Category Archives: Clinical Placement

Lady, your son doesn’t need any treatment. YOU DO!

So, I was working in the ED yesterday because my preceptor is the VMO on call for this weekend. A mother brought in her son who has a small laceration on his chin.

Mother: HELP! My son is injured badly! He won’t stop bleeding.

Child wasn’t crying, but wasn’t saying much either.

Me: OK, I’ll just get you to fill in the form and I’ll triage him in a sec.

Mother: BUT HE’S BLEEDING! HE’S GOING TO LOSE A LOT OF BLOOD!

Me: Sorry, we have a spinal patient needing more attention at the moment.

I went off to help the patient with the ?cervical fracture. Came back to see the lady and her son after 10 mins.

Me: OK, you can come in now. *lead both to the procedure room*

Mother: I’m afraid he may have broken his jaw when his chin landed on the cement block.

Me: *assessing the jaw and playing with the child* Can you point to where the pain is?

Child points to the chin.

Me: *pressing around the mental protuberance* Is it painful here?

Child shook his head. I went ahead and checked for any other injuries. Child only had a superficial laceration about 2cm length and 6mm deep on the mental protuberance, no discomfort other than the superficial injury itself.

Me: OK, it looks like your son has just got this laceration. We’ll give it a good clean and then we’ll glue the wound.

Mother: I think he needs an x-ray. You can see that he is in pain.

Me: Look, I’ve examined your son and he is not complaining of any pain to me even when I pressed around his wound. I don’t think he’ll be needing any x-ray.

I left to grab some saline and skin glue. Came back, gave his chin a good wash and proceed to start gluing.

Mother: Oh, aren’t you supposed to give it a clean?

Me: *thinking ‘lady, you should have been watching me instead of texting the picture of his wound to your relatives” I just did a minute ago. *kept gluing*

When I was done, the lady asked if she could also get his prescription of the preventer med for his asthma.

Mother: My son has been having asthma attacks recently. I haven’t given him his preventer for almost 2 weeks cos the GP has given me the wrong dosage for his preventer.

Me: *thinking surely this lady could have gone in for another prescription* OK, I’ll check. *went to the medication room to look for the same med, which the ED doesn’t stock, but there was an equivalent med*

I went to check with my preceptor if the substitute med was appropriate, which he said yes, and to the mother to see if the child had specific drug allergies, which he didn’t.

Me: Well, we don’t have medication A, but we have got medication B which essentially does the same thing.

Mother: I don’t trust you and that medication. *went into a rant about how she would rather not give him any medications than accept medication B, how the medical system is so corrupt and inefficient, and how the doctors know nothing whatsoever.

Me: !!!

 

Some days, I just wish that there is a plague that targets stupidity and ignorance.

Tagged ,

And my new life has started…

Hello WORLD, I am back.

After grueling months of exams and the move to my rural placement in Leeton, I have finally gotten my life back. I would rather not talk about the exams just because everyone would probably know how the word HATE does not justify my experience.

Leeton, where I am starting my year-long rural placement, is a town with population of 11,000. So far I think this is the smallest place I have lived at. Another med student and I have been given a heritage cottage to live in courtesy of the council. I must say, I love this little cottage. Two good sized bedrooms, a cozy lounge, a modern kitchen and a large bathroom, oh and some olive trees and rosemary bushes in the yard. I may need to learn how to pickle my own olives. Leeton is pretty much a foodie heaven; yippee me! The largest producer of citrus in the Australia, headquarter for SunRice and Berri Juice, a lavender farm around the corner, what else can I ask for?

Placement-wise, I have had a session of parallel consulting, which has been pretty interesting. I feel like I probably need to have a separate post for this purpose. In the meantime, it is almost bedtime and I have to go.

Cheers,
N

And here comes the third year…

I can’t believe it that:
1. I only have less than 2 years before I graduate (hopefully if I pass the mid-year exam and OSCE)
2. I’m in my 5th rotation out of 7

For those of you clueless as to what I am up to, I had my renal medicine rotation at the Wollongong Hospital before the Christmas break and now I’m in Nowra doing general surgery. Renal medicine was very exciting to the point that I am also considering renal medicine as a career path in addition to paediatrics.

Renal medicine really taught me to be very well organised and meticulous in my approach. We sure had a lot of patients in the ward and it was hard enough trying to remember when Mrs. A had her last dialysis or if Mr. Q’s creatinine has come back normal. Every morning 0800hr start, we started checking all the patient files for tests or PACE calls or nursing report. It was very administerial, but I had a lot of go’s at interpreting test results. I also ended up getting a lot of practice at doing cannulation and clinical examinations (although I didn’t do any examinations of the nervous system).

I’m starting my week 3 out of 5 for my general surgery rotation and I must say that I think I am getting a lot more comfortable with where I am. I sure need to do a lot more practice with my clinical skills, but who doesn’t? Prior to this surgical rotation, I’ve only had Urology rotation under my belt, which was OK (with the exception that Urology in general seems to be very privatised although medicine shouldn’t be, but that is another spiel altogether). I was expecting short ward rounds and interns or residents running around like headless chooks because the consultants and registrars are never around. I was pleasantly surprised to a very supportive team; consultants who are willing to give their time to give tutes or even just let you scrub in for procedures, registrars who wouldn’t stop bombarding us with questions and tips for the OSCE (I meant ‘bombarding’ in the best way possible, my reg is great, I wish all regs are like him), residents and interns who would put a little bit of their time to go through the med chart or fluid balance chart with us. In this rotation, I’ve taken my niche as the vampire (bloods, cannulation), the scriber (I even got to scribe for a PACE Tier 1 call), and the bedside chart man. GSM, can all my rotation be like this one please?

