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working in a hospital

I take my work too seriously. Jiahao ccan testify to that.

Half the time, I bet nobody takes me even a quarter times as seriously as I do myself. That's why I tend to be affected a little too easily I guess. Can be good, can be bad, who's to say right?

It's my first independent week in the wards as a full-fledged pharmacist all on my own. 2 episodes have struck me hard:

1) A certain Dr from my ward came over to me one day and asked. This Fluconazole, is the dose ok? I stumbled and said I would check. And check I did, even though I rmbed very clearly why we started the pt on the drug the day before, and why we chose that dose. Just had to be doubly sure. So I confidently got back to him with my answer, and his response left me in shock. He said "this patient has a crcl of ___. Is that too high?" For the love of pharmacy, I did not check the renal adjustments of this drug. And he addressed me "Ms Koh" (nth wrong with that, but it just didnt sit very well w me lah haha)

Lesson learnt: Read the whole bloody monograph. If I can't do my job properly as a pharmacist, why do doctors need me in the team? And dear Dr, I will be sure to be ahead of your qns before you get the chance to "Ms Koh" me again. You good ah. (Y) But really, thanks for the humbling lesson.

2) I entered the ward on Monday and saw one particular pt who was admitted since feb, who had a long chain of antibiotics history. She was by then barely arousable. I had a gripe with the choice of Abx as I thought it could have been more aggressive to try and bring her back. Although, it was alrdy decided that we've reached the end of the line of this pt. I checked and checked and checked with various seniors, and hesitated to challenge the decision. Eventually, in view of the fact that it probably wouldn't have made much of a diff, I went away on Tues thinking "ok, I will trying discussing with the dr nonetheless tmr morning if she's still on the same therapy." Lo and behold, I was madly sick on weds and had to take an mc day off. today, when i returned to ward, the bed was empty. passed away at 6am it seems.

Lesson learnt: Sometimes, it really is true that you can't save everyone. Frankly, I had a 60% gut feel that nth would've changed even on a new antibiotic, plus the pt was so old. It just struck me, because her son was always thr. I also rmb the fruits/chicken essence at the end of her bed, where there was a note written in chinese "dear mother, we hope you get well soon." And it struck me further that my own grandmother was also warded somewhr else, how much would i have wanted the drs to keep trying? I don't know. I don't think the course of treatment was wrong, however, my lesson to myself here, is to just ask if ever in doubt. To not be afraid, for the sake of the patient who might need my intervention. and finally, to never leave an intervention till the next day to "see if they'll change their mind." That is my job- to convince them.



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