Saturday, 26 March 2011

Work adventure

The thing about working in the medical field is that everyday is an adventure. No one day is mundane and no one working day is the same. I have been on-call quite frequently these few days (as noted by the dearth in posts), and for some reason i've been getting really busy calls lately.

The on-calls in Slim River used to be really relaxing and manageable by one person. But since we had a specialist and housemen, the cases seem to be pouring in, And for some reasons many of the babies delivered over here seem to have rather bad outcomes comparatively.

Case in example: In just two days of every other day calls i had a day 12 of life baby who was fitting, a newborn baby who had meconium aspiration syndrome and subsequently pneumothorax, a newborn who suddenly turned 'blue' at 5 hours of life, a few premature deliveries,2 neonates with necrotising enterocolitis and a 3 year old in severe diabetic ketoacidosis (which sad to say i suspect was the result of poor socio-economic reasons).

In one day alone i had done a lumbar puncture, intubated , inserted 2 chest tubes in a neonate, inserted umbilical artery and venous catheters and done a few direct suctions. Of course this would probably be a normal call in many tertiary hospitals, but mind you mine is a district hospital with only one paediatric medical officer on-call a day covering the casualty department, special care nursery, general paediatric ward, as well as labour suit and operation theater standbys.

But for some reason, i have stopped being the worrywart medical officer i was before. Thanks largely to my ever cool and forever in a good mood paediatrician and the fact that i have a houseman to share the work burden. It has made me approach calls in a different light.I used to worry and fret a lot when bad cases come in but now i approach it with an open mind. It has made my calls less stressful despite the circumstances and i am less likely to shout be rude at nurses/referring doctors now.

I am also less likely to be exasperated at parents who bring their children who have been febrile for the past four days to the casualty department at 3 am in the morning, only for me to find the child playing happily in the casualty department. All these kind of parents just distract from the critical patients who need more attention.

And on that note, i don't understand how a parent can just allow her child to stay in the same house with an uncle who has active tuberculosis. You have to have some inkling that if you keep it up your 4 year old daughter is going to contract tuberculosis too right?Worse thing is, the mother had no idea when the uncle was diagnosed, when he was started on the medication and whether he is compliant on the medication. It took me some time to drive it home to her that her ignorance is probably going to cause chronic lung disease in her ONLY child and future ONLY source of income.

I need to have mass a parent education program  in Slim River one day.

I'm going to be houseman-less on my next on-call so lets hope it's gonna be a peaceful day.

Babies and children under twelve, be healthy please!!


shinchee said...

haha... like the last statement, but of course in reality, kids will still get sick...
kudos to u in helping those kids, esp the pneumothorax baby, i dun remember there's a chest tube with paeds size! any alternatives?
hope the subsequent calls will b running smoothly... :p

saltvinegar said...

There is! Size 8! NICU will have.. a temporary alternative is to put a branula in i suppose..

He he thanks Shin Chee.. hope HRPB is treating u good!


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