Call Fatigue
There comes a point in time whereby I start to feel that night calls are just too tiring and that life would be so much better without calls.
Yes, I know I used to say that night calls were the best learning experience ever. But sometimes we just get so tired, we don't learn anything.
And call fatigue can be dangerous, especially for the patient.
- Imagine being super tired, with 5 new cases waiting to be clerked, 20 plugs and bloods to take and only 1 hour left before you have to start your ward round.
- The nurse shoves an ECG in front of you and says, "Dr, note ECG." You take a glance at it, especially the ECG interpretation and you sign because it's doesn't say normal sinus rhythm.
- You see some ST changes but can't quite make out the significance with your tired blurring eyes.
- Your mind screams, "Sign the ECG and get out!" and you do so accordingly.
- You just missed an AMI.
In my opinion, calls should be limited to maximum once a week. And we should be on call only with the wards we can working in the day. This ensures that the patient receives continuity of care. But the limitation of manpower prevents us from doing that.
And rostering me for 7 calls next month is just plain torture. I'm complaining to the SPCH (society of prevention of cruelty to HOs).
SIP memories
SIP students are here! Reinforcements have arrived!
Sure brings back memories of when I was a student.
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December 2005 SIP entries*
November 2005 SIP entries
The types of medical students
Which type were you?
* from
http://theunderweardrawer.homestead.com/scutmonkey.html *
Beauracracy in the hospital
The hospital is one big maze.
Like a maze, it takes many turns to get from one place to another.
ie. Many people are needed to get a single thing done. Organizing a urgent scan requires an urgent form, talking to the staff nurse at the radiology room, talking to the radiologist, the porter who sends the patient down etc.
Like a maze, it has many dead ends.
ie. Fierce radiologists who scold you, sending down the radiological form after 5pm requires calling.
Like a mouse, we have to learn to know the maze and its dead ends and to avoid them.
If not we won't be able to get our cheese.
Countdown
Counting down is painful and almost intolerable.
It keeps me constantly on my edge, making me unable to relax when I want to.
It irritates my nerves, with the constant reminder that time is ticking on.
Argh!
Annual Leave
Why do we have leave?
Because we need to rest.
Because life is not just all work and no play.
Because we need the time to reflect, and to ponder on what we have done so far and how well we have been doing it.
But that's easy to say, but hard to do.
How do we know if we have done well or bad?
We need a inner mirror. Someone or something to compare, like an international scale of measure.
Who can give us that?
The good, the bad and the average
Some days are good.
ie. All your patients are stable and well. Your MO is helping you with your changes. Your consultant is in a good mood. The nurses help you with the bloods.
Some days are bad.
ie. All your patients are dangerously ill. Your MO is post-call. Your consultant's temper is short. And the nurses ask you to do a thousand and one things.
And some days just fall in between.
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Why can't all the days be average?
I would trade in all my good days for the bad days to go away.
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Audrey thinks we should look at it from the other angle.
A good day is boring and nothing is learnt.
A bad day can be useful as it gives one valuable experience.
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What are your thoughts?
Convocation
A medical student's life is not complete without the convocation. Likewise the house officer's life has not began without convocation.
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Here are the much awaited convo photos.
My dad can't wait to try out his new Panasonic Lumix camera which sells at $799, which he got at $399 because it was a display set.
You may notice that yours truly has a perpetual frown on his face. This phenomemon is the 'House Officer's Scowl' and is caused by many bad work days. The treatment for this is leave.
My lame attempt at posing.
Found some friends before the ceremony started.
Incidentally I was asked to do an live interview whereby it will be screened before the ceremony. Now I know how I look like on the projecter screen.
And, metaphorically speaking: my 5 years of medical studies can be summed up in this moment. The feeling of achievement when I put on the gown, when I receive the scroll, when I see my parents and their unspoken pride and also when I see my friends whom we have gone through thick and thin together. All in 5 seconds.
Post Convo Euphoria
The CG guys who weren't on call or post-call. We made it!
CG8899. Yes I came up with the name. It's a long story. You guys were a great bunch to work with. Really missed you guys since work started.
The overworked SGH medicine bunch.
Using the staircase asthetically.
My parents!
HO / MO
When does one become an MO?
MO.
Is it a just a position one automatically fills in when you've completed your Ho-ship or is it a position that you occupy because you have the capabilities od performing MO tasks?
Can one be both proficient in being an HO and also an MO?
I'm trying to be more involved in the care of my patients but completing the HO tasks leaves me with little time to learn my cases.
Honestly I get a wee bit frustrated for not being able to do both.
But then again, I really like the feeling of having someone senior looking out for you. It's good when I know that the patients are always being looked out for.
Having an MO is definitely better than not having one. Period.
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On the phone, I always introduce myself as HO.
But sometimes I realise some don't like to talk to HOs.
It's like a lack of respect, some say.
Do people want a MO to speak to them because MOs are better?
Or that they just want to speak to someone else of higher seniority?
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