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I Ordered A Chest X-Ray For The Wrong Patient | Housemanship Diaries
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It was during my tagging period in the Surgical Posting and I was a Female Surgical Ward.
It was my first day being in charge of the acute beds and side room. I recalled one of the patients being a Urology patient. Usually, if the patient is from other departments, we are not required to review them. This patient in particular was intubated and sent to our ward to be placed in one of the acute beds for further monitoring from the Urology ward.
Upon transfer into the ward, the patient required a portable CXR for post-intubation. I did not screen through the casenote since it was from another team. The nurse in charge informed me of a new case but did not tell that the patient needed a CXR. Hence, my reply was “it’s not our patient, it is from a different team. They will review later.”
Hence, the Urology Medical Officer on call came after a while and reviewed the patient. He went to check the system and was confused as to why the chest x-ray was not done for the patient. The nurse immediately informed that I did not want to do it considering the patient is from another team.
At that time, afternoon rounds with the Surgeon was currently ongoing and I was disturbed from writing my reviews. I immediately proceeded to fill the form and had it sent to the Radiology Department to request for a portable chest x-ray.
Amidst the rush, I had wrongly written for another patient instead.
I only realised it when the radiographer came and did an x-ray on two patients at the acute beds. One, the intubated patient from another department and another which is a patient of ours.
I realised my mistake and rushed back to check the form and was met with a very angry daughter of the patient.
I admitted my mistake and was yelled at. After such a tiring week and a hectic day on top of tagging itself, I could not contain myself any longer and tears started streaming down my eyes uncontrollably.
Thankfully enough, it was just a mere chest x-ray and nothing more or a wrong operation done. Since the patient is under the colorectal team, the surgeon in charge and the medical officers in charge will proceed with their rounds again and I could not contain myself again and tears started to stream down my face again.
The medical officer in charge noticed and asked me to go to toilet, understanding that I needed some time for myself to recollect myself again. Hence, I excused myself.
After a while, I went out and rejoined the rounds and admitted my mistake to the medical officer in charge to which she laughed and said “well she has a free x-ray now and were there any changes as compared to the previous one?” To which I answered none.
She was amused considering that it was over a mere x-ray which was requested for the wrong patient that I started breaking down.
Thankfully, it was just an x-ray.
The lesson learnt here was for me to be extra careful in the future because it could have been worse and become medicolegal.
Please try to avoid doing anything out of rush or pressure and always slow down for a bit and reconfirm the patient and procedures to avoid or minimise errors.
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Writing After A Long Time
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Day 496 of my housemanship journey, a the time of writing this article.
A few months ago, I took a sweet 6-week-long break after having just completed my first year of practicing as a junior doctor.
It was unplanned and definitely a blessing in disguise.
However, that rendered me to overshoot my allocated amount of leaves within a posting . Thus, I was extended in my fourth posting, Surgery.
Ever since I came back to work on the 2nd of October, it has been a tough 1 and a half month. My body was shocked back to work and it was a tough season as there were many people leaving the department.
Working the morning shift was even more tiring than working the night shift. Hence, in order to survive without collapsing out of exhaustion, I chose to work during the night shift consecutively for days.
Looking back, only a month and a half flew by but it felt like months have gone by instead.
However, today, I am able to write after what feels like a really long time. I feel that I can slow down at least for the next month at least and enjoy my work instead as we transition into a good season in this department.
A huge batch of house officers has been allocated into this department and this morning, there are 17 junior doctors in charge of a single ward as compared to previously when there were only 3 – 4 junior doctors.
Is that a good thing?
For those who have been in the department for some time like me, we definitely appreciate this break. However, a part of me also question if they will be able to learn as much as we did?
If you are currently struggling with bad days at work, just remember that it is these days that teaches us and makes us grow and that good days are definitely coming.
For when it does arrive, it allows us to appreciate the moment.
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While growing up, when I was asked regarding what I looked forward towards in the future, I always had the answer.
Photo by Derek Finch on Pexels.comThe answer was simply, I wanted to be a Doctor (coz that’s what I knew my whole life and indirectly working towards albeit having other interests).
Thus, from primary school, next would be high school, moving towards science stream in school and pre-university in a course which would serves as a prerequisite into entering medical school.
Photo by Tara Winstead on Pexels.comIn medical school, my focus was always on the exams, completing that particular posting, completing that year, completing preclinicals and moving onto clinicals, studying for the grand finals, completing medical school and graduating.
Upon graduation, applying for housemanship to start practicing. I always knew that I wanted to practice in Sarawak General Hospital. Thus, that didn’t require much thinking. Working my way there, and finally, starting housemanship.
Now that I’m a House Officer, completing each posting, working towards completing a year, now focusing on completing the whole journey.
But after that? I feel lost and aimless.
Previously, when asked regarding my need to have a family, I would brush it off. Not that I didn’t want to but I’ve yet to meet the person that I would want to spend the rest of my life with and build a family.
My aim was mainly catered towards my parents. But they’re doing just fine on their own. Thank God for that. I don’t see my purpose anymore actually.
In regard to post-housemanship, I have no idea of which speciality I would like to dive into. In terms of being surgical based or medical based, the thing I learnt over this past 1 year is that I’m definitely a surgical based person. Though, I have enjoyed paediatrics very much (which I supposed is a very much toned down version of the chaotic medical posting).
I wouldn’t know, as upon writing this article, I’ve yet to complete my medical posting.
The medical field is not just tied to 6 different postings. As a House Officer in Malaysia, we are required to rotate to 6 different postings throughout our 2-year-duration in housemanship which are, Surgery, Medical, Orthopaedics, Obstetrics and Gynaecology and Paediatrics. The sixth posting, we have the privilege to choose among Emergency Department (ETD / ED), Anaesthesia, Klinik Kesihatan (Community Clinics) and Psychiatry.
However, in reality, the clinical field is vast and there are other specialities that we as House Officers have yet to enter. In terms of non-clinical field, it is another vast category.
Which of it am I?
At times I wished that I always knew of what I wanted to be, such as a Cardiologist or a Surgeon but after assisting in the operating theatres and working as a junior doctor, none of it appeals to me 100%. Sure it is interesting but is it something I would want to be doing for the rest of my life?
Having completed a year of housemanship, I thought that the answer would be clear to me by now. Yet, I’m still as unsure as I had been before. I’ve approached multiple seniors, medical officers and specialists and talked to various doctors from different fields regarding their experience. I seem to have the information but my heart was not fully captured by any of it.
Everything seems nice and interesting. I hope that in time to come, the answer would be clearer. The least I could do at the moment is to put my best foot forward in whatever department or sector that I go through.
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Sometime ago, I wrote about “The Small Change I Hope My Blog Would Make“, whereby I mentioned that with every article written and uploaded on this website would spread some form of comfort and positivity, especially within the community of junior doctors.
Perhaps I’m just simply being optimistic. I have to. That keeps me going, even on difficult days to the point it has become a default reflex for me.
Nonetheless, I love to write and sometimes I do get lost that I tend to deviate from the topic at times and divert back to the main topic at hand.
Living in this world which has its flaws and problems at every corner, I try to see the good aspect of things and thus, I try to end my articles on a good note or some encouragement, which is mainly directed at me actually. However, I never know who may be reading my written articles and perhaps just need some encouragement and kind words at the moment.
It serves as a “happy ending” just like a fairytale in which I escape in one too many times.
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Eric
The Theoretical Doctor
