5:25AMWhen I arrive at the hospital, SK and WJ, the other two house officers (HOs) on my team, are already in Paediatric Ward B. WJ hands me an updated patient list and signals me to join them and the night team for handover reports.
6:00AMSK, WJ and I “divide and conquer” our pre-rounds. We attend to individual patients and ask parents if their children slept well overnight, perform physical examinations and browse through their electronic charts to note down vital signs or new lab results.
We try not to wake those who are still asleep but few rouse and start crying as soon as they see us with our stethoscopes. Fortunately, I have just the trick to soothe a fussy child – a few strips of animal stickers that are stowed in my trusty sling bag.
7:40AMThe entire team is present – the ward specialist, three medical officers (MOs), three HOs, two nurses and four medical students – and ward rounds begin. We update the team on overnight events, vital signs as well as lab results, and discuss each patient’s plan for the day at their bedsides. The pace is swift, and my neat handwriting turns into a messy scrawl.
During our presentations, the stern attending specialist sometimes interrupts to clarify some points, or to quiz us on clinical questions that are relevant to the patient’s illness.
10:50AMAfter reviewing all thirty patients, SK excuses himself to escort a patient for an MRI, so WJ and I are left to delegate our to-do list. WJ prepares for blood-taking procedures while I start writing discharge summaries.
11:10PMA nurse informs me that a febrile four-year-old with dengue fever has been admitted. I go to Bed 12 to meet the boy and his family, introduce myself and begin to take a medical history. I gather some information from his parents and do my best to examine the crying child.
After reviewing his blood results, I decide to start him on some intravenous fluids and note down plans to repeat a full blood count in the evening.
12:00PMSK has returned to the ward, and is speaking to a nutritionist over the phone. I return to the nurse’s station to complete the summaries, but WJ calls me to help him with an intravenous cannulation.
2:00PMWe hustle down to the conference room for a continuing medical education (CME) session. A houseman presents a case of Tetralogy of Fallot, and we discuss about cyanotic heart diseases. I finally have time during the session to drink some water and eat some raisins that are being passed around.
3:30PMThe CME concludes and we return to the wards for evening rounds to make sure each patient is doing okay. We also check on the patient in Bed 12 and review his care plan.
4:05PMThe head nurse informs us of newly admitted patient in Bed 20. A specialist from the Suspected Child Abuse and Neglect (SCAN) and two police officers are also present. I notice that the eight-year-old has three stitches across her right forehead and a bruised lip. The specialist performs a thorough physical examination, to reveal that she also has more bruises on her back and buttocks which raise concerns for child abuse.
While WJ notes down findings and plans in the progress notes, I am asked to request for an X-Ray for the patient.
5:30PMThe on-call team is here for handover, and we go through our list of patients and inform them of what they need to know in order to take care of them overnight.
6:10PMThe handover is interrupted by a nurse who alerts us that a patient’s mother has fainted and has become unresponsive.
We immediately attend to the lady – a young mother in her mid 30s whose infant daughter was admitted for seizures. She regains consciousness by the time we approach her, but looks tired and confused. After a quick assessment, we find that she is dehydrated and has a slightly elevated heart rate.
Unfortunately, she hit her head at the corner of the bedside table when she fainted, and is bleeding from a deep cut on her forehead. I help her to the procedural room to clean and suture the wound under the supervision of my MO. We also start her on intravenous fluids, and report the incident to the specialist.
7:30PMAfter an exhausting day, it’s finally time to go home and rest up for another eventful day at work tomorrow. MIMS
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