Today... Nothing much in the morning, the specialists very late only came to do the round ward. I was looking forward to the teaching about insulin therapy, but when my friend and I reached there, the doctor said it is exclusive for HOs only. And there is no CME today because there is only a CME every forenight. Double disappointments.
However today I was given a chance to take ABG again, because initially the HO has some difficulties in inserting the branula and the patient has a bad impression of her. So she asked me to help her take it. Taking ABG is really not easy. Though able to feel the pulse very clearly and the patient is not obese, but somehow I can't insert the needle into the radial artery. The worst thing was that the patient keep making a lot of noise >.<. So the HO asked me to take from femoral artery. I was thinking, are you serious? Femoral artery? Because the risk of having hematoma is much higher. Anyway I just try and do it because she said is very easy. As she said, the femoral artery is very big and palpable, just that it is deeper. One insertion, and woopa... the bright red arterial blood flow up into the heparinised syringe. Thank God really. Since ABG was taken successfully, the patient also quiet down, but he still complained about the branula on his hand. So I warned him that if he pull it out, the doctor will poke him again.
Btw, in the afternoon 2 patients passed away. There were some medical staffs carried a metal casing to carry them away. Very sad to see those things happened.
Last week I was still wondering about asking the patient's family to decide whether to NAR or DNR for the patient. Personally I think that the doctor should do their best in saving patient's life. Today I got my answer about it. The consultant in my ward from gastro explained that the very first principle in medicine is: Patient Autonomy! If patient cannot make the decision due to unconsciousness or confusion or other reasons, it is not the family, who don't have medical knowledge and skills to make consent. Doctor is the one that should make the most suitable choice for patient according to the situation. We should just counsel the family, let them understand the reason behind the doctor's decision, rather than letting them making the choice.
What he said is true. How can the family, especially those without medical knowledge can make the decision in how to save patient? But according to the consultant's words, doctors nowadays due to pressure from boss and the family, and they want to save themselves from all the troubles, doctors will ask the family and get their 'consent' when come to making decision, but this is a wrong practice. Suddenly I remember what Peter said.
Peter and the other apostles replied:
"We must obey God rather than men!"
Acts 5:29
Sometime instead of doing things according to what other people want, we should do what God commands.
No comments:
Post a Comment