Drawing again after so many years

 

meh

received this snapshot in my job chat group.

Wah.

If you just look at the numbers like that, it almost seem like we're doing quite well as compared to most other hospitals.

BUT

What about nurse to patient ratios?

No one bothered to look at that number.

Bad mistake.

Really bad.

So what if you have 1000 patients. If you have 250 nurses, one nurse can care for 4 patients. Perfect.

So what if you have 500 patients. If you only got 50 nurses, one nurse takes care of 10 patients. You will not be able to remember what the heck patient had before that relates to his or her current condition. You won't have the brain capacity to care whether the patient has been going hungry unnecessarily and that you may need to go fight the doctor that ordered NBM like they've gone zen and no longer need food.

You won't have time to care for your patients with patience and love because you're fighting for time to do basic care for the next one lying beside. And what about that one that is yelling at the back because he or she got so much needs and wants that we have no time to meet and cater to all of them?

And ten is almost like the average number of patients per Nurse these days... NETT. Not total per shift.

You see the difference?

We don't care how many patients there are, actually. 

We care about how many patients we each have to care for.

Period.

feeling a little out of place

Was scrolling through Facebook and curiously clicked on the profile pages of my colleagues.

Needless to say, all the Doctors came from reputable schools. Duh. They're the ones with straight As.

Then I realised a lot of the seniors also came from reputable school too. Hwa Chong, Raffles, NJC, River Valley, Nanyang...

I looked back at my profile.

Wow

Ok.

Growing up I always had this sense of pride when I compared myself to people and they are from neighborhood schools. 

As if I am from a different level.

Lol.

Such a bitch.

And those from RI and HCI probably think the same of people like me.

Idk man. There probably are people that don't bother maybe.

But idk why now I still have this sense of... inferiority almost.

Not very good for my mental health huh. But I can't seem to help it.

Can't help but wonder if it's part of the reason why I don't function as well as my colleagues.

Why I am not as outspoken and confident.

But looking back, I have got school mates that are outspoken and confident...

So i guess the problem just lies with me.

Hah.

Ystd was so busy with my shift I didn't get to go for break.

Today I took MC

Cuz of this weird pulling pain down my shoulder to the 4th and 5th fingers both sides. Took some Nsaids and Vitamin B. Hope it helps.

3rd time successful

Yay, middle aged indian male.

IV 22G successful.

No one was with me.

Yay...?

2nd time successful

2nd time successful IV insertion. 

Now in a 70+ year old elderly. 

But he's got good veins. 

But maybe cuz I had Dr KJ behind me so I was kinda more relaxed.

Erm.

Anyways.

It counts 🤣

One happy thing today~ 😊😊😊

Paranoid Personality Disorder

So... I am starting to feel pretty sure my mom has this 

So, according to this web, sign and symptoms:

• Doubt the commitment, loyalty, or trustworthiness of others, believing others are using or deceiving them.

## believes there are scammers on Youtube that pops a scam when she is watching videos, asking her for money.

• Are reluctant to confide in others or reveal personal information due to a fear that the information will be used against them

## refuses to put profile pictures (not even of random Google photos she likes) or birthday on her online accounts, refuses to put even her name initially. Thinks ppl can make use of that and do bad to her.

Recently she's saying that my aunt (my father's Sister) has casted black magic on her using her birthday and that's what has caused her hospitalisation few years back.

To this I argue: you means every one that ends up hospitalised are there because of black magic? Who is it so free huh. Every day I seen hundreds of patients getting admitted. Who isit casting spells on them? Got so many ppl nothing better to do casting spells everyday ah? Black magic work so well why not do it to benefit themselves instead.

Then she smiles and shut up.

• Are unforgiving and hold grudges

Always holding grudges. Lost count. Example, repeatedly saying that if it was not for that worker that did not place the metal rod properly and causing her to hit her head and then all her studies went downhill and she became a drop out eventually and that's why she married my dad cuz of her low education level.

• Are hypersensitive and take criticism poorly

My dad has gotten the hard end for this one. 

