Atrás a trabajar..

Salam..

It has been quite some time since my last entry here.. and the main reason for it is that I'm now back to work..

It was definitely unplanned.. initially, I chose to be out of work as my dear hubby is working in the ED & I knew that his shifts are changing every week.. and it would be very inconvenient for us.. and I was proved right! last week I was working from 8am to 5/6pm and he was doing the 4pm-12am shift.. and this week he is doing 6pm-2am shift.. so we barely had the chance to speak to each other.. and for the past week, I had been breaking fast all by myself except for a few nights that I went out & the night that a few friends came over.. we are 'lucky' as for now as it is just the two of us.. I can't imagine the time when we will have children of our own.. I really don't think that this is sustainable..

I have been seriously thinking about non acute medicine.. although I love acute medicine, I don't think that I can survive a few more years to come before we can achieve the position that will allow us to have reasonable working hours.. A few days ago, we were discussing about this matter in our team.. about how many doctors chose the field that would give them the chance to have life outside the hospitals.. one of my colleagues was saying, the top achievers in his class are all taking radiology as they chose to have a good working hours.. and he himself is planning to pursuit haematology.. I do agree.. internal medicine are far too busy.. especially being a registrar.. during oncall, basically the registrar is taking care nearly all of the patients in the hospital - he/she needs to review all the new admissions, the sickies in the wards, the HDU patients and the surgical patients that need medical review.. it is a very demanding job.. I am not surprised that foreigner doctors are filling up the general internal medicine specialist registrar schemes as many of the locals chose not to do internal medicine..

And as for me, I haven't decided yet.. still doing lots of thinking.. many factors need considering.. and along the way, I continously seek the guidance from Allah... for He definitely knows whats best for me.. Although I have planned to be off work during this Ramadhan, He has better plan for me.. coming back to work this time makes me realised that I actually enjoy & miss working.. especially with great colleagues! I will definitely miss this team.. from my lovely SpR, 'crazy' fellow SHOs & superb interns, we are the A team! (or at least that is what we thought;p).. we are having great time together.. and I thank Allah for giving me the chance to enjoy my work.. and I hope I can stay happy & keep enjoying my work in many more years to come.. ameen..

I wish you happy celebrating the remainder of this Ramadhan..

Unsustainable..

Salam..

Not so long a day ago, I had vented about the stretch me and my fellow colleagues in ED are facing to keep the department, at the very least, crawling, if not walking.. I can say with very confident that I enjoy working in Emergency Medicine, and that is a fact.. But right now, because of shortage of personnel in the job, it feels like I am being sucked into the vortex of 'Job comes first, Life only then'.. It's like in the army!

Rota

The new rota has been proven rather 'inhumane' for us.. Tough, to say the least.. At the present, we are doing 12-2-14-break schedule.. That's twelve days straight (5x 9-hour shifts, then 2x 12-hour shifts, and then 5x 8-hour shifts) starting on Monday morning, finishing midnight on Saturday the week after.. Even that seems breathtaking to explain!

And after that is the long-awaited, highly-anticipated weekend off.. That's the '2' part..

And then, the nightmare stretch begins..

Five days of 6pm-2am shift Monday to Friday,
then 2pm-2am Saturday and Sunday,
then midnight-8am Monday to Friday,
then 8pm-8am Saturday and Sunday..

And all that is really hard to swallow..

After all that

After all that, then we get the deserved break for a week (after a week of nights, which is standard) but also have the opportunity to pull an annual leave entitled to us for another week.. Which in total gives us just under two weeks of leave.. Now, doesn't that sound lavish?

Of course, it does.. And I like the breaks! But, is it humanely possible for a doctor to work 26 out of 28 days, albeit shift work.. Sure, you wouldn't let a pilot fly an airplane for more than twelve hours, you don't see a truck driver on their ninth hour on their shift!

Venting.. Is that all there is?

Not really.. There is also the legality of it.. The European Working Time Directives (EWTD) has documented that doctors are to only be allowed to work at a maximum of 48 hours per week.. I'm sure by now you have your calculators out and start adding up the hours than you and I are clocking every week..

As for me :
Week 1 - 69 hours
Week 2 - 40 hours
Week 3 - 64 hours
Week 4 - 64 hours

Ooh.. That is easy way off the scale for legality, isn't it?