Random facts:
1. I got a Sony Ericsson XPERIA X10 over the break as a present. It’s an android phone and I’ve grown accustomed to checking my email and FB every morning when I sit in the toilet.
2. Yes, I sometimes look at my poo to try to guess what it is in the stool chart.
3. I do wash my hands and disinfect my phone after using the toilet.
4. I also downloaded a WordPress app on my phone, so I should probably start updating my blog more frequently. (Although not my food blog, because it is gross to blog about food while sitting in the toilet…)

On that note, I’m out.

Byes.
N

my life summed up as a PPD

PPD = personal and professional development

See, at the UOW GSM, we have this thing called PPD. We have to do an assignment to reflect on something that we have learned thus far in medicine that would help develop us as a doctor. For me, it is like a cleaner-and-more-politically-correct blogging. Anxiety has always been something that I struggle with and I can’t help reflecting on it for the past couple of weeks due to several incidents that have happened. These are not necessarily what contribute to my anxiety, but I’ve just been in a reflective mood that I can’t help being reflective in almost every segment of my life.

SELF WORTH

All my life, I have always had that thought of being not good enough for everything. I am a middle child and I am sure that if there is such thing as the clinical diagnosis for middle child syndrome, I would be its poster boy. Growing up, I always felt that I was never good enough for everything; that is exactly the feeling I’ve tried to fight. My extended family always compared me to my older sister and younger brother; ‘why are you not as smart as your sister?’ or ‘oh look at your brother, isn’t he so cute?’. I had to constantly fight for people’s attention and that explains everything about me now. I listen to music that other people wouldn’t listen to and as soon as the artist becomes popular, I would lose interest. I do things that make me unique like taking dancing lessons as well as doing martial arts. Not that I am an attention-whore, but my upbringing has programmed me to be someone who always lusts for attention.

MOM

At one point in my life, I really hated my mom.  She always has this bitterness towards my dad’s extended family and it didn’t help that the first 2 years of my life, I was raised by my grandma (dad’s mom). Physical punishment was normal then and it would be a lucky day for me if I only get beaten once. I had nightmares about my mom and they were all the same. Me in a 4 by 4 room running away from my mom who was trying to eat my brain. I would say I had that dream constantly until I was about 13.

Another time, when I was in the eighth grade, I had to help my brother study. My brother doesn’t listen to me, never did never would. Mom was mad at me, we got into a big argument, and by the end of the night, she said something that shouldn’t have been said to a child: ‘I wish that you were never born…’ OUCH. I confronted her about it a couple of years ago about this and we made up. Forgiven but not forgotten; that was 14th of June 1998 Sunday night at 745pm. You can call me bitter, but it’s like when you’ve had a sharp knife pierce through your skin and you bleed. Eventually the skin heals itself, but you would still have the scar as a reminder of what happened.

DREAMING VS. LIVING LIFE

What comes with being a middle child is the dreaming. My imagination always runs wild; starting from having a dessert bar to building my own ultra-modern and monochromatic house to thinking about food combinations that can potentially work well together. I think my dreaming is what kept me going and distract me from living my life. Being a child who really hated being home, dreaming was my escapism. I think that might have contributed to the fact that I plan way ahead for my future despite having a somewhat disheveled present life.  I’ve thought about this a lot in respect to my clinical experience. I lack an outline in general. I’m so focused on the endpoint/my dreaming that I get disoriented. I don’t have an outline that I can easily follow in clinical skills. I freaking cook without recipes and I make stuff as I go. Clearly I’m living a sad disorganised life.

SELF LOVING

The last thing that I could think of was the lack of love for myself. Being a middle child, I couldn’t help feeling worthless. I sometimes felt that my parents didn’t love me and that my siblings were more important to them. How has this affected my life? Well, the most concrete thing would be the condition that my room is in. It is in an utter mess, yet I would rather clean this entire (share) house instead of cleaning my own room.

Well, I think that’s enough PPD for tonight…

shazzam… exams.

for the last 3 postless months, i’ve been stressing about the exam so much that i barely have any time for other things besides med to do. there was a few days off for med revue and birthday parties, but nothing much more. exams are scary and i’ve taken steps to work my ass off by –

1. banning myself of facebook. it’s been for 3 weeks now that i live without facebook.

2. banning myself of paging dr. not only does the new peeps who ask stupid questions without reading the forum annoys me, but i’ve also been spending in the chat lobby for too long. but then i promised a few paging dr. friends that i would let them know about my progress with the barriers and life in general. which is why i’ve decided to just post my updates here again. as i should.

3. i quit making pizzas for crust. they hired way too many 15 year olds and now that i am almost 10 years older than these people, i don’t feel that it’s for me. instead i do chemistry tutoring; 8 students to be exact.

i’ve recently gotten my placements for phase 2, which i am very excited about. 2 in shoalhaven and 5 in wollongong. life’s great other than stressing about the exam. i’m definitely looking forward for my birthday, which is 9 days before the exams. i think we’ll be heading to 1945, an indonesian restaurant in pyrmont. i so want a rijstaffel right now…

that’s enough update for now… byes.

n

p.s. in case you’re wondering why i’m writing without a single capital letter, my shift button is busted and so is my function button. the mimicry that my shift and fx buttons do is quite amazing. it’ll turn off my screen, refresh my page with no reason, and the worst of all, turn my webcam on and off… imagine how annoying that will be when i’m skype-ing with someone.

will i buy a new laptop… i’m financially pretty tight at the moment. besides i’ve only had this netbook for 1.5 years after my old one was stolen last year. my parents said they’ll give me money, but i don’t feel comfortable asking them for it that i end up telling them i have enough even though i’m pinching pennies. the bright side though, i invested the money they gave me in a time deposit.

p.s.s. i realise that the last p.s. is probably longer than a normal p.s., but o well. it’s my blog, my rule, my grammar.