Thursday, April 03, 2008

Bravo, David Archuleta!

A BEAUTIFUL performance this week, of Dolly Parton's moving Smoky Mountain Memories.

It brought tears to my eyes with its poignant lyrics, soaring melody, and of course, David's amazing voice.

He really should record a Christian song album one day ( depending on his American Idol contractual terms, should he sign on with them ).

*spoiler alert*

Ramiele Malubay is out, with Brooke White and Kristy Lee Cook rounding out the bottom 3.

I'm predicting David A and David Cook for the finals.
Carly Smithson and Michael Johns may fight for #3.
Jason Castro will be kicked off soon if he remains complacent.
Let's see if I'm right.

Interesting Read

Thanks to a friend for bringing it to my attention.

No-one knows what we're doing at the A&E level, and it's easy to blame us for problems that appear to be direct results of our alleged "mismanagement".

This couldn't be further from the truth. The lodgers aren't technically the A&E's problem, but the hospital's. As such, the hospital should take steps to find solutions and clear inpatient beds.

Furthermore, A&E departments all over the country have implemented new work processes to minimize admissions ( e.g. observation units, vetting of admissions by seniors ), but we still can't stem the tide where lodgers are concerned, 'cos there's a persistent shortage upstairs.

I obviously can't comment about the internal workings within my institution. But I feel it's important to let the public know that the A&E isn't sitting on this, and that some of the work has to be borne by others as well.

Can a hospital pride itself on being "JCI-accredited" if it flouts guidelines on patient privacy, safety and medical management? When will a brave soul ( or even better, a few brave souls ) say "to hell with popularity and making pots of money" and do what needs to be done?

There's been a major surge in patient attendances this week. I did 2 calls in the past 5 days, and had to work non-stop during both of them ( usually, seniors can rest for a few hours once things settle down ). I've noticed a significant number of people coming in the middle of the night, for complaints that are (1) minor - meaning they can wait till office hours, (2) protracted - i.e. been around for days / weeks even, but the patient decided to come to the A&E at that unearthly hour for a check-up, or (3) MC-related - they're already awake ( doing who knows what ) and came early to beat the peak-hour crowds and get medical leave quickly so they can go home and sleep.

May I remind you all that manpower during night shifts is skeletal. At my department, there're only 5 doctors on call between 12mn and 8am, at least 3 of whom are medical officers. We're expected to handle all the resuscitations, as well as the critical care and consultation cases. When we're preoccupied with resus patients, the other queues understandably pile up. That's when patients and relatives start complaining, since they have no insight into the inner workings of a busy, shortstaffed A&E.

Put more doctors on night shift, you say? Give us more medical officers then. We don't have enough to go around as it is, and a nunber of them aren't even deemed efficient or safe enough for night shifts. The senior doctor pool is also being roped in to do more nights to make up for the MO shortfall -- a wise move since seniors make faster decisions and can attend to ill cases with minimal backup.

Sadly, morale in the department seems to be at an all-time low, with frequent MCs among the MOs and constant exhaustion all around. These just add to the whole problem in a vicious cycle pattern. I'm getting really sick of it.

Anyway, that's just me grumbling. We all know things will probably stay like this unless someone powerful steps in, takes our concerns seriously, and implements some major changes.

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