Well, hopefully the people of Ireland will understand this situation and will start talking and writing to local and national politicians, newspapers, TV stations and make the policy-makers understand what they are doing putting the populations life in the hands of overworked medical professionals..


Hopefully, in the next near future, Miss Harney will change something and make the system better, before it all collapses and lives are sacrificed..

Salam..

Tough.. And It Will Only Get Tougher..

Salam..

Just under a week (I guess) from my last entry, and here I am now again facing the blog page, scribbling nonsense.. Maybe, it is just another way of me venting..

Ramadhan

Alhamdulillah, we have now entered the holy month on Ramadhan.. Myself and Ina have now completed two days of fasting, and to be perfectly honest, it is quite different from the ones we had encountered before..

As we all are aware, the Hijri calendar is shorter than the Gregorian calendar, which essentially makes the Hijri months going 'backwards' in relation to the Gregorian.. And as we have anticipated and, in a way, 'feared', Ramadhan now is getting closer and closer to the summer times - at the season where the days are long and the nights are short.. Even for this Ramadhan, at least at the very beginning, fajr is around 4 o'clock and maghrib is around 9 o'clock in the evening.. That makes it easy 17 hours of fasting daily.. Put going to work in between that, and some other work-related issues, subhanallah, it is hard and challenging..

Day-1 of fasting is usually the hardest of them all where our body and mind are trying to adjust to the change.. Ina was oncall up till 10 o'clock last night.. She managed to finish by 9.30 pm.. Kak Riza and Ustaz Wan invited us to break our fast at their place, and so we did.. I picked Ina up and brought her there.. Thank you, to both of them..

Still another 28 days to go, insya-Allah..

Work

Work being work, it is tough and will only get worse, at the rate things are going.. Specifically, we are short of SHOs in the Emergency Department (ED).. At present we only have 5 out of possible 8.. Furthermore, we are short by one registrar..

And work in the department is not getting lighter, with the closure of some services in the satellite hospitals - Ennis, Nenagh and St. John's hospitals..

Fair play to the bosses who have worked, and still working, tirelessly to try to fill the quorum.. At the moment, we are doing 12-day shift, 2-day break, 14-day shift and then post-nights break.. With these numbers, the job is becoming less and less appealing for other people to apply.. *sigh*

A good news just before I left work today, insya-Allah we will be getting two new colleagues in the next two weeks.. So, hopefully this will help alleviate some of the burden we are experiencing..

There is 'I like the job' and there is 'I'm just too tired to cope with this job, no longer physically feasible for me'..

Well, so much for venting.. Maybe some more some other time.. Hopefully, I will be blogging about something more educational and meaningful the next time..

Salam..

No-Pilot Mode

Salam..

Alhamdulillah, I managed to squeeze some time to jot a word or two in this page.. To be honest, much has happened in the last few months that blogging was way down on priority list.. As a matter of fact, despite many of you had thought Ina was at home all along, it is not solely true.. She is back to work! So, you can only imagine what our schedule is like.. And what our house looks like!

June
June was quite a busy time for me.. I had loads of academic stuff going on and it took a lot of my time.. So, I will not bother you readers with my so-called educational strive..

One good thing that happened was my mom's birthday.. In all fairness, it was all Ina's brilliant idea.. We (and by 'we' I mean Ina) actually booked a surprise birthday present for mom.. It was a home delivery of a bouquet if flowers and a mocha cake.. But, I think Ina will disagree, and probably a bit disappointed, that they delivered the wrong flower and the wrong cake..

Mom with her birthday present - sent with love from Ireland

Believe me, the hard part was to make certain mom was at home at the time of delivery, without making her suspicious of the surprise plan..

June was also the month I bid farewell to Milford Care Centre.. Having worked there for a total of nine months, I suppose I will miss that place.. Despite not all people like to be working there, I enjoyed every bit of my time there.. I was sad to leave the service and move on to something almost totally opposite.. It felt like a farewell that I might not return to the place.. The first six months I was there, I knew I would be coming back later in 2010, bot not this time.. I got a cap from Dr Conroy and a book voucher from Dr Stodart as gifts.. I thank both of them whole-heartedly..

