Friday, October 02, 2009

4 months old

Had a series of busy mornings and double shift this week, with extra work due to various audits -- documentation, ISO, assets. Today was another busy morning for me at the ward. I started with 6 patients and had 2 new admissions this morning.

On duty this morning were the ward manager (NO), the admin staff, I and SN J -- taking teams near and far from the nursing stations respectively, HCA K and SEN MY for our respective runners. I arrived just-in-time to take report as I was overslept. NO briefed us during report handover due to the ISO audit to be done today. She wanted us to follow-up with various document and equipment checks.

There was a constant flow of admissions since yesterday evening, of which 2 admissions were assigned to my side of the ward. Majority were GE related cases. It was Children's Day yesterday, so it made me wonder what the children ate during the celebrations on the eve of Children's Day that may have caused their GE. Both team had many IV medications this morning -- probably correlated to our GE incidences -- and we did not have enough syringe drivers to go around between 10+am to 11+am.

Just after the shift handover report, there was an IV cannula that leaked. HCA K and I tried to save the IV cannula site but it couldn't work. Immediately thereafter, a new admission arrived for my team. I admitted and orientated the patient and her parents, assist the specialist who came to diagnose the patient's illness, follow-up with RMO for IV cannulation, IV drip and blood investigations. All that work took about 1.5 hours of my morning. Add to that following specialists on their rounds. By the time these were somewhat settled, it was already just past 10am. Unfortunately, many of the new medications (including IV medications) since yesterday night were not supplied and were not available from the ward stock either. Thus, I had to quickly put in my pharmacy requests. Thankfully, the night staff managed to give the morning doses of the TDS oral medications, and there wasn't any febrile cases, so I did not have to rush for the morning TDS medications, except for nebulization. Then I did one round of medications. Before I could administer the IV medications for those that were available, SN J came to borrow 1 of my 2 syringe drivers as her cases were slightly overdue. The rest of the morning was various medication follow-up when available or due, interruptions from both the NO and the admin staff to correct various documents and workplace items before the ISO audit. I was pretty stressed and hungry by 12+ noon, as I have not had any break. In addition, I was still pending several overdue IV medications due to a combination of medication and/or syringe driver unavailability. Then another new case arrived for my team. The admin staff instructed me to admit this new patient. I was already over-my-head with overdue medication and IV, so I told her to get the NO to admit instead. The NO helped. Seeing that I still looked stressed at 1+pm, the NO came over and instructed me to take a break, saying, "工作永遠做不完得。” ["Work will never be finished."]

Then I took a break and ate the bread that I brought from home. After my break, I did my mid-day round of medication and continued with my outstanding IV medications. While I was taping my handover report, I was interrupted for the pre-ISO audit briefing by the NO to all staff. Thereafter I continued to tape my report while the afternoon staff were listening to the other team's tape. Unfortunately I could not pass report for the second new case which I have not seen, and who went down with the case-notes for ultrasound investigations. Actually, I should thank the NO, the admin staff and my runner HCA K for handling this new case for me.

Thus I am 4 months old but I still struggled through today despite my side of the ward not being at full capacity. In the end, I only left work at 4pm after completing my documentation, pharmacy forms and ward billings. I am so tired!

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