Wednesday, July 18, 2007

Life @ QEH medical houseman

1. WORKLOAD好CRAZY..CALL親都NPO x 28 hrs ... 慣哂了,日日都唔會食Lunch,日日都唔會有urine output...算啦,放工之後係咁補充lor..如果唔係,真係驚自己renal failure。

2. 經常沒有時間收症,超快愛上FEMORAL, (不過我而家盡量femoral vein instead of femoral artery, 因為親眼見過D haematoma... formed within 30sec after femoral puncture..真係好terrible)我做fever ward,跟本上係一個老人院,日日都有無數既blood culture同埋無數既drip for iv antibiotics, 個個都係OAHR, bed bound, multiple bed sore, non-communicable既呀婆,全部超級contracture,所有limbs既joints都長期FIX左係150度flexion...點抽血呀?仲要係唔可以contaminate既culture?? 咪全部femoral vein/artery lor... 想點呀..

3. 成日都TREAT 姑娘... 好多時D野真係唔死得人的,K3.2都係咁追住你要補K,patient跟本好STABLE好正... 又試過得30Kg既呀婆4個鐘出左50ml尿,又係咁叫尿少,跟本呀婆bp/p 正,renal function normal, 又有足夠ivf,... 我同個姑娘講,其實咁輕既呀婆黎講,夠尿架啦,佢又係LOOK大對眼望住我....咁我咪將條水由q12改做q8黎treat你lor... =_="

4. trauma to patient much more then treating the patient. 尤其是fever ward果D老人院呀婆,老人院見佢地發燒,post-SARS嘛,點都送佢地入院啦,A&E見到佢地一"CHU"菜咁,實收入WARD,咁FEVER WARD會點做呢?抽堆血,打DRIP落ANTIBIOTICS,例牌TAKE urine, sputum, NPA for resp virus, blood culture,之後因為呀婆成日掙扎,所以開哂restrain prn,都最後FEVER DOWN,咪on a course of augmentin and tamiflu咁走返去老人院囉。全個過程呀婆都係一"chu"菜咁黎,一"chu"菜咁走,對發生過既事完全唔知道,我真係唔知咁樣搞一輪有咩意義LOR。仲要因為係FEVER WARD,又係post-SARS嘛,唔可以探病架,想見下呀婆都唔得架。

.....我唸呢D故仔長講長有,算啦,接受左啦,每個人都係身不由己,老人院要交代,姑娘要交代,醫生都係要交代,最後受苦既咪又係呀婆... 坦白講打少幾個DRIP,拮少幾次血,對一個成"chu"菜咁既呀婆黎講,有咩分別呢?

5. 盲目開treatment order... 經常唔夠時間唸清楚個cause...冇得收症.. 因為實在太多野要做.. 自己實在好似一部機器,多過似一個醫生。

6. 真正開心既,我唸係有一次cert左一個呀婆,佢有pace maker既,MO話叫我開個suture set,拎返個pacemaker出黎,然後suture返D皮。如果唔係個pacemaker入燌化爐會爆炸的。呢一個工作,我真係感覺到一種神聖,真係好比心機suture,真係珍而重之咁將個pacemaker交返比呀婆既屋企人。

暫時係寫咁多啦,今日好難得6:30就放左工,實在少有,我平時冇網上架,所以唔會咁快有得update。