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Thursday, December 16, 2010

Pembahagian itu

4++am. I’m in ICU. Alhamdulillah semua patients stable.

Got to work early tadi, dalam 10min awal. The day docs cam pelik apsal aku awal, slalu lembap semacam je kan. Hehehe. :P
Went to send hubby to Malvern East train station coz he gotta get his car from the city. He left work early around midday coz he was unwell. Kesian hubby L I didn’t realize he called during that time coz I was already fast asleep. Bila bangun in the evening hubby was lying down flat on the floor in the lounge mengadap tv. Kesian dia. Makan pon taknak coz kurang sihat. Hopefully it wasn’t something that I made yesterday.
I didn’t get to spend that much time with him before work coz aku bangun pon lambat. Sempat makan some junks before going to work, then left to send him to the train station. Tu yg sampai awal kat spital tu :P

Kat hospital ni ada 12 ICU beds. The hospital is only funded for 9. In a critical situation where u need more beds, this hospital can create 3 more beds, provided the 6 are not that sick but not ready for ward yet that these will be stepped down to HDU (high dependency) patients, instead of ICU (intensive care). Which means, 6 will be very sick ICU patients needing 1 to 1 nursing & the other 6 will have 1-nurse-to-2-patients nursing. Kalau ada people yg need ICU beds & ICU are full, these patients will need to be transferred to a different hospital that has ICU beds available. And kalau hospital ni really desperate, the 6 HDU patients sometimes are discharged to the ward prematurely with ICU liaison team reviewing them daily on the ward. This is in term of the nursing.

In terms of satu katil brapa cost untuk man & service (linen, etc) will be ~AU$3500. Tu belum masuk if the patient needs ventilator, intra-aortic balloon pump, Vigileo cardiac index machine, monitoring, ionotropes, art line, CVP, all the nitty gritty termasuk setiap gauze, gloves, fluid drip, syringe, oxygen mask, blablablabla. Cost akan naik. So imagine if a patient is ready to go to the ward but ward bed is unavailable. So the patient will be stuck here in ICU, using all the resources that’s meant for a sicker patient needing ICU.

See how the resources are spread out kat spital ni? Tu baru ICU je. Well most public hospitals are like this. Ada Nampak tak kat mana funding might be a little bit not enuf along the lines?

Sibuk plak aku pasal finance & economy of the hospital. Yup, as u grow further into ur career its not only ur patients that you have to think about. U also hafta think about especially your own professional development, which means training & passing assessments. And, whether u like it or not, u hafta think about the funding distribution & expenditure of the unit u r in as well. Pretty much these will actually influence ur patients’ care. As much as ideally kita tak peduli about all these complex things and nak treat patients based on what we actually learn at uni/ along the way. But pretty much being a doctor doesn’t only mean a person who treats a patient, but also a leader, an educater, a carer of the funding, a manager, an advocate..
not to forget; a friend and a human being...

Waaahh, philosophical plak aku ye.. seperti kata one of my intensivist bosses.. ICU is all about physiology, pharmacology aaaaand philosophy.. heh..

Lepas abis shift pagi ni kena gi hantar timesheet kat HR. Nak dapat gaji kena la pegi every fortnight hantar timesheet kat building yg sama dengan psych ward tu. Bohsan betul. Setiap fortnight aku kena jalan kaki pegi situ. Kadang kalau not rostered terpaksa drive jauh-jauh semata-mata nak hantar timesheet bodo tu. Hubby kata apa punye health care system la Negara maju ni still guna paper timesheet to get paid. Apsal tak guna online system je, bukan takde technology tu kat Negara maju nih. Hmm... malas dah nak komen banyak-banyak.. just don’t get me there. Aku memang bersetuju sangat dengan kenyataan dia. Haha.

Oh ye, risau plak aku tengok weather forecast for the rest of December. Macam spring punye weather forecast plak. Aiyaaaaa... aku ada macam-macam plan for the next 2 weeks ni.
Hmm... Hujan rahmat...

But I hope that starting this end of week until at least Boxing day it will be a very nice day everyday... Amin! Ada lah plan aku, nanti cerita.


azian said...

salam doc,
salam kenal...
seronok baca blog...

A~ said...

hi azian. thanks lots for visiting my blog yg tak seberapa ni. (malu aaaiiii!!)
salam kenal too :)

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