jon's blog

i could go on for 40 days and 40 nights about my blog title and bore you to bits and pieces with 10,000 different ideas i actually had for the name of this blog but because of the 500 characters limit that is imposed upon this mechanism which, by the way, is supposed to promote free speech, i shall shorten it to just two words basically describing what the hell this is all about and who this hell belongs to.
Tuesday, October 30, 2007

project 355: even 'free' has a motive

there's a sort of unwritten code amongst smokers to offer cigarettes to their fellow like-minded people when asked for one. well, i'm not sure whether it's an unwritten code amongst our local smokers, but i follow it none the less. for the sake of karma and people helping me out in times of dire need. the usual routine would be a stranger approaching a smoker (while in the act of smoking), asking to sell a single stick of cigarette for a nominal token sum, say.... a dollar. a typical pack of smokes costs anything between nine dollars (crappy brands like 'Halftime' or 'Texas') to twelve (premium brands like 'Davidoff' and 'Dunhills'). so let's put the average at roughly ten bucks for a pack of fags. that equates to roughly fifty cents for a stick (it comes in twenty sticks a pack).

a dollar for a single stick therefore, is really worth the price and really all that tempting to take. but i always refuse out of empathy. i'm almost always out of cigarettes on the 24th of every month (payday is on the 25th) and i really need all the help that i can get when it comes to nicotine. true enough, karma always pays me back when i ask random strangers for cigarettes with this token payment of a dollar. they generally refuse payment and gladly hand over that precious stick of goodness. i've even had nice people who gave me an extra cigarette with the good tidings of 'one for the road'. not once has the door been slammed shut in my face when i ask for a stick.

of course, this is a practice that goes well with strangers that chances are, you will never ever see again in your life. during the days of the green, brown and black combat boots, there were selfish creeps who kept asking for free fags. i'm all fine with acquaintances asking for cigarettes. but i'm not fine if they KEEP asking for cigarettes every few days. Pangkeng and i call these people 'buay zi dong eh chee byes' (which loosely translated from Hokkien, means 'chee byes with no initiatives'; ask your local Singaporean friend what 'chee bye' means). apparently, karma will deal justice and vengeance in due time because as word gets round the work place that these people are parasitic by nature, they will eventually be blacklisted from the smokers' list. it's another of those unwritten codes amongst smokers.

you simply gotta love these unwritten codes, eh?

--

it's not everyday that one gets free cigarettes from strangers. it's not everyday even that one gets free cigarettes from one's neighbours. and it's definitely not commonplace for your neighbour who's a Satanist to give out free cigarettes. but it's happening to me.

it's not everyday that one's father suffers from tinnitus. it's not everyday that one's father suffers from macular degeneration. it's absolutely not everyday that one's father suffers from insomnia and constant migraines. but then again, my father is forty-five and fast reaching a mid-life crisis. it's all happening to my father.

it's not everyday that one has irritating neighbours who do the most bizarre things. bizarre like shouting 'ZHU BA JIE' in the most absurd hours of the afternoon (refer to project 355: all smokers are friends, a post that i wrote in early January this year). bizarre like gibberish words. sometimes these things irritate my father who comes equipped with a strong sense of justice and a copy of the King James bible in the other hand. my father seems to be constantly at loggerheads with the neighbours who live above us. and for a good reason actually. they crank up their karaoke on saturday afternoons and sing horrendous versions of chinese pop tunes. they have an eighteen-year old son who smokes like a chimney and tosses cigarettes from the balcony, most of which end up along our corridors.

and guess what? their son is a Satanist who practices the dark arts and gives me free cigarettes.
or at least that's what he tells me.
it's all kinda falling in place now, isn't it?

