Satisfaction

As requested by Falconz long ago.. Sorry ah, has been trying to upload this picture but always tried doing this in the late nights when net traffic is so heavy, it never got to be uploaded.. But here it is :)


Got an advice from an MO:"We are whores.. We work to satisfy others. We must make everybody happy."

How true, I've been working to please consultants, registrars, nurses, patients... The only times i can please myself are instances like:
1) Prescribing analgesia to a painful patient then seeing him sleep soundly after that
2) Catheterising a patient with a bloated bladder and having him thank me profusely after that for reliefing his discomfort
3) Receiving my pay check..

Other times are "whore" times:
1) Patient complaining of reflux symptoms (i get this pain from the stomach that goes up my chest..) Vital signs stable, ECG normal, cardiac enzymes normal and consultant decides to refer PINK letter to cardio on a saturday afternoon for AMI/ischemia. and our dear cardio does not want to return page till 1 hour later... ended up going home late...

2) On call at 4am: "hi Dr ah.. this patient got fever 37.7, says got 1 nurse got flu then pass to him then not happy, already on panadol but wants panadol extra but we don't have. Can come and appease him or not ah?"

3) Just arrived at patient's bed side to clerk her and her son asked aggresively:"how is she ah? why you all don't tell us anything one? you all must tell us ma!"
"sorry sir, is it alright if i ask a few questions and examine her before i update you?"
"OK.."
finished history and going on to examination..
son pops in again and once again:"so her back alright? she said her spinal cord broke (!!??) just now"
again have to appease him and explain it is the vetebrae body and not cord that broke..
how important is communication..

4) Most times i could keep my cool, or should say i need to keep my cool. there was once when i was really at wits' end and chose to remain silent..
Patient had closed fracture, needed fixation, been fasted from morning for emergency op. parents really angry that till night OT was not available. refused drip offered by nurse
So along i came and explained at length Emergency OT needs to prioitise life threatening cases and therefore necessary to wait..
Patient's uncle and mother most aggresively demanded a fixed operation time which of course only god knows when it will be, said patient had been fasting for so long, was in pain.. explained again and again about emergency OT system and that someone's life will be at stake if OT given to non life threatening case first. Offered drip as patient had been nil by mouth..
they refused again..
what to do, they say patient haven't taken anything then offer them drip they don't want...
so asked them:"what would you like us to do?"
said wanted operation..
as we were going in circles. i chose to keep quiet and they also got nothing to say..
silence for 2 minutes and i chose to push my registrar into the limelight..

Realised i should learn some tricks from him, how he bravely put to them, though not in a direct way that their relative is not the only living being in the world that needs op.. and after that they still needed a 5 minute discussion before they made the almighty decision:"OK, put him on drip then.."

whole exchange took almost an hour.. setting the plug took at most 5mins.. though i was shaking at the thought i would miss the vein, bringing on more outbursts..

I guess what they told us the first day in med school counts, our aim is to:
1) cure sometims
2) relief often and
3) comfort always.. make sure patients and relatives are comfortable and these exchanges can be lesessened