A Long 48 Hours

The past couple of days have been interesting.

Monday was the first day of a new ward rotation and J. was unpleasantly surprised by one patient who had had no bowel movement (i.e. um, passed faeces) for 5 days and was not responding to that most reliable of tools: the fleet enema.

As such, he had to go back to the old-fashioned technique of manual evacuation. Yes, it is exactly as it sounds. The patient, being unable to lie on his left due to a recent left-sided op, lay in a right lateral decubitus position with his legs drawn up. J., with the bedpan nearby, an incontinence sheet beneat the patient, double gloves on his hands and lubricant on his finger, proceeded to stick his finger up the patient’s behind and dig… and dig and dig and dig out as much faeces as his finger could reach.

Then, while considering giving a fleet enema immediately post-evac or giving PEG solution 2L, he absent-mindedly removed the left glove… in the process flicking shit onto the patient, the bed, and the unfortunate staff nurse helping him hold the patient. Damn.

Smelt like crap. That was not a good start to the day.

Subsequently, J. was on call and lost his temper, in the deliciously chilly sort of way, twice. The first was with SN T*** M**” who called him to take a repeat blood for a haemolysed sample which yieled a spuriously high potassium level of >6mmol/L. This man had beautiful veins, so J. asked her if she could just quickly take the blood. “No lah, cannot. I very busy now.” she said… although all she was doing was writing her pre-going home report, instead of filing the notes of a patient who had come back from an operation whom she had called J. about to do a post-op review.

As it turned out, the >6 K+ sample was taken at noon, and a repeat U/E/Cr had already been done at 1800hrs that was perfectly normal. So T*** M*** had once again proven her ineptitude.

In the second incident, J. was doing two post-op reviews and one of the patients had some nausea and vomiting. He had a choice: IM metoclopramide (given by nurses, but slightly more painful since it goes into the muscle) or IV metoclopramide (given him him, but straight into IV cannula). So he chose the IV option and asked one nurse if she would help him get the required items (1 x 3ml syringe, 1 needle, 1 alcohol swab, 1 vial of metoclopramide) while he examined the patient. She handed him the maxolon vial alone. J.: “Heh… might be a bit hard to pour this in. Would you mind helping me get a syringe and needle?” SSN: “Aiya! Can go get yourself lah.” and she went and sat down at the nurse counter.

Hmm. That’s not ideal for the working relationship, is it? So it was that J., who usually clears all his things post-procedures, labels his own things and so forth at his own time, decided that it wasn’t worth the effort doing all this at that particular nursing station. Aiya! They can clear the sharps/litter for him lah.

The rest of the night was decent… except for ? acute pulmonary oedema and ? acute abdomen, both of which raised J.’s cortisol levels.

Post-call was pretty decent. Afterwards, an ex-classmate messaged J. to remind him to meet at 1830hrs for dinner. What he neglected to mention in his message, however, was that dinner was the next day and not that day. He spent an hour traveling only to discover that the date given to him was wrong.

It was when he arrived home, that he discovered that his door was jammed with the door knob mechanism spoilt despite the lock being fine. As such, he sought the help of his neighbours and eventually managed to break in through the kitchen window and not require the aid of a locksmith.

Hurrah for criminality!

Then it was off for a 5km test of the new running shoes. They’re good. More on that later.

So there it was… 2 days of minimum rest and maximum excitement. J. likes it!

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