its been 3 weeks already in the Medicine ward and i couldnt come up to write another post.
basically was distracted. now that i got a few pics clicked, i thought its time.
Medicine ward, i thought would really give me an experience in dealing with the majority of common illnesses, unfortunately though, the way we interns work there makes it unlikely.
but since no one wants to work more than absolutely needed to, this system ends up fixed in place.
the way it works is, that each intern is assigned a room in the ward, and as the room gets filled up, the intern gets more work with managing his patients.
understandably the ward has some rooms, which hardly get used, and some which are always full. dont ask me why! there are lots of reasons.
and also because we get so comfortable handling our room, we dont want to change halfway either. so i got COPD room (female) and i have been seeing only COPD (lung disease with chronic cough) cases these 2 something weeks. :P
and since my room has oxygen supply, any other case needing oxygen is shifted here as well. so once in a while i do see a variety.
otherwise, i would say medicine ward is the easiest and most slack of all the wards in our hospital, mainly because when you are on call and its your night duty, in medicine you are not expected to attend calls in the ER. the PGs are supposed to do that! so you are practically only handling the emergencies in the ward itself, which hardly occur.
yet, just yesterday i had my night. and one of ritwika's patients developed hemoptysis (coughing blood) . and let me tell you, i havent seen so much blood being coughed out ever! and the lady was in her mid 20s!! poor girl had such a hard night. she must have coughed out almost 1 litre of blood by morning, despite medicines to stop the bleeding! we had to monitor her overnight, hoping that she doesnt collapse after losing so much blood! luckily she had a healthy haemoglobin of 12 and her blood pressure wasnt too high/low either. today she must have gone for bronchoscopy (scope to view the lungs) to find out where and what is bleeding. dunno the result. will ask ritwika about it.
on the other hand a lovely incident i had in the ward, in my own room! this patient, a 70 yr old lady with COPD, still there in the ward, has been lying there for 15 days already. she was there when i arrived and basically she was on antibiotics to remove the infection in her lungs.
somehow, she kept on coughing and coughing and you could hear the phlegm inside her lungs. but the chest seemed pretty clear to the stethoscope!! so somehow, one day "chest physiotherapy" came to my mind. and i remembered i saw someone do it in paediatrics ward on a patient with pneumonia. it apparently helps to remove tough and sticky phlegm from the lungs by loosening it!
during the rounds i asked the PG (srijana) if we could do that? she seemed to like the idea and i got a hint she was surprised not to have thought of it herself. i, too, wondered why she didnt think of it herself! anyway, she asked if i knew how, i said no, she asked others, sambhav knew how! he taught me how to do it on the patient. we did it for like 10 mins. basically you have to use cupped hands to hit the chest gently from down-up.
the next day, the patient's son and his brother were so happy! they thanked me for doing that, apparently what medicines couldnt do, this little step did! its removed a lot of phlegm and she slept so much better at night after a long time! they also told me she felt so much better now.
they obviously showed how much they appreciated it. and i felt so good! i tried my best to convey in nepali that it was my pleasure. and i was happy for them.
they went on to ask me where i was from, what will i be doing after this, why couldnt i stay in nepal. how sweet! i told them i have to go back to my country :)
the son learned it from me and i guess he helps his mom out now! i was so proud that i came up with something useful, and it actually helped my patient. small things do matter!
another interesting thing happened recently, one intern and one PG got beaten up in the ER by family and friends of a patient who died under mysterious circumstances!for two days the hospital remained closed, no new cases were seen in most departments as they were holding meetings with the management for better security.
what do we care, we enjoyed the break from work!
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