July
It was a new beginning for me.. I had decided that I want to do Emergency Medicine as a career pathway.. And so I did, having secured the job in Limerick before July came.. Unfortunately, instead of 8 SHOs, there are only six of us.. And we are short by one Registrar.. It only meant that the workload is greater and it will only get worse.. Nationally, there are 270 NCHD posts not filled on 1st of July, and the number is still increasing with people who have a job now opting to resign and flee the country.. It also means that training is getting more scarce as we speak..

Ina was also called to do a locum job given one Geriatric SHO had resigned and did not arrive on scene in Limerick on 1st of July.. Ina is doing a 3-month post as of now.. She will be back at home in October, insya-Allah..

August
It is only a few days in August and it feels like it is flying too quickly for my liking..

Erin celebrated her birthday back in Malaysia - unfortunately, being on-call on the day itself.. Zuhaili has now settled in UiTM in Medical Imaging, which is technically Radiography.. I haven't spoken with Intan for a while but last I checked she was managing okay.. Zaqwan is still in school at seems to do well..

As for me, life goes on with Ina here.. Where to next? I don't know yet.. Hoping to get an Anaesthetic SHO job in January as part of my own EM scheme.. Maybe look and assess my chances getting on to the Registrar Training Scheme for EM (SpR).. Otherwise, hmm.. Australia, maybe? I don't know.. I'm keeping my options open for now..

Well, Ramadhan is coming and before we know it, it will be Eid.. Alhamdulillah, I will be on leave on the week of Eid and the week after.. Unfortunately, because of shortage of SHOs, I am only now allowed to take one week off as annual leave after the night's week off.. It also means that traveling home to Malaysia will be difficult.. *Sigh*

Salam..

In desperation & hope..

Salam...

We were shocked by the news early yesterday morning.. the flotilla carrying aids to Gaza was attacked by the Israeli commandos.. and a number of aid workers were killed with a number of others were injured..When I first heard about the news, I held the tears at the back of my eyes.. these are people who are sending humanitarian aid.. they were in international water.. and the Palestinians are already waiting with hopes at the Gaza's bay..

Ya Allah.. it was too much for me to imagine.. it was too painful.. I felt helpless..

I've been following the news since yesterday morning & I hope so are you.. and keep the prayers going please.. the Israeli is trying to make it as if it was the mistake of these humanitarian workers.. take note of these & make your family, friends & colleagues understand:

1. Israeli were saying it was their right of self defense.. they said it was a threat to them so they have the right to block the aids..
what about the Palestinians? they were denied the rights to live.. they couldn't even have cement to rebuild their houses.. most everything going into Palestine need to go through Israel.. (some go through Rafah).. they're controlling the quantity of things that can go through which clearly are way less than what are needed in Palestine.. what right does Israel has to be the 'custom checkpoint'?? what self defense are they talking about? these are not warships.. these are humanitarian aid..

2. Israeli said they have been offering to channel the aids through their land..
these ships are carrying things including those that are needed by Palestinians but are banned by Israeli.. they carried medical & reconstruction supplies, children toys.. do you think by surrendering to Israeli, they will keep their promises?? what would make them allow these banned items to go through this time when they have been banning them, like since forever??

3. Israeli suspects the ships are carrying weapons to be smuggled..
I watched the news yesterday.. the reporters have been interviewing a few protesters in UK including those that have been sending humanitarian aid before.. these are people who have experiences working with Palestinians & have been dealing with Israeli.. they are peace activist & humanitarian workers that has been working together despite of different religions.. they have worked beyond the restrictions of political issues.. and one of them said she knew these humanitarian workers in the ship.. they are her friends.. she knew the nature of Israeli,that they would shoot & kill anyone without needed to be provoked.. she told the reporter that each time they are sending out the ships, each ship has to go a thorough check according to the international laws.. there is no way that they can even have a firearm in the ship..

4. the commandos were being attacked first..
why did the commandos intrude the vessel in the first place? the vessel was in international water.. they have no right at all to 'touch' the flotilla.. they weren't being shot at from the flotilla.. they were the ones who intruded the flotilla.. and these humanitarian workers on the ship had said that they would send these aids by hook or by crook.. of course they wanted to protect what they're carrying even with their lives.. of course they were defensive & volatile when the commandos started arriving one by one onto the vessel.. they have no weapons other than what they have in the flotilla - metal bars, knives & whatever they could put their hands on.. if they have firearms as accused the Israeli, they probably would have shoot even before the commandos landed on the flotilla! amazingly no Israeli was shot dead.. commandos with full tactics & strategies have shot dead a number of humanitarian workers that have no firearms on them.. what a way to show that they are commandos!

