Busy + Sedih + Letih

Salam'alayk

Hari ini wad sangat busy...sangat, amat, amat, amat! Allahuakbar..
ingatkan syif petang selalunya rilek sket..terlupa plak yg sekarang dah di medical ward K12, no longer in K6-ortho ward.
Nature medical ward memang sentiasa sibuk sebab got a lot of patients with many + different cases huuu mcm tak biasa plak pun bole..
em aku menjaga acute cubical yg kedua hari ini. Selalunya ak akn menjaga acute cubical yg pertama. Nak ubah angin plak hari ni =p
Usually acute cubical yg kedua ni tak banyak la patient yg perlu hourly vital signs monitoring tapi hari ni ada 3 patient aku yg perlukan hourly observations.
Vital signs mean checking the blood pressure,pulse rate,respiratory rate,temperature and level of oxygen saturations.
Acute cubical is the place where chronic patients and those who need higher monitoring or high dependency are placed. I don't know why, here in HOSHAS, we, the IIUM student must in charge of this acute cubical and even the Sister of the ward already told us so. O-kayy..no objection.
Em around 6pm like that, patient of bed 24, P.cik Razalin informed me that he had difficulty in breathing when I passed by his bed. He's already wearing nasal cannula with 3 liter oxygen[nasal cannula= one of the devices to supply oxygen].
His diagnosis is = Chronic Cardiac Failure (CCF) + Sinus Bradychardia. Coincidently, Nanad was just standing at the next bed therefore i asked her to help me to prop up the patient to Semi-Fowler position. Then,i quickly informed the staff nurse in charge, Kak Huda about P.cik Razalin. She asked me to keep monitoring his oxygen level.checked his oxygen level and it was so good and no problem at all.100%. normal level of oxygen saturation in the body = 95%-100%].
But the number appeared in the pulse rate column made me unhappy =( red in colour.ohoo that is not a good sign! 42. brady!
[normal range of pulse rate= 60-100 beat per minute]. it is not so abnormal since patient has sinus brady but it is dangerous! brady case is so serious + dangerous. high monitoring is required.informed the staff nurse again n DR Ng, HO incharge noted. em tried to checked his BP but failed! cannot feel his pulse. Sangat laa slow n sayup2 je bleh rasa huu..asked Manjung student to repeat n the result was still same. try amik BP guna manual pun tak dapat..sampai gi pinjam stethoscope DR Ng! haha..em i left mine at home =(
finally staff nurse tried to do it but also failed..huuu..em MO on-call was called n few mins later, she arrived. Dr Nurul Hana.
Em patient next to P.cik Razalin was P.cik Basuri, bed 25.
Diagnosis: Basal Ganglia Bleeding. his condition was worse than P.cik Razalin actually but he's stable. Half-conscious. Around 4-5 o'clock i'd already done suction on him because there're a lot of mucus in his oral-pharyngeal tract. Accumulation of mucus on oral-pharyngeal can cause airways blockage and will lead to short of breathing.
While I'm buzzing around attending p.Cik Razalin, I already heard the snoring-like sound of P.cik Basuri due to the accumulation of sticky sputum inside his mouth. Inside my head, i'd planned to do suction on him right after P.cik Razalin condition improved a lil bit. Suction is a sterile procedure, done to suck the mucus that block the airways tract. it can be oral,nasal or trachy suction, depends on patient condition n docs ordered.
Em monitored the two of them at the same time, sharing 1 machine but one used the BP cuff n one used the oxygen sensor hehe kenalah kreatif sket.. em bila Dr Nurul Hana pun dah sampai kt P.cik Razalin aku pun trus blah ke katil P.cik Basuri dan...
aku nampak suatu keadaan yg kurang menyedapkan hati..kenapa muka p.cik Basuri dh pucat kuning + bunyi snoring tu dah hilang dri pendengaran? aku pegang tangan dia. Sejuk. Ak cari pulse. none! Allah Allah.. oh my God! aku terus panggil Kak Huda yg masa tu tgh dgn Dr Nurul kt katil P.cik Razalin
aku trus buat suction n as expected memang byk mucus dia. machine BP tu beralih tmpt. P.cik Basuri lebih memerlukan perhatian berbanding P.cik Razalin dan Dr Nurul pun terus attend p.cik BAsuri dan bermulalah situasi yg bertambah2 sibuk..
