Sunday, October 19, 2008

Professional Doctors? How About Professional Patients!!??

Preface:



Electrocardiogram (ECG) is an investigation that allows physicians to 'visualize' the heart based on the direction the electrical impulse travel in the heart.

This is achieved by placing the ECG leads on the limbs and the chest. There are 6 chest leads and their locations on the chest look like this:



[End of Preface]


Last week I had the 'opportunity' to take an ECG from a patient. Normally doctors would simply say to any of the nurses "Kak, ECG bed ini ah." But us medical students don't get to speak to nurses that way. So we tell the student nurses instead (heheheh. This is how we pick up bad habits from our seniors). But the batch of student nurses in the ward that day was a new one. None knew how to do ECG. So it had to be yours truly lah.

I have to point out that this patient is different than the one depicted in the picture above. She is about 60 years old and weighs around 90kg. So a proper representation of her would be something like this:


Don't act innocent lah.
(Photobucket disallowed the original picture. So here is a more viewer-friendly version)

A student nurse was there to chaperone me, but did nothing more than clipping the limb leads. I had to be the one who apply the chest leads on.

It was tricky. The left breast was really in the way. However, throughout the years of training, I've managed to keep my cool and maintain a striaght face. "Makcik, saya kena letak sensor pad ni kat bawah ye. Boleh ye Makcik." She agreed.

Leads 1, 2 and 3 was easy. 4, 5 and 6 were the difficult ones, and in ascending order. Clearly I was short-handed (pun inteded! WAAHAHAHAHA!). I had to alih the breast upwards a bit, and still the celah was still too deep. Leads 4 and 5 attached. I moved to the last and most difficult lead, lead 6.

This was very very tricky. In the end, I had to resort to just pushing the lead with my hand as deep as possible.

It was heavy, warm, and sticky (nak termuntah aku ingat balik benda nih). Finally the lead was in place. Just as I was about to move my hand away and thought that things were ok, this Makcik gave me a quick, discreet, naughty, smile. OH MY GOD!!! ARRGGHHH!!! Why????!!!!!!!

Quickly I pressed the buttons on the ECG machine and print the reading. I told the student nurse "You cabut semua balik cepat-cepat." I stashed the leads in the drawer and pushed the machine away. No thank you. No good bye.

No amount of chlorohexidine can wash the guilt stain I have on my hands. Tidaaaaaaaaaaaakkk!!!!!!!!!

37 Comments:

Blogger yipwt said...

oh man..i am beginning to envy your job...

19 October, 2008  
Blogger Azman said...

Yip, are you serious??? 60-year-old lady wei!! Nothing to envy! Hahaha.

Wait wait. You're being sarcastic kan? haha. Demmit.

20 October, 2008  
Blogger KOOKY KASH said...

Man, ni test je. Kalau you pass, dapat awek2 yg muda-gebu.

What about male gynae? Diaorang punya job lebih menarik agaknya?

20 October, 2008  
Blogger Izrin said...

wow man! best nya.. haha.. ok i didnt mean it that way..haha.. but at least, u have a reason to do it.. next time kalau ada orang muda yg cun sexay, then i think instead of u blah cpt2, the leads do not just end at 6. terlebih-lebih seronok plak nanti..:p

20 October, 2008  
Anonymous Anonymous said...

hhahahahahahahaahh siak lu man...gua hampir nak tergelak kat opis!

Isma

20 October, 2008  
Blogger Bagan said...

May there one day be a young bodacious female patient who needs that...eheheheh!

20 October, 2008  
Anonymous Haza said...

Alamak, that "Bagan" was me, I din realize I was posting with hb's account! Sorry! Inilah akibatnya suami isteri ketagih blogging!

20 October, 2008  
Blogger Azman said...

Ehem. Saya adalah seorang jejaka yang professional dan beretika. Ehem.

Hahaha.

20 October, 2008  
Blogger yipwt said...

The proof of your 'professionalim' ehem...is on the makcik's face...

enuff said..hahahaaha

21 October, 2008  
Blogger Dr.M said...

HAHAHAHA! LAwak ahh.. Such an innocent post from an innocent carer who'll have to do this on a daily basis.. HAHAHA

21 October, 2008  
Blogger Dr.M said...

btw : 2nd November I'm doing the Genting trailblazer lah. HaiiYAAA !!! Rosak plan kita nak berkain pelikat for Terry Fox run.. bule start movement ni ! Haiiyaaa.. tak bule join !

21 October, 2008  
Blogger bola2api said...

weh.. ada gak 60 y.o. rupa mcm joan collins ker.. anita sarawak ker..

diorang punya ehem ehem mesti masih best lagi hahahahhaha

24 October, 2008  
Blogger Dancing Ciken said...

HAAHHAHA

01 November, 2008  
Blogger JustJasmine said...

It's now quite scary having to go to a male doc...

22 December, 2008  
Blogger Daniel Ng said...

LOL! i love the viewer-friendly version of the picture!

22 December, 2008  
Blogger bluestarstsl said...

it's funny to read this article. haha
are you still a medic student? or already houseman?

22 December, 2008  
Blogger Azman said...

JustJasmine: I understand. After a while, male doctors get so used to it, they forget a female patient's anxiety never wanes when it comes to male doctors examining them. But ethically, a female chaperon must be present at all times, everytime a male doctor is examining a female patient. It's the patient's right to request for a chaperon.

