Nurses kept coming to me and saying this patient has got pain, needs panadol/endone/moprhine- can you write it on his/her drug chart, this patient is short of breath, this patient has a lump, this patient's family is here and want to know what's going on.
I kept thinking I don't know how much morphine to give or to give Oxycontin or Endone (!!). And the nurses kept telling me to do this and that. I'm more junior than them so I thought they must know what they are doing. Then my husband pointed out (it must be from his Monash training): go and talk to the patient.
Err pretty obvious solution. Now, why didn't I think of it. Why was the first thing I thought to look was Mims or the therapeutic guidelines? (Must be the RMH training)
When I actually went to the patient and talked to them; it was obvious what needed to be done. I knew how to do my job after all. LOL
For example once a nurse told me "Patient in bed 10 has a headache, can you write her up for some Endone?". I was tempted to just write it up because I had so much paperwork to complete or suffer the Head Nurses' wrath. But I took about 10 minutes to talk to the patient and clarified that the patient actually DID NOT have a headache. Her scalp was painful because she had been scratching lesions on her scalp so much that it was raw. So it wasn't a headache that needed strong painkiller. What she needed was steroid cream and anti-histamine for the itchiness! Problem solved.
After that I don't follow what the nurses tell me to do anymore. I tell the nurses I will go and see the patient and see what's going on. Sometimes the nurses don't relay information very accurately. Like yesterday one of them told me the patient had chest pain. They panicked and did ECG, gave GTN/morphine (protocol for chest pain). I went to the patient and it turns out she had epigastric (abdo) pain which sounded like indigestion. Gave her some Mylanta and her regular omeprazole and that was also solved!!!!
Just after graduation Erika was telling me "
There's this saying; for the first 6 months, Melbourne Uni students when consulted will consult the therapeutic guidelines, Oxford handbook and Mims..whereas the Monash students will just go and see the patient". LOL looks like it's true.
6 comments:
klau aku gi jumpa patient then still dunno what to do.. nak watpe plak? uhuu..
aliya, aliya, akak pakai tudung tajj yang aliya berkenan tu! i bought if from a malaysian who's studying in indonesia. she marked it to RM 40, but still..cheaper dari nak gi indon beli sendiri, hehehe
intan- takpe..then write in the notes what you've found on history and examination and in the plan section say Discuss with registrar re: plan. call ur reg and he/she will give you some orders hee hee.
kak aini- wahh..nak tgk gambar!! bleh la mintak akak poskan ke sini kihkih
I like this. Sebab it teaches me a lesson too. To ask the said person himself.
I can see the danger on you if you don't take the initiative to do the extra work. Depending kat orang lain ni sangat merbahaya. Now I cancellah nak apply jadi doctor. :D
hahahaha
it's not really "extra work". mmg itu kerja doctors cuma we are so burdened by too much paperwork and legalities that we think we can't afford to take some time to see the patient and listen to what they're complaining about.
working in a hospital is a lot like playing chinese whispers. you have to trust that the person telling you is telling you the right thing or writing a report that is legible. and we know how inaccurate THAT game is! better go to the source (patient) but it is very time consuming and annoyingly repetitive for the patient.
Wah wah... profound.
Similar to what I learned over so many years (learned it the hard way) ... rather than taking the words from others, I spoke directly to the operators themselves. More problems can be diagnosed correctly.
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