Seething

My registar has been sick for the past 2 days so I had to do her work on top of mine and not get my afternoon off. It just so happens that we had 3 discharges on both days so work was inflated. 6 discharges meant 6 new admissions and therefore a ton of work. You wouldn't understand unless you worked there.

Unlike acute hospital setting where discharging a patient involves typing out the discharge summary, organising a medication perscription; discharging people in rehab involves much more on top of all that. We have to fill in these forms depending on who needs them: warfarin dosing chart, discount taxi coupon application, driving assessment test, application for household aids, centrelink medical certificate (which is 2 pages long), disability pension application, housing application and apa-apa entah lagi forms to fill in.

My head is just swimming with things and forms "I have yet to fill in". It's just depressing. But no one understands. Everyone thinks rehab is "slow". They think we have regular coffee breaks and sit around doing nothing.

Today was probably the worse day in rehab so far.

Morning: did ward round seeing 15 patients with the visiting consultant from 8.30 until 12, INTERSPERSED by seeing by myself:
- patient with left shoulder pain
- 2 patients with low blood pressure
- a patient that needed a catheter
- patients with chest pain
- patient not happy with her pain meds
- patient not happy with the timing of her meds
- patient with shortness of breath
- patient with discharge coming from his p3nis
and organising the 3 patients to be discharged that morning.

Then from 12-3 I did amendments drug charts, filled in forms, admitted 1 new patient while being interrupted by nurses and other staff wanting:
- warfarin doses
- making changes to medications
- adding medications
- ordering new blood tests
- calling up patients discharged that morning for their warfarin doses
- printing new drug charts for old patients because their drug charts had no space left to write on

Then at 3 I had to do a ward round with the Orthopaedic registrar who sees the orthopaedic patients there.

Then at 4pm I tried to admit the 2nd patient while being interrupted to:
- fill in hydrotherapy permission forms
- fill in taxi voucher forms
- fill in disability pension form
then at 4.30 I remembered I hadn't made the prescriptions for patients who were to be discharged tomorrow!!!!!! I had to do 3 scripts in a space of 15 minutes...I'm pretty sure there's lots of mistakes but I'll deal with that tomorrow. The pharmacist will be more mad if I don't get the scripts in before 5pm!

Then the visiting consultant suddenly wanted to see his new patients because he won't be around next week. Nasib baik ada dua aje. But still, it took some time too. I only had 5 minutes left to start the admission for the  3rd patient and do all 3 discharge summaries for tomorrow. Impossible.

I gave up. I just left. Why didn't I just stay back, you may ask? Because I will not be paid if I stay after 5. I am not stressing myself out for FREE. I am not altruistic.

Furthermore it was supposed to be my afternoon off and the management should have provided me with a replacement registar (because she was off sick for more than a day) but wasn't done because the admin person is on holiday! I have a big mind to complain big time but since the head of rehab is really very nice to me, I won't add to her troubles.

What pissed me off so much was the nurses' and other staff's attitude. Here I am holding the fort on my own, doing as much work as I can at the same time (e.g. writing notes while waiting for something else to print), not taking the one hour PAID break that I am entitled to, drowning in paperwork... yet they just dump the stuff they want me to do on my computer keyboard without even asking me nicely to do it. Or they demand "have you done this" "make sure you do this". Oh my God, I am just busy, not stupid or incompetent. I have it on my to do list and when I get the time to get around to it, I'll do it!! If I can't do it today then it is not urgent or important enough to do at the moment!!

Can't they help out? Like find out what the INR is first before asking me for the warfarin dose. Or fill out the forms, stick the patient bradma on the forms then just ask me to sign it. Do the things that doesn't require 6 years of medical school, 2 degrees and medical indemnity to do. A school kid could do it, why can't they? They seem to be busy enough that they can take 2 or 3x 30 minute meal breaks and eat a proper lunch.

I hope my registrar comes tomorrow or it will  be 3 days in a row of bad days like this. Fridays are always the worse because we have to do work for Saturday and Sunday and Monday in advance. Plus there's the audit meeting and pharmacy audit that takes up a lot of time. If I'm alone again tomorrow I'll have the workload of 4 days for 2 people. I don't think I can take it anymore. I am starting to begrudge my registar for being sick though I know she is truly sick.