• Read hidden meanings in the innocent remarks or casual looks of others

Recently was on the public transport back home with her after getting groceries from Jurong point.

Came home and she was talking about the group of ang mohs in front of us giving us glances and talking in a foreign language. I noticed that they did glance once or twice but didn't think much about it. Like whatever. 

She feels that they are talking bad about us.

I asked her if she had understood their language.

She said no but still insisted on her gut feeling.

I told her maybe they just think we're hot chicks. 

She laughed.

• Perceive attacks on their character that are not apparent to others; they generally react with anger and are quick to retaliate

Always. 

• Have recurrent suspicions, without reason, that their spouses or lovers are being unfaithful

Uhm this she never reveal if she does think so.

• Are generally cold and distant in their relationships with others, and might become controlling and jealous

Very cold and distant towards her mother and siblings. Though the long distant relationship may have been the cause.

• Cannot see their role in problems or conflicts and believe they are always right

Stubborn in her beliefs 

• Have difficulty relaxing

Very anxious. Especially when out of the house. Becomes very reliant on us. Gets jittery sometimes.

• Are hostile, stubborn, and argumentative

Stubborn. Bold. Caps. Italic. Underline. Though she don't usually win me in an argument. Guess it runs in the genes.

...whut

Dreamt a weird dream.

Somehow was unwell at work, fainted or smth. 

Woke up and the Dr was telling me that I've got this gyne issue 

"Neemoid ecchymosis"

Lol this condition does not exist.

But in the dream it's something along the line where I had this weird swelling and bruise on my womb.

So I had to undergo surgery for it immediately.

Was calling my mum about it right before the op with the OT staff's phone. It almost felt like i was ready to die.

Very quickly the op finished.

Saw the many specimens from others hanging around.

Then I was discharged.

Lol.

Was on my way home calling my sis to find my mom, only to know she's told my dad and he's bringing my paternal side of the family to the hospital to visit me.

Lol.

Then.

I peed.

In real life too.

itching... but will I scratch it?

If only I had the courage to just... go on my own...

Can't imagine the stress I would be in though...

Kinda already stressful just looking and imagining myself going through it all.

Will it ever happen? I asked my mum today.

She replied, "Unlikely."

Sigh.

Oh man...

 So, the kid in the house has been in Canada for 1 month now

Looking at all the places she's been... I am so envious.

I wanna go back to Taiwan for a trip.

Taiwan still has it's leisure travel boarders closed though.

Just went and looked through all the stuff I uploaded in Drive.

Gosh the quality compress until I can't tell what is what

What the heck is 360p

Why does it still exist in 2022

LOL.

So I kinda silently made up my mind that if I do go Taiwan again,

I want to book hedo hotel again.

For it's interior and it's service.

Hopefully, it still has the free chauffeur to airport service the next time I do go back.

COVID. WHY.

my advanced care planning

So I was whatsapping a colleague who just left ED to Carehub and somehow the conversation led to staying single ... 

So my plan is to earn as much as I can then when I finally have enough of everything and have reached the state where I can no longer care for myself/ have enough money to sustain crazy healthcare expenses... I'll hire a private nurse to take me overseas, and then start my countdown to my last days. Go sightseeing for a while (if I still can see) then admit to a hospital for euthanasia.

What's the point of being alive, have got no family around anymore (assuming my parents have passed when I reached that state), and have no quality of life.

Right?

Hmm... Looks like I've got quite a bit of a choice huh. Hahaha

people leaving

So... 

When is it going to be my turn.

Ugh...

Why am I always so busy no matter where I am allocated.

Really tired.

sick and tired...

不想上班。。。

真的有点厌烦了。。。

累了。

luck

went down an escalator that was coming up.

dyshidrotic eczema

Think I've found the condition that I have.

Occasionally have small deep blisters that form on my hands and feet.

So I did some research and found out the following.

Pompholyx usually starts as intense itching and burning of the skin on the hands and fingers. The palms and sides of the fingers (and sometimes the soles of the feet) then erupt into tiny itchy blisters that may weep (leak) fluid.

