Tuesday, May 29, 2007

Singaporeans You Are So Stupid

Remember my previous rants about patients not reading the instructions to take the queue number... well I sorta gave up on telling them to read the instructions. Guess a large proportion of Singaporeans are possibly illiterate or just plain stupid.

So what I do now is to press the queue button to generate the queue ticket, "snatch" the prescription from the patient, tear off one queue ticket and staple it to the prescription myself. I'll leave the other queue ticket hanging from the machine, and tell the patient to take the queue ticket, but guess what. I think most Singaporeans are simply too retarded to even follow such a simple instruction.

When I tell them to take their copy of the queue ticket, some will show a stupid look on their face, and then walk off without taking the queue ticket. Some will look up at the "serving queue number:" display just above my pharmacy, then proceed to walk off without taking the queue ticket. *Roll my eyes*

You probably want to argue that not all patients are Singaporeans. I agree, but you forgot one pertinent fact. I am looking at their prescriptions with their names, ICs/FIN numbers, and addresses clearly printed on the prescriptions. I can easily tell who is the Singaporean and who is the foreigner.

Let's just face the fact. Singaporeans are stupid. The reason why Singapore is prospering is probably due to the few intelligent people we have running the country and ensuring the rest of the idiots do their job in a clockwork manner.

Saturday, May 26, 2007

The O.o and The >_<

The following rules apply:
1. Anything in brackets are actions.
2. Anything in normal font are speeches.
3. Anything in italics are thoughts.

The O.o


Me: This is chlorpheniramine, it is used for runny nose and allergy symptoms like itch. Take Xml Y times a day when necessary. The medicine may cause drowsiness so your child may sleep a little more than usual.
Parent: What do you mean by when necessary?
Me: (Raise an invisible eyebrow, BP starting to creep) It means to use when the symptoms are present, and stop when your child no longer experiences the symptoms. I am not here to teach you English, buddy.
Parent: What do you mean by symptoms? I am not a doctor how would I know what symptoms to watch out for?
Me: (Brain shoots urgent neurosignals telling my eyes not to roll) I've already said this is used to treat runny nose and allergy symptoms such as itch you retard.

Me: This is panadeine, it is panadol plus codeine. Take X tabs Y times a day when necessary to relieve pain. It already contains paracetamol, which is panadol, so don't take panadol containing products with this medicine. The codeine component may cause a little drowsiness.
Patient: So can this medicine be used for pain?
Me: (Gave the patient a are-you-a-retard look) I just said this is a painkiller. If a painkiller is not used for pain, pray tell me what did you use it for? Poison your estranged husband?


The >_<

My senior: Did the doctor explain why your child need to take Risperidone?
Parent: Yes, she did, but can you tell me more about this medicine? What is the usual dose given? What is the max dose it can go?
(I can smell one those I-think-I-Am-As-Good-As-A-Pharmacist/Doctor parent/patient from miles away and this is one.)
My senior: There isn't actually a straight forward dosing for such medicine. Such medicine usually requires some titration to be done depending on individual patient's response. In addition, in paediatrics dosing is usually based on body weight so there isn't a usual dosing.
Parent: But is there no like common dose that is used.
My senior: Like I said, there isn't such a thing as common dose. It depends on individual response. Usually doctors would start low and then slowly titrate the dose upwards till the symptoms are controlled. Currently, your child is prescribed 0.5mg/day, max dose studied in adults can go up to 6mg/day.
Parent: Do you know why I am asking? I have rejected Dr S for 6 years.
My senior: What do you mean by you rejected Dr S?
Parent: I do not want to start drug treatment for my child. I don't think my child actually needs to start drug treatment, so I rejected Dr S's suggestion.
(I went off to dispense to another patient at this point.)

For the layman reading this, risperidone is an antipsychotic medicine. It is indicated for the treatment of schizophrenia, mania, people whose moods cycle between mania and clinical depression, and behavioral problems in children or teenagers with autistic disorders. What I cannot understand is, if the parent think his son does not need medical treatment then why on earth did he continue to bring his son for consultation? Did he think miracles happen by breathing in the hospital air? None of the conditions mentioned above can be waved away with time or with counselling. Those conditions essentially exist because there are imbalances in the neurotransmitters in the brain. Counselling, scolding or coaxing is not going to put them right, but medicine can. By denying his son the medicine for 6 years, he wasted 6 years of his son's life, because such patients cannot fit into the society with their conditions uncontrolled. He probably cannot go to a normal school and even if he can, will probably have to struggle with keeping up with the other children. This puts a damper on the child's morale and may worsen the condition; it becomes a vicious cycle.

Tuesday, May 01, 2007

Integrity vs Thievery

Heard 5 tabs of voriconazole went missing in the wards. According to the pharmacy assistant (PA), who placed the medicine into the medicine trolley, the staff nurse looking after the patient requested for the medicine to be topped up again the next day. Puzzled, the staff went to the ward to search for the medicine in case some stupid nurse misplaced into another patient's medicine compartment. What she found was the blister pack, in a nearby bin, with all the voriconazole removed. When the PA queried the staff nurse looking after the patient, her disinterested reply was to go look for the night staff who was looking after the patient prior to her.

Naturally the PA reported this to the in-patient in-charge who then informed my manager. My manager was understandably angry, after all we are talking about a few hundred dollars that went missing. Nobody was apprehended for the missing tablets, and my manager now wanted all expensive tablets to be stored under lock and key in the control-drug cupboard. All usage of the medicine will also have to be recorded in a book. *roll my eyes*

Crux of the matter is not the location which the medicine is stored, rather it is the integrity of the staff looking after the patient. The tablets were entrusted to the nurses looking after the patient and they simply shrugged their shoulders when queried why the medicine went missing. Sure know how to shirk their responsibilities do they not. The tablets were obviously stolen by a staff of the hospital as we are the only ones with access to the medicine trolley. Narrowing things down, if the tablets went missing in a span of less than half a day, then only 2 groups of people could carry out the act: nurses or doctors. Only these 2 groups still remain in the ward after pharmacy office hours.

Whatever it is, I am surprised no action was done to further investigate or to bring the police into the matter. After all, this is theft, and if you consider the act of pushing a tablet from a blister pack, it is likely to obtain at least one complete print of the thumb. Identifying the culprit is probably easier via this method. Unbelievably, this matter was not raised up to higher authorities either, the thief continues to work amongst us, and the theft was simply glossed over.