Daniel: Haha. Subtlety is the key.

bluestarstsl: I am still a student. My final exams will be on the end of Feb. Hopefully I'd start work in May next year.

22 December, 2008  
Anonymous Anonymous said...

all i wanna say is ure not professional, how can u be a doctor when u have that kinda attitude?

22 December, 2008  
Anonymous Anonymous said...

u think student nurses are your hand maidens? we learn the ecg too okay, there's no need for assistance la babe, pls respect the pt's dignity.

22 December, 2008  
Anonymous Anonymous said...

nothing funny about doing an ECG on that lady... ur attitude is way not professional at all... a disgrace to the medical community...

22 December, 2008  
Blogger Azman said...

Anonymous: I took a verbal consent before taking the patient's ECG and she agreed. I made sure the curtains were pulled. Like I mentioned, it was a new batch of student nurses, so none knew how to do ECG. Granted, the senior student nurses know a lot more, and some know more than me. I enjoy working senior student nurses because I get to learn new things from them. I didn't boss around the student who assisted me, and true, I didn't need assistance, but I needed a chaperon. She was kind to accept my request, so in return, I took the liberty to teach her how ECG was performed.

Clearly I neither take advantage of the student nurse nor the patient.

I didn't find the situation I described as funny. I find it disturbing. People who read it find it funny. If you don't get what I mean, just wait till one day when you're sponging a 56-year-old paraplegic man, and when you were about done, he says to you "Nurse, thank you for giving me a good time."

Good luck, comrade.

23 December, 2008  
Anonymous laila said...

this thing about doc-nurse rivalry mmg is everywhere kan?

23 December, 2008  
Blogger Satish said...

that was awsome azman..can i link you dude ?

23 December, 2008  
Blogger Iron Butterfly said...

omg. hilarious. adoi. how old is she again? 60? isk. (refraining further comments takut kang ader self-righteous anonymous hentam u more).

23 December, 2008  
Blogger Azman said...

Typo in my previous post: I enjoy working WITH senior student nurses..

The typo can mean so many other things, good and bad. Haha.

Laila:I notice it's not just doctor-nurses conflict lah. Consultant-specialist-doctors-nurses-housemen-student are all affected lah. You may loop the lineage whichever way you want, and I bet some conflict will be there. It all boils down to respect, give-and-take, humility and being courteous. Someone can be the greatest consultant physician or surgeon, but if the person has a cock of an attitude, it means nothing.

Satish: It would be an honour. :)

Iron Butterfly: Hihi. Nasib baik you paham.

23 December, 2008  
Anonymous ed said...

dude, found this link through kenny sia, man that's funny, especially on the 6th lead, wahaha!

23 December, 2008  
Anonymous Anonymous said...

hie azman, im sorry for the misunderstanding, i didnt know u enjoyed working with student nurses, no hard feelings k- from a senior bach. student nurse

23 December, 2008  
Anonymous von said...

anonymous so touchy n sensitive.

24 December, 2008  
Blogger AmyKsy said...

funny!

24 December, 2008  
Blogger Azman said...

Ed: The patient berpeluh. I also berpeluh. The only difference is that, I have her peluh in my hands!!

Anonymous: Hey don't sweat the small stuff. Miscommunication happens even between lovers, apakan lagi total strangers.

Von: No big deal lah. :)

AmyKsy: Thanks!

24 December, 2008  
Anonymous Anonymous said...

Hospital mana ni? I nak buat appointment..;o)

24 December, 2008  
Anonymous Anonymous said...

v6 should be placed on an imaginary horizontal line from v4.

Your diagram is wrong.

from another medical professional.

24 December, 2008  
Anonymous Anonymous said...

that is your problem... you like to offer medical scenarios to ppl to show off... and probably attract some traffic... and like you would really spondge a pt and clean them up...

tell you what, pass your final, and complete your housemanship first, then come back and read this post again... and see what would you think that time.

there is nothing wrong with the V6 position, only whether ppl can interpret the ECG correctly or not.

24 December, 2008  
Blogger SpankHugKiss said...

hahahahhaha

dats a good one..

veru cute of the mak cik..!!!

24 December, 2008  
Anonymous Anonymous said...

kalau kamu kat russia lagi best. Makcik semua tak mandi. U guess bau ketiak lebih busuk ke bau dari bawah buah dada? lol.

25 December, 2008  
Blogger Blueapple said...

nice one... we need a few moments of laughter in our life... cant be too serious all the time rite?

i'll link u too..if u dont mind..k

26 December, 2008  
Blogger Azman said...

Anonymous: Yes, you're right. V4, V5 and V6 should all be on the same plane. It was an honest mistake of mine.

Anonymous again: What if I tell you I have sponged patients before? And there's no reason for me to attract traffic to my blog. Not that there's any add or counter. I don't earn anything. Show off? How?
Yeah, I will take your advice. When I'm done with housemanship, I will read back all that I've written, although I might find it troublesome as there would be hundreds of other similar stuff I would have written in between.

SpankHugKiss: Cute? Haha. At least I don't find it that way. :P

Anonymous 25 December: Hohoho. I don't want to meet them mother Russians.

Blueapple: Glad you got my point Blueapple! Feel free to do so, and thanks! :)

27 December, 2008  

Post a Comment

<< Home