In severe cases, the blisters may be quite large and may spread to the backs of the hands, feet and limbs.

The skin can sometimes become infected. Signs of an infection can include the blisters becoming very painful and oozing pus or becoming covered in a golden crust.

The blisters will usually heal within a few weeks. The skin tends to become dry and crack or peel as it starts to heal.

It's not clear exactly what causes pompholyx, but it may be triggered or made worse by:

a fungal skin infection – this may be on the hands or at a distant site from the blisters (such as in between the toes) and will need treating

a reaction to something that has touched your skin – such as certain metals (particularly nickel), detergents, household chemicals, soap, shampoo, cosmetic products or perfume

stress

sweating – pompholyx is more common in spring and summer, in warmer climates, and in people with hyperhidrosis(external link opens in a new window / tab) (excessive sweating)

bleak hopeful

 so now... am attending this zoom where the hospital APNs are sharing about their roles and so-called "achievement" or "contribution" to the hospital like reducing hospital reattendance etc.

Whenever people ask me about my so-called final goal/ destination in nursing, more often than not, I had replied that I want to be a community APN specialising in chronic diseases. Was kinda inspired when I went for my polyclinic attachment and sat in for a consultation with the APN. Can still remember her talking to her patient regarding his sugar control, his medication and diet, and the patient had left the room with new information on how to control his sugar levels. He had been taking lots of fruits -- contributing to his high sugar level. It had never crossed his mind that fruits could one day be an obstacle in his health management. In the eyes of many elderly, fruits are good stuff.

So it kinda stirred some strings inside me since then.

I want to do something like that too.

But.

It feels a bit unreachable.

From my observation, all the APN had one thing in common. 

Outspoken.

Knowledgeable too.

These which I have not.

Kinda sad.

People tell me, you can force yourself to be outspoken.

You can force yourself to be out there, to be noticed.

I don't know about that.

Sometimes I hate myself for that.

I just refuse to make myself uncomfortable.

I just want to stay in my little shell.

Maybe I should.

And just slowly rot inside.

God.

This is getting depressing.

The zoom lecture is getting more and more uninteresting.

Like - 

so many boom pows, fireworks, things that I am still not at a level to understand.

Which reminds me again of how far I am from them.

...

...

still going downhill

Ok. Something is seriously wrong with my luck these days.

Initially I didn't think too much about it.

You know, life is all ups and downs.

But ... It's been stuck in the downs for some time... And still kinda not picking back up.

So... Update re: the IV NOVOSeven.

I received a call from my new nurse manager BV. Asking me who had ordered the medicine. So I replied as to what I rmb, the Haem Dr. What name exactly I can't rmb. I've got so many new MOs to recognise and remember their names.

Then the next question. Did our ED Dr note about the order?

Yes, Dr Lim EL noted. He came over for a while while me and RN CPN was preparing the medicine. And he threw a casual comment about yah yah learn it or smth along that line cuz we were fumbling with the instructions paper.

Third question. Was I preparing the medicine to give ourselves or to give to the Dr to give?

Uhm... I thought nurses were licensed to give IV meds as long as it's not a controlled drug? And MAR did not stop me from administering it. It allowed 2 registered nurses to cosign too. So... 

She went on the say that apparently it is a blood product so we may not be licensed to give... But like... Blood transfusions leh? 2 registered nurses can give ah...?

She was like we need to find out. May need to EHOR ( reporting the event to the higher ups ). Lol. Fine, I wait for their final decision. But I definitely did not cause harm to patient what... Dr's hands more skilled in giving IV meds meh. Idk man. As long as we give the meds over the stipulated time, like for this NOVOSeven it's 2minutes, why we cannot give? I don't think ward nurses (experience from my 4 years as a student) handed any drug other than IV controlled drugs to doctors...

Ok. That's that.

Next thing.

Ok. This, I feel like I abit too naive and got too much integrity to spare.

Was sending pt up to Neurosurg High Dependency ward... Just when I am about to end my shift. With a new MO. He kinda pushed a bit too fast and didn't really stop in time for the flappy door to fully open. And... You guessed it. We broke the door.