As we already know, the Zionists have been successful in spreading propaganda before.. they are manipulative & I suspect they would be as manipulative as before in this matter.. so be proactive.. we need to make as many people understand the true situation.. we need to start fighting the idea that they're trying hard to put into the minds of people (that they are not entirely guilty in this matter).. use whatever media you can.. the plain basic truth is that they have attacked a humanitarian aid in international water & have killed aid workers who were trying to protect themselves & the belongings of Palestinians..

And on top of that, keep praying to Allah.. for He has the power over all the things..

'Do they not see that Allah , who created the heavens and earth and did not fail in their creation, is able to give life to the dead? Yes. Indeed, He is over all things competent.'
(meaning from al ahqaf,ayat 33)

In desperation & hope, I turned to Allah..

3 years...

Salam...

It was our third anniversary yesterday..

It has been 3 years since the day we shared our life.. the day he became my very best friend..

3 years had gone by.. and we certainly had gone through a lot.. and I thank Allah for He has granted us with happiness & love that keeps growing stronger every day..

To Abang, happy 3rd anniversary.. these 3 years had been so wonderful.. you've been very patient with me.. you're a loving & a caring husband to me.. I hope & pray to celebrate with you in many more years to come,InsyaAllah... for the countless time, I love u! :)

Doctors..

Salam...

Indeed it has been more than a month since my last entry.. apart from exams, lack of ideas would be the main reason this page had been so quiet...

This entry will be a long entry.. and I must warned you that you may not like what I'll write, you may disagree of my humble opinion.. I do not mind.. this is merely my opinion & I know all of us have different experiences which inevitably led us to the differences in our principles & opinions..

Recently, the following link has been increasingly glamour, being posted in the facebook by a few friends of mine

Why we left and why we will continue to leave...

I had involved in a lengthy discussion with my fellow friends (some are doctors, some are not) regarding this matter.. to be honest,my first reaction after reading this article was "i didn't know doctors have serious issues with nurses & MAs back in Malaysia".. but I do understand that this article does not represent the doctors as a whole.. reading the article, I realised it was written based on his own experience.. and as I said earlier, everybody has different experiences.. I know a lot of friends (doctors) who are close to nurses.. again, I know this articles doesn't address the nurses & MAs as a whole.. every basket has a bad apple.. no matter what your profession is, not everyone is really good in what they're doing.. so, it is unfair to generalised just because we know one or two that unfortunately falls into the 'bad apple' category.. even from my own experience, I've worked with, I must say, the best of nurses to the worst ones.. same goes to doctors.. yes, we tend to forget ones that are good.. but I do not like making generalisations.. it unfair to those who has been working very hard to be good,if not the best, in their profession..

Well, the main issue that I would like to discuss does not include the issue above..I've read different sorts of reactions to the above article.. some agree, some don't, some blame the writer back.. it is interesting to see different types of responds especially those of doctors.. i know this issue is a very delicate issues to be discussed.. because all the people including the public are getting different inputs regarding this issue from a lot of different sources.. this issue must be looked at from different various angles..

What I want to discussed first is the issue of doctors overworked in the public sector.. because I believe it is one of main reason why people are unhappy at work which leads to demotivation, dissatisfaction, anger and eventually poor working environment.. it is certainly not a new issue.. it has been a longstanding issue.. it has been highlighted in the news, has been discussed over and over again.. and of the main thing that has been highlighted was the doctors who are working overseas/out of the country and how the government should do something to bring them back.. yes, it may be one of the reasons.. but how about those who quit the public sector to join the private sector? do you know at some point, about one third of doctors leave the public service every year to join the private sector? do you know at some point, private hospitals account for 20 percent of Malaysia’s hospital beds, but they employ about 54 percent of the doctors in Malaysia? what has been done to attract them to stay in public sector? when I Googled about this issue, I came across this

Medical tourism (under the topic Malaysian doctors who return home exempted from public service with conditions)

Wow, that is a lot of money.. from RM58.9 million in 2003 to RM 299.1 million in 2008.. yup, private sector is growing fast.. but what happens to the public sector? hopefully an equal improvement.. I know that the basic salary had been increased for doctors which is a good sign.. I don't really know about other incentives that doctors get in Malaysia.. training grant & study leave would be a good idea.. especially for those who are going for mrcp/mrcog/mrcgp etc.. but we have to realise doctors who left are seeking better life, not only in the financial side (probably not even because of financial stuff) but for better working hours, better facilities & equipments, better working environment.. there must be something that can be done to persuade (not forcing) the doctors to stay in the public sector..

