Taking a stand

I should tell the story from the beginning. One of my new doctors started a patient on Gentamicin yesterday. She prescribed and had it given stat. I found out 5 minutes after it was given. That happened at 11.40am. You must be wondering why am I making such a fuss out of it. Well, gentamicin needs therapeutic drug monitoring and our hospital policy states that it should be given at night so that blood sample could be taken the next morning (12 hours later) at a decent hour when everyone is at work. So, when she ordered the dose to be given at that time in the morning, it means that the poor on-call doctor has to wake the poor patient up in the middle of the night to get his blood sample. I explained the whole procedure to her and she seems remorseful of her action.
Then, this morning at 11am I received a call from the nurse asking if she can give the gentamicin now as the doctor has just ordered it to be given. I voiced out my frustration to the nurse and she mentioned that it was actually ordered by another doctor higher-ranked than the doctor I spoke to yesterday. Hmm, that explains why she didn’t dare to contradict him.
As I was contemplating which doctor I should approach, the nurse very kindly ‘dragged’ the senior doctor to me and told him that “the pharmacist wants to talk to you about the gentamicin”. Thanks, nurse. She told me later she met him at the foyer and thought she better grabbed hold of him so that I could sort it out with him.
I reasoned it out with him. He resisted at first but finally gave in and said I could have it my way. I felt a sense of triumph there :).
The junior doctor later confessed to me that though she remembered what I said but she does not dare to contradict her senior. Hmm, and to think we actually told them during orientation week that it’s alright to question your consultants as they could get it wrong sometimes.

Miss Hospital

Where was I?

Lady comes in with a script for Aricept and asked us for a quote so that she could get the money from welfare.

“Oh, the doctor gave me this for my memory.”

The quote comes up to about $115 or so for Aricept and about $99 for the generic brand. We thought we’d go with the generic brand so that it looks better on paper (double digits as opposed to triple digits).

Fast forward about a month and a half later, said lady comes back to us.

She passes some papers to us and said, “They are going to pay for my pills. The one for my memory.” (Kudos for remembering what the pills were for)

“Lady, this isn’t what we need. We need the yellow paper with the shiny sticker. That one would pay for your pills.”

“Isn’t that the one that says they will pay for it?”

“Nope. Did you receive a yellow paper with this letter?”

“Why, I thought I’ve given it to you!”

“No, this is not it. Would you still have it at home?”

“Well, I would have to go home and look for it.”

We looked at the letter again (it was a letter saying something was approved for and they will bank in $24 into her account per week) and guessed that welfare was going to deposit money directly into her account/send her a weekly cheque of that amount for her pills. If it was true to what we guessed, that’s not very good a plan. She’d probably spend it without knowing what the money was for.

“It would probably be a good idea if you could contact welfare to see how exactly are they going to pay for your pills. Speak to your case officer.”

So off she goes!

I’ve not seen her since.
If she does come in for her pills, would she remember to take them? Seeing that she hasn’t got any caregiver and there is no next-of-kin to contact. $99 is a lot of money for the medication to be sitting around and her thinking it’s not working (hopefully she’d forget 😛 )

Miss Community

Is it the ego?

I have had a few similar encounters with this particular doctor. Occassionally, he will prescribe something with a really weird dose and/or frequency. Whenever I queried it the nurse will tell me that the doctor was not sure what the correct dose or frequency and that the pharmacist (me) will sort it out if it’s incorrect.

I am always there in the ward (well, most of the time anyway) but he will not ask me for help. And when I do approach him to get it corrected, he will be quite flippant about the whole thing. What if I didn’t get to see the chart in time and the nurse has administer it? Is it so difficult to ask the pharmacist for help? I figure he thinks that one incorrect dose won’t kill the patient. His ego is more important than the patient’s well-being, I guess.

Miss Hospital

Black (as in my mood) Friday

I have a love-hate relationship with Fridays. I love it because it means the weekend is here. Yet, I hate it because I have to work with someone that I have become increasingly impatient with.
The irony of yesterday was that I actually prayed the night before that I will have patience to deal with this particular technician and that I will not be rude to her no matter how much she annoys me.
The day started with the usual mistakes she made but never seem to learn not to make them again. And things just spiralled out of control for the next 4.5 hours. She just has an excuse for every single thing and refused to listen or let me have my say.
I actually had to walk out and calm myself down as I was this close to screaming at her. It was then that I remembered my prayer and how I have failed the test God gave me.
But it’s all her fault that I behaved that way, not. Although she was the cause of it but it still didn’t excuse my behaviour. I felt bad that it turned out that way.
It didn’t help matter that upstairs in my ward was a pile of work waiting for me. So many new patients to see and so many that requires education that can’t wait till Monday as the patients might be discharged over the weekend.
Some smart-aleck told me that actually God heard my prayer and gave me more patients (patience-got it?)! With the mood that I was in, he was lucky he didn’t get a black eye.
Oh well, I guess I have to focus more on my enunciation ( did I get that right?).

Miss Hospital