While we could definitely have stayed silent about it since no one witnessed the event other than the both of us... I don't know what gave me the courage to confess to the nurses that we might have broken the door. Like the flap kinda popped from the higher metal hinge on top controlling the opening and closing.

So. They asked for my name... And the MO's name. She said she might need to report to her Sister regarding this.

So how? Have to tell my Sister lah... Otherwise their Sister call my Sister and then the whole shit is going to be worse. So have to prepare them lorh... So I told Sister H. And... Yah. Waiting for updates.

Walao.

You get what I mean?

Like on top of my swayness in patient load... 

Ugh.

sometimes I just do the stupidest things

So... Today's story starts with this medication: NOVOSeven

A little bit of information about this medication --

So...

The story was, it came as a new set of complicated shidazzle. Need to connect the adaptor to the vial lah, connect the plunger by pushing and twisting tight lah, connect the syringe to the adaptor lah, swirl the medicine slowly lah draw out the medicine into the syringe lah, expel the air lah...

All went well until I tried to give the patient the medication. Then I realized that the syringe couldn't fit the IV cannula luer lock.

RN C.P.N. attempted to transfer the medication into our syringe by drawing it out from the tip of the syringe. But the needle couldn't fit the tiny tip. 

So me being the kanchiong one and having a few new patients pushed me to want to get things over and done with quickly.

So I did what I observed Dr's do when preparing lignocaine - pour into a syringe and put back the plunger. (Wrong demo alert)

And.

You guessed it.

I spilled the medicine.

$2000++ in one tiny 1ml.

Gone. 

So... I resupplied the medicine again and that was another hoo hah with the Pharmacist side.

Need email lah this and that lah...

I was trying so hard to remain calm.

I feel my left sided chest pain coming back, probably due to anxiety.

I called my Nursing Officer on shift to report on what happened. Integrity at the max man. I jolly well could have pretended nothing happened and give the pt the spilled medicine. Non-sterile anymore. (Wrong thinking alert).

God.

So I handed over to the afternoon shift since he came at 1430hrs.

And then I thought of a better way I could have handled the whole shit. (And this time I did the following as I cosigned it with him)

After dilution, LEAVE THE DAMN MEDICINE IN THE VIAL AND NOT FOLLOW INSTRUCTIONS TO DRAW IT OUT.

THEN, DETACH THE ADAPTER FROM THE VIAL.

THEN, USE A 3ML SYRINGE WITH GREEN NEEDLE TO ASPIRATE THE DAMN MEDICINE INTO THE SYRINGE.

DISCONNECT THE NEEDLE AND GIVE THE MEDICINE WITH THE 3ML SYRINGE WHICH IS KNOWN TO BE COMPATIBLE WITH THE LUER LOCK!

OK.

That was a lot of exclamation.

Well. If they're going to ask me to pay for it then I guess I will give them my bonus for this month.

Damn it.

🤦🏻‍♀️😑🤯😵🥴💥👀

continuing my stay in the living room

So... 

Just when I thought I could stop staying in the living room...

Was literally cleaning out the toilet of our "isolation room" aka my room when I asked my sis to go do an ART cuz she was having headaches, sore throat and was feverish.

That was it.

As she put it, she was "pregnant with COVID"

And just nice, day 7 is when she was going to fly.

Lol.

Gosh... It's been really hot and humid the past few days.

And last night I have gotten so many mosquito bites over my left hip...

Mosbye apparently don't work too well huh.

when things just go down the vortex

scalded myself with hot coffee...

Ugh.

🤦🏻‍♀️

back in the living room

well... 

as the title suggests, I am back to my life of living in the living room.

the dad has caught it.

2 lines

Though I also feel a little sore in my throat, I'm negative.

Well, at least for today.

Ha.

Glad I slept for 10h last night in my room.

Only slept for about 2h just now in the living room

God it's so hot and humid right now...

I don't know how he's going to isolate for so long

He never really spent 24h at home, what more 24h x5 in a room.

Good luck to us.