Archive for July, 2007

Medicine Admin Folk Need Better Language/People Skills

Some time back, the final year students of the YLL SoM received an email from the Dean’s Office. It started with,

I am pleased to inform you that there will be a briefing for all M5 students on M5 specific matters on [Day of Week] [Date] from [Time] to [Time + 1hr]. in Lecture Theatre [Number]. We look forward to your attendance*.”

Naturally, all M5 medical students love nothing more than an extra 1 hour briefing, on a subject that is unspecified, held after a 2 hour lecture, instead of going out, eating dinner, sleeping at home, or generally having a life.

Maybe it’s a lesson on how to communicate with patients:
“It is my pleasure to inform you that you have terminal hepatocellular carcinoma!”
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SIP: Nursing Staff

Without nursing staff, patient care could not reasonably be expected to occur. Besides the usual recordings, drips, bloods, drug calculation and administration, the nurses are the first people to note when a patient needs medical attention.

Like any other profession, the individuals in the nursing profession run the gamut of competency.

Fortunately for J., the nursing staff of the Gastro/Endo ward of SGH have been nothing short of outstanding.
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SIP: Call Superstitions

The day before my next call, I thought I’d focus on an article that appeared in Weekend Today on Saturday.

Bath or bao makes or breaks one’s day

It focuses on an humourous article published in the Annals of Academic Medicine by a team of NUH physicians, including the well-known A/Prof Erle Lim, consultant neurologist and Prof Vernon Oh, senior consultant of general medicine.

Take a Bao if You Are Not Superstitious

Some other common superstitions were not mentioned in the above articles. These are widespread beliefs among healthcare workers.
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Not Quite SIP – Patient Sensitivity

Perhaps it’s a Singaporean thing, but Singaporean patients seem to be exquisitely sensitive to comments.

Of course, there are the occasional incredibly trusting patients that make J. feel guilt-ridden to the core. Such as the youngish Indian man who called all the medical team “Sir” though the SIP students and even the A/Con requested that he not elevate the team member’s status so much. Heh. There’s the elderly Chinese man who, after consent is taken, goes “Whatever you think is best, doctor. You’re the doctor, you understand better. You guys have to poke me again after 3 times? If must poke must poke lah.” (the team was tracking his liver function with daily LFT & PT/PTT’s).

The younger generation, on the other hand, seems to have thin skin. And as a [future] healthcare professional with an occasional outgoing personality, J. has learnt that it is very important to watch what he says because patients, not having been medically trained or worked in a hospital, might not understand things the way he and others in the hospitals do.

Take this one example at a children’s hospital in Singapore.
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Medicine SIP – The First Call

It’s nice that as a medical student, one still has no real responsibilities. So for the first call, J. tagged along with the house officer (HO) from the team he’s attached to.

Life as HO1-on-call at this particular hospital is shit.

The MO on call pointed out that the year as a house officer is a shit thing that every physician has to do once in their life. Well, except for places that have abolished internships, but that doesn’t count, does it?

Fortunately for the HOs, JoT and J. brought their mystical ‘aura of slackness’ with them, and there were no new admissions to the teams they were on after midnight. Unfortunately for the HOs, the sheer overwhelming number of patients in this major hospital overwhelmed the aura of slackness by having sufficient changes to leave the HO with little to no sleep at night.

J. is very glad he is still only a medical student. For the HO, with a full day of work ahead of her, it’s hardly easy.

Time to work those IV cannulas, venepunctures and arterial blood gases. There’s little to no backup when on call.

Software – Foxit PDF Reader

There are many documents that are sent out in PDF form, including medical journal articles, making it essential for everybody to have a PDF reader on their computer. For most, this would mean Adobe Reader but this is one of the biggest pieces of bloatware around. When J. first started it, he had to contend with his anti-spyware program asking permissions for a whole list of plugins activated when all he wanted to do was to read a memo.

In the past, when using Adobe Reader 7.0, he would use Adobe Reader Speedup, a handy little utility that disables the plugins from launching, speeding up Adobe Reader considerably. However, now that he’s using Adobe Reader 8.0, it doesn’t really work all that well.

Thankfully, along comes a handy little program: Foxit Reader . It’s fast, it does what it’s meant to do, and only takes up a few megabytes of space. J. likes. If you’re not into fancy plugins for PDF files, if all you want to do is read and print, why stick to the huge installation of Adobe Reader?

Medicine SIP – The 1st Week

Disclaimer: J. is very tired and is therefore not in a normal state of mind. Anything he types in this entry should not be held against him. You wouldn’t do that to a tired medical student, would you? Would you?

J. was posted to the Gastroenterology ward of a major hospital in Singapore for his medical SIP. He leapt into it with the enthusiasm of a thousand kangaroos on crack.

He’s also sporting an amazing new shiner that never fails to get people to ask, “What happened to you?”. The answer, folks, is that J. was involved in fisticuffs with a 7 foot 2, 450-pound muscle bound maniac and if you think that this bruise looks bad, you should go to the major hospital’s ICU and see what the other guy looks guy. Bwaha.

Anyway, the point, as previously mentioned, is to get a feel of what the House Officers (aka Interns) do for 4 weeks. These guys have long hours. J.’s in hospital at 7.00am, beating the traffic, and gets home at 8.00pm. In the meantime, he tries to clerk patients, attend round after round after round, help out with changes, setting plugs, drawing blood, observe abdominal taps, etc.
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