Saturday, January 21, 2006
Today, the inevitable happened. I broke down and cried in front of my patients.
Since this month started, I have been frustrated and depressed because of my current rotation in Pedia in NMMC. There are so many patients, and so much work to be done, and it just so happened that I’m the only clerk for my team (read: I’m the only clerk for 45 patients!). But I didn’t want to complain, because:
#1. Past groups also had clerks who worked alone.
#2. Bandoy has been on DUTY ALONE for the past four months, and my present problem is NOTHING compared to his selfless sacrifice.
#3. Guia was the only clerk for HALF of the entire surgical ward a few months ago, and she dressed 5 burn patients TWICE a day EVERYDAY.
#4. Guia and Pie don’t have a PGI now, and one of them has to go to the ER during their 24h duty, and that’s one of the craziest things to do in this world.
#5. I figured if I’m going to PGH then it’s probably worse than this.
I was bitter and miserable particularly during the first week. I walked around Divisoria sulking, and splurged my allowance on food and DVDs. I shed tears of disappointment at home, especially because I couldn’t insert IV cannulas and I was lousy at extracting blood, which caused mothers to freak out and torment me with their deadly glares and vicious comments. And because I work alone, because I have poor skills, and because I also happened to be an obsessive-compulsive individual, I finish very late everyday but still don’t get all my work done. But fortunately (praise God!), I was gradually able to adjust and improve my skills, many thanks to my groupmates (Hya and Pie particularly) who stayed behind with me to help me with my insertions and discharge summaries, etc. and who encouraged me and cheered me on despite my dreadful ability in IV insertion. Honestly, IV insertions bug me the most. It’s like the skills I’ve developed during the past ten months all vanished because I am now faced with “tiny people” (kids, children, the pediatric population, babies, etcetera) who incidentally have fat, rigid and restless extremities with absolutely no signs of any blood vessels. At first I took it as a challenge, but with the many insertion failures, cannulas wasted, and mothers hating my very existence, I have started to lose confidence and saw it as a very fearful task. And that is why I always put it last on my list of things to do, never mind that my patients are losing electrolytes through their stools and that they don’t get any meds because they don’t have an IV line for the whole day. Sometimes I just endorse them to the clerk on 24h-duty, or beg a resident to insert them for me. I survived the past 20 days doing every task to the best of my abilities, but sadly, I was also frequently asking favors from others and sometimes leaving without finishing my responsibilities just to at least get home by 8pm.
So today was no different from the past days. Except that I finished rounds with Dr Orog at 2pm already. My gosh. How can I carry out and finish my duties before 5pm if we finish that late?! And I had plans to leave early because I needed to buy a new pair of shoes. My new shoes lasted for only a week because the heel broke off because it got so soaked in the rain yesterday, so I’m presently wearing my old shoes which are already too embarrassing to wear because it is already too tattered and it has HOLES on the sides. But no choice, I don’t have any other decent shoes because I hate shoes because my feet are too big so it’s difficult to find sizes that fit. Anyway, so I wanted to finish early, but it just so happened that we had to intubate a patient this morning and then I don’t know, we just finished late. And I couldn’t leave Dr Orog in the ward to go to the ICU to carry out Dr Malimas’ orders because I was doing the prescriptions for the meds. So we finished around past 2pm, then I took my lunch with Hya and Pie around 230, then I went to ICU to extract blood and carry out Dr Malimas’ orders which were mostly “follow up chest x-ray result WITHOUT FAIL” or “attach serum Na and K WITHOUT FAIL” and I wanted to discharge this one patient but I couldn’t because her chart was in the billing office. Also, one of my patients in PICU was referred for venous cutdown but when the surgeons went, the watchers refused the procedure, so I had to go back to the ward to “lecture” them on their foolishness (“Nay, MATI-UROK jud na imung pasyente kung di nimu pa-dextrosan”) and after getting their consent, refer them again to surgery for the cutdown. Then I had to extract more blood from patients in the ward, go to the labs to get results, go to the radiology department to have an x-ray film read, and then I had to accompany the intubated patient for x-ray. I had so many things in my hand that I had to ask Pie to do my discharge summaries and to get my official x-ray results for me. There was not a single minute that I wasted and yet I still finished around 630pm. I doubted if I had enough time to buy shoes knowing that it’s an exhausting undertaking to find them in my size, but I wanted to leave already. But I still had to do the very last thing, and the very hated thing: IV re-insertions.
