Monday, April 09, 2007

must say, the week of HDU was much more interesting than gastro. although my job was just to keep the patients alive thru out the nights, so that the teams could sort out their problems during the day time, i was not doing any clerical work. alright, "keeping patients alive" might be an overstatement, as i didn't do any CPR, gave any inotropes, or commenced anyone on any interesting drugs. mine has generally been a watch-and-see approach, and often than not, the saturation would pick up and the heart rate would come down. thank God! indeed, all the patients had real pathology and multiple concurrent issues. although because the majority had AF and renal failure (requiring fluid assessment), i was nearly beginning to forget who's who.

Talking about fluid assessment. it's just a nightmare! my clinical skills are non-existent. looking for a JVP is practically useless, cos i NEVER see it. embarassingly, i wrote "JVPNR" in one of the patient's notes, and the renal consultant came around and wrote his entry immediately after mine, stating "JVP 6cm"!!! IF they can't tell u whether they were thirsty or not cos they're drowsy, you don't know whether they were born with sucken eyeballs, they have no skin turgor cos they've elderly winkled skin and their tongues look dry under the mask with highflow oxygen, their urine output is good but may just be post-obstructive diuresis, AND you are blind like me when it comes to looking at the JVP, then WAT DO YOU DO???

the 7th and last HDU night was absolutely beautiful. finished going thru all the patients, one by one, in 5 hours and only got paged for some fluids 2 or 3 times in the next 7 hours!!! yes, i could actually sit on seat long enough for it to get warm. the most unfortunate thing though, was that the internet was down for the entire time!?! so what does one do on a night shift and there's no internet access?!?!?!?! about 1-2 hrs till the end of the shift i called IT (cos i didn't want the day shift people to suffer like i did) and they didn't even though that the internet AND intranet were down! took my details. said they might call me once the problem's fixed and even quoted by home number by typing my name onto the system. Gosh!!! there's really no privacy of info at hospital!!

so i can say that i really enjoyed the week of HDU, but then... last night (or day, rather, since i was sleeping during the day), i dreamt that the some of the patients were running into problems, with tachycardia, abdo pain etc and i was mentally preparing to sort them out when i start my next night shift, then i realised, still in my dream, that there WEREN'T going to be another night shift and felt a great sense of relief!! so go figure!

posted by zhinger @ 6:06 pm

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