I believe that a proper & thorough study is needed to improve the overall working condition for the public sector.. some doctors are too frustrated that they ended up making complaints in the papers/blogs or whatever medium they can get.. I don't blame them.. but I feel voicing as a group/unit will bring greater effects.. through a proper body for example through NGOs or doctors associations.. but having read those responds by various people, I know it's going to be a challenge.. some doctors are not supportive of the others.. this brings me to the 2nd issue.. I know seniority is a big thing back home.. which has its good and bad side to it.. but I don't understand why it is so badly needed.. respect is something to be earned, not demanded.. and it is sad if a superior is being feared, not being respected.. it doesn't contribute to a positive working environment.. but some said if you're being too kind, they will 'step on your head'.. great! then nobody would ever be nice.. it is always should be give & take.. people being nice to you, you should be nice too.. bullying probably has become less now.. but I do know a friend of mine who quit not because of workload but merely because unacceptable bullying.. it is probably an isolated case.. but it proves that it still happens.. and sadly, when he reported to the hosp director, the answer was 'nothing can be done'..

It is even sadder when the doctors are questioning why others are complaining too much.. funny how many times I've came across this phrase 'kitorang dulu lagi teruk.. tapi survived je..' which is another way of saying why bother changing the system,it's good enough now! of course surviving is one thing, making things better is another.. parents will strive hard to make sure their children has a good if not better life than they have.. but why some doctors doesn't want to do the same for their junior colleagues? refuse to help to ensure better conditions for the next generation? even if they do not want to help, just don't scrutinies others who are fighting for a better future for doctors.. and I know some doctors are sick of hearing others whining especially if the others are their juniors/subordinates.. they feel like many of them are spoil and refuse to learn which unfortunately in some cases are true..but I know it is hard to differentiate between 'spoil' and overworked especially when the superiors already experienced those themselves, that overworking is a norm that every juniors have to face.. but then, less work should mean better outcome,more thorough and quality work can be done which unfortunately some junior doctors take for granted.. the definition of overworked itself varies.. how many works do you have to do to be qualified as overworked? straight 48 hours? 52 hours? 80 hours per week? not having time for breakfast & lunch,does that qualified as overworked? I have no idea of what working time directives does malaysia has for doctors.. but we should have one.. yes, people say doctors must endure long hours.. but not too long.. because tiredness will set in and it would begin to cloud judgment and lead to mismanagement.. doctors are humans.. we have limitations.. our mistakes are often unacceptable.. so whatever can be done to reduce the risks of making mistakes, it should be done..

From the discussions I had,we made a conclusion that doctors should be united.. doctors associations & NGOs representing doctors should be more proactive.. we should put aside whatever differences we have - seniors, juniors, races, local grads, overseas grads- and fight for the better future.. because in the end, we are all working in the same system and we are serving the community.. we deserve the best so that we can give the best.. doctors in the private sectors should help too.. there are so many things that they can do.. I found this blog written by a doctor working in private sector & I found it very useful..

The heart of the matter

and this is one of the article written by him (a very good article)

My health, my country

I'm sure there are more doctors who critically analysing the healthcare system in Malaysia.. as for the above doctor,I must say I like his positivity.. I hope we can stay positive and help doctors like him to improve our healthcare system..

It's time to make our voice be heard.. I'm hoping for better lives for doctors.. in which we have time to do what normal people do - outing with family/friends in the weekends, going for a long holiday every now & then, having time to look after ourselves, having enough time for spouse & children, having the time & energy to study, going out in the evening for a jog/to the gym.. also a good working environment where we respect each other, working in high spirit and with high motivation.. and much more.. it may not happen in 10 years time, probably not in 20 years time.. but we have to start taking steps, big or small.. as it is certainly not impossible..