Abusing Emergency Department

After being in the department for almost 2 months, I have seen literally thousands of patients and about a small portion of the patients seen in the department does not warrant an admission to the emergency department.

Few of these patients will present with insignificant body injury and then, prior to being discharged from emergency department, they will ask for medical certificate for 2-3 days. This is usually seen at the end of long weekend / public holiday.

A small number of patients who has been under followup of specialist clinic presented for a variety of complaints. Upon further questioning, their motive is to seek earlier clinic appointment or to seek earlier date for surgical operation. Truth be told, the waiting list for operation in the government hospital is very long and it is extremely difficult to get earlier date for operation unless the patient him/herself has suffered an emergency complications of the organ itself. Otherwise, I personally recommend them to go to the private hospital for an earlier date for operation. In term of clinic appointment, it is quite difficult to get earlier date unless your medical condition has deteriorated significantly over the past few months

There is quite a big group of patient who came to emergency department for insignificant minor trauma. For example, they had been involved in an accident and then suffered a small abrasion wound about 0.5x0.5 cm. Apart from that, they are quite well. Although emergency department is reserved for all type of trauma cases, I don't think this group of patients should come to A&E. At least they should go to GP first to seek the appropriate treatment. Most of the time, this minor trauma will resolved by itself without any intervention.

Emergency department is for emergency cases. If the community keeps on abusing the department for non life threatening condition, I don't think the department can cope with the large number of patient and give the best treatment for all patients.

The Last Rotation

I am now in my last rotation as a houseman. ETD (Emergency and Trauma Department) and once it was called as A&E (Accident and Emergency).

This posting is one of the best posting as it combines all of your previous learning experience in the the other postings and sharpen your skill to diagnose and manage life threatening conditions. Apart from that, this department has one of the best shift system and even the tagging period, the period whereby the new houseman enter a department, is also enjoyable.

Personally, I might be thinking to join this department as a medical officer in the future too.

La Tahzan

Dari Abu Abbas, Abdullah bin Abbas r.a : 

" Bahawa pada suatu hari saya sedang berada di belakang Rasulullah SAW ( di atas binatang tunggangannya), lalu sabda baginda : ' Wahai anak kecil, sesungguhnya aku telah mengajar kamu beberapa perkataan. Peliharalah ( perintah ) Allah, nescaya Dia akan memelihara kamu, peliharalah ( kehormatan ) Allah, nescaya engkau akan merasakan Dia berada bersama-samamu. Jika engkau memohon, pohonlah kepada Allah semata-mata. Jika engkau meminta pertolongan mintalah kepada Allah semata-mata. Ketahuilah bahawa jika semua umat manusia berkumpul untuk memberikan kepadamu sesuatu menafaat, nescaya mereka tidak akan mampu memberi menafaat itu, melainkan dengan sesuatu yang telah ditaqdirkan oleh Allah. Begitu juga sekiranya mereka berkumpul untuk menentukan suatu mudharat untuk kamu, nescaya mereka tidak akan mampu menentukannya, melainkan dengan suatu yang telah ditentukan Allah ke atas kamu. Telah diangkat kalam ( tulisan ) dan telah kering ( tinta ) buku catitan. '

The Shift System

With the recently introduced shift system for the houseman officers in Malaysia, I found that this system is better than the previous system.

There are more free time available for the junior doctors. The old system has produced an environment consists of overworked and sleep deprived doctors. The shift system helps to reduce those burden and help to improve the quality of the lifestyle for houseman officers. With more time to rest, I find that I am able to give more concentration to the work compared to the old system.

Regardless of this, there are still room of improvement in the new shift system. Overall, I hope that the entire healthcare system could be improved without any external pressure and ultimately, to give the best quality of health service to Malaysians in the future.

3 years old blog entry.

This entry was written on Monday, 19th May 2008 using Blogger scheduled post.

I'm not sure whether this entry will be published on this date or not. This is my promise to Crayon Kakak that on this day, I would write something for her.

This is her old entry 3 years ago...
--------------------------------------------------------------------------

.....3 tahun akan datang, kakak tidak harapkan anda, anda dan anda masih terus di sini. Tapi, untuk tarikh ini, 19 Mei 2008, kakak mahu langsaikan “hutang” entry yang kakak tak buat di blog AA sebelum ni. Kakak cuma ada satu permintaan. 3 tahun akan datang, pada tarikh 19 Mei 2011 [sila buat reminder, 19 Mei 2011], kakak harap kakak akan terima e-mail, mesej, komen or what-so-ever yang menyatakan bahawa “Saya Masih Ingat Kakak”. [Ini bukan paksaan. Biarlah datang dari hati yang ikhlas].
Dan ketika itu, tentunya kakak akan tersenyum dan terus tersenyum . Maaf kalau permintaan kakak terlalu tinggi. Kakak tak minta hadiah apa-apa, cukup-lah dengan yang ini.
crayon said … Kenapa 3 tahun? Kerana kakak sudah berblog lebih dari 3 tahun. Masa 3 tahun juga kakak rasa bukan satu masa yang lama, dan bukan juga satu masa yang singkat. Cukup untuk menentukan siapa kakak di mata anda ....

-----------------------------------------------------------------------------

So, who is this blogger? She has been blogging in various blog platforms. I started to know her as Aria Ayumi back when she was still blogging using blogspot. After a while, she moved on to Wordpress platform and start to use the nickname of Crayon Kakak. On 21st June 2008, Crayon Kakak was officially closed. Now, she is blogging as Diya in blogspot again.

Is this cheating? I hope it is not. The reason I wrote this entry 3 years in advance is that I'm not sure whether I'm going to live when that time comes. Death can come unexpectedly and I don't like to break my own promise to my friend.

If this entry is managed to be posted today and her blog is still available on the internet, this is my message to her.

I still remember you and your blog.

I started to know you when you were once called Aria Ayumi. Your blog was entertaining and interesting to me. It gave me a different perspective towards life and helps me to gain experience from your own personal writing.

I hope that on this day you are a bit more closer to reach your dream and not being burdened with sadness. I hope that the person that you are now, is a better person than 3 years ago.

Anything that you have learned so far....please remember those lessons. Anything that is positive, keep it and practice those lessons. Anything negative, use it as a guidance for your future.

Hafiz
19th May 2008.
Melbourne, Australia.

p/s: Interestingly, on 19th May 2008, Tun Dr Mahathir quits from Umno and later joined again on 4th April 2009.