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My boy moving up to Kinder 2.

There’s no formal training on how to become the best parent to your child. It’s like a natural phenomena of nature to be a protective parent your offsprings. Instinct. You make decisions based on how you want to protect your child and how to give the best possible care. You know you are inexperienced but you just know that it’s the best choice to make.

My boy is moving up to Preparatory level or in other pre-schools they call it Kinder II or just Kinder. Could this be the perfect timing to transfer my son to another school?

I found this pre-school just within the area that has better and brand new facilities. The school building was built to really become a school. Sinks and toilets are designed for kids. They also provide snacks for the students (included in the tuition fee ofcourse). The teachers speak in english fluently – which my former boss once said that a person who speaks the language fluently is also a good sign that that person is smart and intelligent.

Ok. Son is not just moving up but also transferring.

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Patient absconding in the Philippines

Have you ever really encountered the term absond? Oh well, it’s basically the term used for patient who went on AWOL or went on HAMA or eloped or simply escaped and went out of the hospital. This crisis is uncommon in the states that’s why maybe it was never discussed probably when we were in the nursing school.

Within the last 3 months, I had 2 patients who absconded from the ward with 2 different cases and reasons.

Absconder # 1 – Who we call “Tatay” during his stay. He was the typical fatherly type of a patient. He wanted to visit Quiapo church as his devotion and promise to the Black Nazarene. Since his condition would not permit him to do so he did not dare to ask permission from the nurses. (I bet he knew we would never allow him to). So he asked his son to help him sneak out. He went out without permission. Took off and rode their car and off they went to Quiapo. That was a friday morning.

Absconder # 2 – Ang balikbayan. This patient just came back from a special mission for a cause in an african country. He was known to have late stage carcinoma and minimal options for treatment. Patient got depressed. While his wife was away to get some medicines from the Pharmacy he went to the toilet, pulled his IV line and off he went out. He walked out of the ward.

When do we use the term abscond? I too got confused. Is a patient an absconder by the time he went out the hospital for any reason at all? Or should there be a 24-hour lee way before tagging patient as absconded?

Hmmm. Not really a typical situation in the Philippines. But it is a challege for Nurses! In the UK, I think they have protocols to follow. This is a common thing with the brits I think.

Ok so Absconder # 2 came back 23 hours after he was gone missing. He said he was in a proper state if mind now and needed the time to think. He reported that he walked around the city for almost whole day.

Absconder # 1 had a cardiac arrest before he reached the Church. Was rushed to the nearest hospital, intubated and went on a coma.

Yes! Surprising and should be taken seriously. Security measures and protocols are important. It should be implemented or revised.

Not all patients leave the hospital to escape medical bills. There are other reasons too. There are reasons why patients abscond.

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Doctor D-bag

As a nurse there are times where there’s a need to accompany a patient when going for a referral to another hospital. Which in our case, this Specialist is not an affiliate in our institution.

So, that day of March 5th I had this chance to bring a patient for a referral to The Medical City. There we went to the 12th floor of the Medical Arts tower as scheduled right before 4pm in the afternoon. We went in to the Doctor’s office and the Secretary on a srub suit welcomed us with such a long face telling me I had to write down my patient’s name and handed me a clipboard where the patient needed to fill up details. We were 7th on the list. I did not insist that we should be seen first just to avoid any argument with that secretary on a scrub suit.

After waiting for almost 2 hours this Doctor Dbag came in his clinic saying “Sorry I’m late” addressing everyone inside. He was about 5’10” tall and about 250 pounder big with a long harry potter-like hair.

It was our turn to get inside as I was called by the secretary on a scrub suit. Doctor Dbag greeted me, my patient and his relatives saying “Dapat pala kayo na inuna ko, admitted ka pa pala sa hospital ninyo”. Like I almost believed his sincerety.

I handed the chart to Doctor Dbag and hover through it. Looking for some lab results. He then grabbed his prescription pad and started discussing my patient’s case. He asked if the patient had a CT Abd done, and told him yes. He asked “Where’s the plates?” When I told him we left it at the ward, he just said “Excellent!” and that started to feel the air in the room are filling up with sarcasm.

He asked the patient “Na file nyo na ba ang philhealth for the ERCP?”. The patient told him he’d complete and file that once discharged. Dr. Dbag said pinagbigyan ko na nga kayo dapat asikasuhin nyo naman yan. Baka sabihin nyo nalang sa akin na hindi na ako maka claim nyan dahil late na” in a very awkward and inapproriate tone of voice. After he discussed the patient’s case an his plan of care, the patient asked “Ano po ba talaga ang sakit ko, hindi nyo pa po ako nadidiagnose kung ano talaga ang sakit ko”. Dr. Dbag went wild again! “Alam nyo sinilip ko na diba alam ko may problema hindi ko pa sigurado kung ano pero alam ko may problema”.

Now you guys tell me if ever you will have a patient needing a gastro-endoscopy specialist, will you refer them to Dr. Dbag?

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Water fountain dance

One of the tatay duties I needed to was to accompany my son on his field trip. And watching fountain dance on a very hot summery-ish day that felt like 40 degC was truly relaxing.

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Case of the week: DM Foot v2.0

In tradition of my case of the week posts. I am posting another wound on a foot. This time its not just any ordinary non-healing wound from an injury but of a diabetic patient.

The photo on the left was taken last Jan. 11, 2012 and on the right was taken Jan. 27, 2012.

Patient is now compliant with oral meds (metformin and others) and was placed on iv antibiotics for 1 week. Also, daily wound care is done to promote healing and tissue repair. Photo now shows positive signs for improvement.

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Why visit Philippines?

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