Next Stop: Pahang

After a long and torturous wait, and finally giving up hope of ever getting your posting as a fully registered pharmacist, I finally got my posting out of the blue, when I'm least expecting it.
I got Pahang!
Which was actually my first choice..call me crazy but my only aim was to get out of Terengganu at that time.
It took me some time to absorb it all, being stupid and ungrateful for it in the beginning and finally accepting it in the end because it is still much better than staying in Terengganu or being shipped off to Sabah.
Still, Pahang IS a big state. I could even be posted to the most rural part of Pahang! That's a chance I have to take now..

On a different note, i finally climbed up Bukit Besar for the first and the last time in Terengganu. I felt like Flubber (the green jelly-like thing) the whole way up and especially all the way down. Gah I still need more work to lose more Flubber part of me!

Hit-and-Run

I so did a hit-and-run today.
Nope, no one was injured in this case.
Yup, shame on me.
In my defense, the KKM (Kementerian Kesihatan Malaysia) owned van was only a bit scratched.
You can't really notice it unless it was pointed out to you. OK it was a wee bit obvious. But it is just one more to the multitude scratches on the van.
Whereas my car took the harder hit and it is now a wee bit dented on the back of the left side. And scratched. Ouch.

My Final On-Call

I just finished my final on-call as a provisionally registered pharmacist at HSNZ on 11th September 2010. And I had to communicate with the most arrogant medical officer ever.

Since it was the Raya holidays, most Muslim medical staff were let go of for the holidays and the Chinese ones had to stay to carry out on-call duties. And as usual during the festive season, the Casualty Department became a hectic place due to the many accidents, food poisoning, and gastritis cases courtesy of the festive season. With this hectic crowd, there are bound to be doctors who have to be borrowed from other departments and health clinics during this Raya season and mistakes in prescriptions are unavoidable.

There was this one case that totally irked me. This particular medical officer prescribed many slips with C. Ponstan II/II BD and T. Vit C I/I TDS. For two days in a row. So I decided to call up the doctor to verify the unusual doses during my on-call. Here was how the conversation went.
Me: Good evening Dr. .... I'm Ling from Satellite Pharmacy 7 and I would like to confirm the dose of a few prescription slips that I received from you.
Dr: Yes?
Me: (Proceeded with the problem at hand). Usually we give Ponstan as II/II TDS, do you really want to give it as a BD dose?
Dr: I know that the max dose is TDS, so it is not wrong to give it as a BD dose right since it is still within the max dose? I have always given it to my patients as a BD dose anyway. But since you say it is TDS then it is TDS.
Me: Alright. Then what about the Vit C? May I know what is the indication for I/I TDS? Cause usually I/I OD is adequate as a prophylactic treatment.
Dr: I usually give it I/I TDS as an anti-anxiolytic.
Me: (Reinforcing statement) But Vit C I/I OD is really already adequate enough as a prophylactic treatment.
(It's not like I can tell that doctor that:

1. We are always running out of stock of Vit C
   
2. Most patients don't even take their meds accordingly
3. There are better sources of Vit C anyway
4. I/I OD is REALLY adequate enough and it is the practice at the HSNZ A&E Dept.)

Dr: But I have always been prescribing it for my patients this way. Since you say it is I/I OD then it is I/I OD.
Me: Alright.
Dr: (Hangs up immediately)

Rude much?

But other than that, I have had quite a satisfying final on-call with new cases to handle and there were these two particular patients that made my day.

One made me took three puffs of MDI Salbutamol (which is overdose even for normal asthmatic patients and I was not using placebos) to get him to understand the MDI technique but he finally got it in the end. He thanked me and then went off happily with his meds.

Another was a Malay gentleman from Kuantan who had to get cough and cold meds from this hospital and he voiced his concerns that his inhalers weren't working for him anymore even though he took all his meds accordingly (and he was using the best inhalers too). So I took the time to explain to him about his condition and that his inhalers might not work as well due to his untreated cough and cold and his inhalers will work just as well when his condition improves. He thanked me for spending the time to explain his condition and for his supply of meds and went home relieved of one his worries.

It feels good to be appreciated and it is these small things that make you remember why you still pull yourself through with your job even when the conditions are less than appealing to you. And it definitely pays to spend a little more time to make a difference in patients' lives.

CDR Part II

Usually, we do not receive chemo orders on Thursdays because that's just the way it is. And if we do, we will only entertain those that come in before 12pm (on normal days).
However, as I was happily on my way out for lunch at 1pm sharp today (after 1 week of not being able to go out for lunch at the normal lunch time), the phone suddenly rang.

Me: Selamat petang, Farmasi Chemo.
Staff Nurse: Selamat petang, saya SN ..... dari Wad ..... Boleh tak kita indent ubat chemo untuk seorang patient sekarang? Patient baru masuk tengah hari tadi dan doktor baru habis ward round.
Me: Patient kena guna chemo hari ni ke?
SN: Ya. Keadaan patient sesuai untuk chemo..(Proceeded with patient's lab results)
Me: OK..Apakah regime chemo patient ni?
SN: FOLFOX.
Me: (OMG what the tooting hell?!) Bolehkah tunggu sebentar, saya tanya pegawai saya dulu?

Thereafter, the conversation went on.

Conclusion:
I had to prepare the worksheet and labels and take out the necessary items for reconstitution. During my supposed normal lunch time. On a Thursday.

Luckily, I did not need to do the reconstitution. If not...But there's no point having lunch at 2pm cause I get off work at 3.30pm. Crap happens.

Cytotoxic Drug Reconstitution

Yes! I made it through my first ever cytotoxic drug reconstitution process without injuring myself or killing myself with the cytotoxic drug!

Somehow CDR is still kinda boring. It's cause I have to wait for the orders to come until noon before anything can be carried out. And all I can do there is read the the manuals, protocols etc. until noon arrives and the reconstitution work can be carried out.

I can finally get back from work on time but I feel weird cause I'm so not used to this much free time. I still have 1 report and 1 CPD to do and I'm still slacking away...

Office Girl

During the past week in my new rotation at Drug Information Services I have been:

1. Making photocopies of documents etc.
2. Binding documents.
3. Cutting carbon paper into tiny little squares.
   
4. Adding up sums for statistical purposes.
   
5. Preparing and sending out papers to be signed.
6. Preparing notices for presentations.
   
7. Becoming a sort of telephone operator and letter receiver.
   
8. Updating the formulary which contains 1467 drugs (had to convert it from pdf to excel, rearrange it in excel then categorize it according to Malaysian Drug Code indication and discipline).
9. And so far, I have only answered 3 drug info queries in the past week...
   

Now I'm being paid a pharmacist's salary for doing most of an office girl's job. *smirk*

New Year's coming

Chinese New Year is coming soon and I'm so excited!
Had a sudden pang and I miss KL out of the blue, feels like a long time since I went back but it was just 3 weeks ago. Maybe it's cause of the people here going to KL in turns every week.
And it's like they say "you can take the girl out of the city but you can't take the city out of the girl".