emergency trolley ditolak, cardiac monitoring was on dan beberapa staff nurse lain yg incharge di cubical bahagian depan berlari2 datang. Emergency + critical situation! senior MO pun dtg after that. Ya Allah tolong..
pantas semua org bagai tahu memainkan peranan masing2. Dr Nurul arahkan aku ambik ambu-bag utk bagging patient. Senior MO [alamak, tak ingt nama plak] pantas intubate patient.Dr Nurul terus buat CPR utk patient dan aku ambil port di kepala katil utk terus bagging patient. bila penat bertukar ganti dgn Che Kasma, student Manjung. CPR pun dilakukan bergilir2 bila masing2 dh kehabisan tenaga, Dr Nurul-staff nurse Haliza-staff nurse Anzah-staff nurse Huda-Che KAsma dan ramai lagi..staff nurse minta aku ganti utk buat CPR tapi ak tak berani ambik risiko sebab aku belum ada lesen CPR lagi, tak pegi CPR course masa last sem sebab kena attend prog lain. nama aku tak naik dlm CPR course tapi naik kt baktisiswa huuu..
em tiada perubahan di cardiac monitoring machine, pulse dropped, BP dropped, oxygen level dropped dan staff nurse Haliza mengarahkan aku get ready utk prepare for LO. [LO=last office=the last procedure that nurse will perform b4 patients 'go forever' atau bahasa mudahnya membersihkan patient + m'kafankan]
aku jadi sebak seketika saat itu sebab bila tiada improvement kt cardiac monitoring machine, maka faham-fahamlah..
terasa sebak sebab he's my patient! i'm in charge of him!tough hajar tough!
bayangkan depan mata kita tgh dok monitor dia, tgh buat suction..recovered just within few mins. Alhamdulillah my recovery process didnt take so much time =)
dan setelah semuanya berusaha dgn gigih dan berhempas pulas, sesungguhnya hanya ALLAH Yang Maha Berkuasa. He knows best. Kun Fa Ya kun.. di cardiac monitoring machine, hanya ada garisan panjang...asystole! Innalillahiwainnahilaihiraji'un...
aku menyudahkan LO bersama Che Kasma sebelum org dri Forensic Department dtg utk mengambil jenazah..
baru terasa nk tengok jam..Allah Allah 8.35pm dah rupanya huuu
em tak bleh blahnya bila p.cik tukang tolak trolley jenazah tu smpai, kmi blum siap lgi buat LO dan pcik menjenguk kami dan terus berkata
'alah buat biasa2 sudah, balik umah nnti nk mandi semula jgk jenazah'
dan tangan dia pun cepat je mencapai hujung kain putih membalut tubuh jenazah
'helloo p.cik!! could u please don't interrupt my job?'
bentak ak dalam hati!
ni bukan soal balik rumah nnti ada mandi jenazah semula ke apa, ni soal tanggungjawab okeyyy..i'm doing my job so please laaa..stay away!
aku tunduk bwh je sebab menahan rasa geram! malas nk tengok muka p.cik tu sebab kang tersembur ayat berbisa lagi beracun + cyanide haaa terasa berdosa seumur hidup plak aku..
sedih dgn sikap p.cik tolak trolley tu huuu =(
w.pun itu hanyalah jasad yg tak bernyawa tpi kta still kena respect wahai p.cik!
em baru nk gerak kemas2 trolley, barang2 smua, patient bed 22 pulak panggil.
Ya Allah she's shivering! checked oxygen, informed staff nurse, checked temperature, OMG! 39 degree celcius..demam teruk!!
'kak Huda, 39!'
'bagi PCM 1g stat!'
lantas aku gi ambik PCM=paracetamol aka panadol dan haruslah menumbuk ubat2 tu dulu sebab nk larutkan dlm air sebab patient tu takleh makan guna mulut, she's on naso-gastric tube huuu tube makan yg masuk kot hidung tuuu..
akhirnya, kuar drpd wad pukul 9.20pm..
pancit!