll be right there.

true enough, the said patient WAS delirious. even with the restraints, he'd managed to pull down his pants, exposing his hoohoo and trying to reach for the catheter sticking out of it. he's 85 by the way.

me: uncle! (he's partially deaf so i have to bellow)
uncle: hmm! yes yes!
me: what are you doing?
uncle: i have to pee!
me: but you have a catheter. you don't need to go pee.
uncle: untie me! why do you treat me like a criminal? let me go!
me: we're just making sure you don't do any harm to yourself uncle. it's for your own good!
uncle: no! let me go! i didn't do anything wrong! untie me! don't treat me like a criminal!
me: you have to calm down uncle! it's ok. you're safe!

i went on and on trying to placate him. all the while trying to listen to his heart and chest to make sure no infection was causing the delirium. but turns out, he's always a bit weird at night.

it was ok for the first time. but subsequently it kept repeating itself and i remember sending a text to a friend saying
'old delirious men who keep pulling out their plugs and catheters should be screwed inside out until they shit sideways'
yeah..i was pissed and cranky at 4.30 am in the morning without any sleep and having the next full day of work loom alarmingly close.

well....off to tempt fate.