“A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment”
A weekday call in the Emergency Department (ED) means that Im the sole gatekeeper of the hospital together with my armies of Medical Assistants (MA) and Nurses. So it is very important to have a good team : Team Minci Activated!
Here, my call would start at 4PM. And end the next day at 4PM too.
My colleagues from the morning shift would handover their cases (if any) so I may continue to see to their management and ensure that the patient is either;
- Admitted to the wards
- Discharged with another memo to come back to ED for a review of their symptoms or repeat a particular investigation
- Discharged with a referral to the nearest polyclinic
- Referred to the tertiary centre (GH Malacca)
Things are usually at a calm and steady pace between this hour and 9pm. To this short moments of sanity, I owe my gratitude to the polyclinic next door for their extended hours service till 9Pm. Its after 9PM when the chaos begins.
Illness and maladies that walk through the door may include;
- a simple straightforward flu, fever, cough
- asthmatics requiring nebs
- change of dressings
- pain of all sorts : eye, back, stomach, leg and the top most important : CHEST PAIN
- trauma/assault cases
- very old people with electrolyte imbalances
- sick kids
YUp. Malingerers. The best friend of hypochondriacs. Whose symptoms are exaggerated with an aim for one piece of paper. The medical certificate. Easily identified as they start narrating their tall stories regarding their illness only to refuse any form of blood taking or investigation (as we see fit) and only wanted a days rest for all the perp to go away. Kenjar! gambong!
So things would take on its toll after 9PM and by 12MN, Id be hoping for no more new cases to come in. I would try to clear all cases as early as possible for I not only want to get some rest ( so I could filter what Ive seen and learnt for the day) but so as my Team Minci for the night could get a few winks of sleep too just in case a major trauma walks in.
On a so called good day, my ED (mind you, this is district) would be quiet by 3 AM, frequented mostly by asthmatics in the early hours of the morning. On a bad day, Id still be up till 8AM!!
And last night was a good night. Heh.