shellgal

A newborn doctor who is enthusiastic about her career and passionate for her life and of course, she also dreams a lot when she is awake...

Sunday, July 16, 2006

Learn to prioritize!!!

I'm oncall in PICU again today.As usual, I do my stuff and see my patients and eat my lunch, dinner and go for a tea break in the afternoon. It was an uneventful oncall also, except that I got to go to other wards to help my colleague (which I am under no obligation to do that, we are supposed to stay in our own ward during our oncall). Not that he is busy or having a lot of admissions, just that he's not efficient enough and good at prioritizing cases. (I reckon ability to prioritize our ward work is very important, as we (house officers) are the sole warden of the ward, and I'm still learning to become a good warden :).
I helped him to handle 2 outpatient cases (Haemophiliac# patients coming to the ward to get Factor VIII and IX injections), to draw blood for culture & sensitivity (C&S) and to set intravenous (IV) cannula (for inpatients). Guess what, in order to relieve his ward burden, my M.O. who's oncall with me in PICU also came to help him. She came by to discharge few patients just to try to partly evacuate the ward for him!And, of course, I helped him to finish the discharge summaries also.
At the end, I can't blame him also, as it's a weekend, and we kinda expected a more than usual busy oncall day. But seriously, we need to learn how to prioritize our work tasks. Please do not go and do the blue book summary (any child who needs long term follow-up in our paeds clinic, has a blue book to summarise their disease progress or improvement, their hospitalizations and records of medications) when the child is not yet stable for discharge, meanwhile Haemophiliac patients who are bruising all over and having gum bleeding, are coming in for factor VIII injection. Please kindly set an IV line first, while waiting for the blood bank to approve the blood products. Bleeding in a patient with coagulopathy^ is not a trivial matter, do take it seriously. And please go and draw blood for C&S and set an IV line at the same time, in order for the nurses to give intravenous antibiotics. Delaying in treating an infection can cause undue consequences (good example is meningitis*)!
Think and act!

#patients with genetically hereditable blood disorders that impair the body's ability to control bleeding. The lowered plasma clotting factors'(factor VIII or XI) activities cause compromised blood-clotting
^a medical term for a defect in the body's mechanism for blood clotting.
*infection of the brain

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