YOU DON'T REALLY KNOW ME }

Wednesday, February 07, 2007

It was a hectic day today. Took a day off yesterday, ended up doubling my workload. I wasn't surprised. However to my disappointment, my work for the day was not covered AT ALL. Anyway, i told myself i am not going to pick up the bits and pieces and so as a result, i focus on a fresh list of patients admitted today.

While i was clerking one case for my patient during my ward rounds, i realized something is written wrongly in the case notes. Patient's age was written as 87 years old. However, as written in the case notes, patient was ambulant, communicative, with no previous serious co-morbids. Hypertension, hyperlipidemia, IHD was all that was written. How could it be. To prove myself right, i went to the ward cubicle and took one quick glance at the patient. Patient was well, sitting up right, doesn't look like the typical 87 years old.

Guess what, patient's year of birth was 1930. It should be 77 years old. Omg. I went to verify with the admitting consultant and he was quite angry with his MO. He said that i was quite observant as this was not the first time i have pointed out mistakes. Previously, a date was written wrongly.

Though all these were not really a serious issue but i do hope that doctors can spare that extra min to be more careful. Another incident: One patient was clerked at 11am when he had actually admitted since 6am in the morning. Reason from the doctor: Too busy. DUH. -_-

My job is to intervene between the doctors to promote patient's recovery. So far, there are a number of them whose cholestrol and blood pressure were stablised after at least 6 months or more and were discharged. It brings a smile on my face as there is a sense of satisfaction. We do everything for a purpose.

Doctors are so fond of concluding patients with hyperlipidemia with no lipid panel results on admission. How would they know patient has hyperlipidemia without results. Even if they got the results by whatever means, please kindly attach it in the case notes for easy reference. For sometime, this had caused a serious problem to me. I wonder how many times i must remind them or how many doctors are needed to be reminded. To make things worse, once this happens, i will have to instruct the nurse or doctor to get it done before patient goes home and this is a fasting lipid. Most patients have already eaten and all i can think of is to request from the lab. (hopefully, they still have some blood samples of the patient) These are all very unnecessarily troublesomes.

Just to share: There is one patient whom i speak to over the phone today. His LDL (low density lipoprotein) was 3.7 (normal range should be 2.6 or below). I called to check with him whether did he control his diet (as advised by me earlier on) and take his medications regularly.

He assured me that he did take his medications regularly, together with a strict diet ever since he was discharged. I didn't believe him. To sound him out, i try to "scare" him by telling him that if that's the case, probably the medicine doesn't work on him, and i told him to come down to the clinic next week to see me so that i could titrate or increased the strength/dosage of his medication.

He sounded reluctant when i added on to remind him that medications will have side effects and increasing of dosage is definitely not going to be positive.

True enough, he had no choice but to admit that he has been eating alot of "junk" food during the past weeks. LOL. I gotta nag at him for a while before he promised to be good. He better be good, cos i have given him a date to come back next month to recheck again. If his promise is creditable, it should reflect a postive LDL.

Babes and dudes, pls be good. Ultimately, we are what we eat. =)

{ 10:34 PM }