I know I had around 2 patients with no line this morning, plus 3 patients for change of new IV site and tubings. I was frustrated and wanted to cry because it was so late but I wanted to get things done before I leave. So I asked them to quickly fall in line outside the treatment room so that I could (hopefully) finish the insertions as quickly as possible. Hya joined in and to accomplish things faster, did the insertions herself and so I just assisted. The first two or three patients were very difficult and gave Hya a very hard life. Around that time, I gave up hope of going to the mall because it was past 7 already. Then, when we looked outside the treatment room, I saw a very long line of patients with no IV lines. They were all from MY ward. I was so upset, and also embarrassed because Hya was still staying behind and it was already late. Hya was also frustrated. In fact, she was VERY frustrated when she saw the long line. And then that’s when it happened.
She turned to me and asked, “Are these all your patients?! You didn’t insert IV on any of them?! What did you do the entire day?!!”
I was mortified at her questions, but the last line shocked me the most. I replied awkwardly that I had to extract blood from my patients in the ICU, and she retorted, “IS THAT ALL?!” I felt like the whole world fell on me. I squirmed and replied weakly, “Well, we finished rounds around 2 already…” and she said “oh yeah…” but didn’t sound convinced at all. In fact, she sounded a bit sarcastic. And so before I even realized what was happening, tears just started streaming down my face. Big fat tears. Tears of vent up frustrations. Tears of disappointment for the past 20 days. Tears of embarrassment from having to ask others to do things for me. Tears of anger. Tears of insecurity. Tears of shock. Tears of sadness. But mostly, tears of pain. Hya’s accusing question asking me what I did the entire day hurt me the most. She, of all people, should know very well that I wanted to leave early today and was in no position at all to be wasting any of my time. It was not my decision or my fault that so many of my patients suddenly have dislodged IV lines. And as much as I am so eternally grateful to Hya and Pie for always helping me out especially in inserting IVs, it was not like I actually forced them to do it for me. It’s not like it was my wish for us to stay so late. It’s not like I’m not trying hard enough. It’s not like I’m just sitting pretty and not doing anything and just being useless. Actually, I’m tired already of being teased as always the last to finish and always the one who’s toxic and always the one who has trouble with IV insertions and always the one who get thrashed by the watchers. It’s not like I wanted any of these to happen.
And so in front of all my patients, I cried. I refused to speak, just kept crying silently for more than 30 minutes(?) while cutting plaster for Hya. I think she too realized the weight of her statement when she saw me crying. I know she probably didn’t mean it, and she was very very sorry for it, but it doesn’t matter because it still hurts. It pains me so much. It was perhaps the very stimulus I needed to simply break down.
My face is all red and blotched now, and my eyes so puffy that they’ve become so so small already. It’s now 4am but I’m still awake and crying, and I’m on duty today. I’m NICU clerk from this day on. Bandoy said I will be DEAD (thanks Doy for your encouraging words). I don’t know. Bahala na.
11 more days till I breathe freely again.
Tuesday, January 03, 2006
[DEPRESSION MODE ON TO THE MOST MAXIMUM LEVEL]
I’m feeling really really low since the new year started. It’s because I’m now rotating in the Pediatrics Department in NMMC, and I just wanna die. I’m feeling extremely frustrated and depressed right now because we have to do all the blood extractions and IV insertions, and yet, I’m still not good at it. In fact, I’m terrible at it and now all the watchers in the Miscellaneous Ward hate me, because I’ve been pricking their babies but really not obtaining adequate blood samples. I’m a failure. I’m no good. I just wanna shrink and let the earth swallow me up. I don’t know how I will face my residents. I’ve been crying and wallowing in self-pity for the past two days. I know I will be better soon, I have to be. But right now, I just wanna drown in my anger and worries. I feel like I’m such a loser. I can’t smile anymore. My whole body feels numb. It’s as if my genki level dropped way way way down the scale, which is very unusual, since I’m a very cheerful person. But now I can’t even bring myself to feel happy. I’m just so full of negative energy. I hate myself, my ward, my patients, my situation, my work – EVERYTHING.
I’m not happy at all.
What’s lifting my spirits up is a simple text message in my phone that says:
Whenever I re-read that message, I sense a slight glimmer of hope. I see a little ray of light. I feel a touch of joy. But the strength that message gives me is not enough to make me last the whole month in this dreadful rotation. I am doomed to be depressed the whole month of January.
Wake me up when