--

i stepped out of my home for my usual post-siesta smoke yesterday. that was when i bumped into the kid who always gave me a free cigarette without fail. i have already taken seven cigarettes from him in my entire life and seven is a lot. though as to why i've never returned any of the favours back to him, i'm not sure why. as usual, he offered me a single stick once again. and i gladly accepted it. for the first time in our lives, we sat along the corridor and smoked away. i couldn't help but think that he looked like a church mate of mine, Norman (Norm: he looks like you with the uncombed, ruffled hair and the fair skin).

we talked. in mandarin. about religion. he claimed to be a practising Satanist who curses his classmates ('have you heard me chanting before when i'm doing curses?'). we talked more. about my father. he said that he thinks my father has something against his family. of course, i neglected to mention the tossed cigarettes butts and the incessant bursts of 'ZHU BA JIE'. we talked even more. about his family moving out at the end of the next month. moving away to Bukit Panjang. and how he would 'miss me'. to which i agreed as well.

and that was when it all clicked into place. or at least the possibility of a theory clicked into place.
nobody gives away free cigarettes out of pure, good intentions. i give them away out of selfish intents based on karma. which makes me wonder why Satan's child is giving me cigarettes. am i the missing link between my father's health-problems and the upstairs neighbours?

or maybe i'm just thinking too much into it?


Monday, October 29, 2007

project 355: better luck with the girls

i have a confession to make: i can't help it but attract more women than men.

maybe it's my character or perhaps it's just my physical appearance. either way, if i got a dime for each time a woman tries to get to know me better, i would have enough money for lunch and dinner. if i used the same ideology and applied it to the men instead, i would have enough money for a packet of tissue papers. so it sounds more profitable for this homosexual to get fresh with the ladies now, doesn't it?

but of course, this latent ability is not exactly helping when one of my main objectives in life is to attract more men than women. there are times, and perhaps just a few small inkling times when i kinda i wish that my orientation was more attuned towards the heterosexuals. for starters, i wouldn't have to worry about repealing section 377a of the penal code and its aftermath. i wouldn't have to worry that much about being HIV positive. i wouldn't have to have sex in dark alleys and corridors filled with the occasional bodily fluid. but most of all, it would be darn easy for me to get the best out of the opposite sex.

you see, i find myself very much at ease communicating and in general, being around the opposite sex. apart from dropping my pants and exposing my privates, there's very little that i can't do with the female species that i can't get away with. actually, i think i can get away with dropping my pants in front of my female colleagues at work. exposing my privates is prolly reserved for the special few. point is, i'm as smooth as a criminal when it comes to charming women. but am i interested in women? well, yes. but not in a 'let's get physical, let me hear your body talk' kinda way. the closest i can think of is prolly a Dionne Warwick kinda interest (cue harmonica opening in 'That's What Friends Are For').

when it comes to men though, i become the world's most socially-inept gay person. i hem and haw my way around the men i take a liking to or around the 'fruit tarts'. it's a silly word that stuck in my mind when i discovered that the older people used 'fruit' as a derogatory term for the homos back in the day. none the less, i say stupid things like 'spork and foon' and 'appendiciti-citis' (this happens a lot in my ward to me). this always results me wanting to bury my head in the ground when really... i would rather bury my head in the perineal area of some other hot doctor.

one perfect incident actually comes to mind whenever i talk about my dilemma of better luck with the women than men. there was this one time when i went clubbing with two gal pals, April and her uber-good friend, Gina. we were at dbl O partying our hearts out. and as much as i love partying with the girls, i always end up a bit of a loser when they get snitched up by other guys on the dancefloor. so it always ends up with me dancing with one of the girls and her behind while she is dancing with another guy who has taken an interest in her. this is when i will head to the bar, get a drink and puff away.

on this particular trip to the club, April got snitched away by some tall guy in a goatee wearing a trucker cap while i ended up dancing with Gina. after a half-hour of irritatingly bubble-gum pop tunes like Hilary Duff and Lindsay Lohan, we decided we had better start looking for April. my guess was that the guy must have plied her with enough alcohol to get her dancing to trance and techno (which all three of us seriously hated). and sure enough we found her a little tipsy, drinking up her (insert random number)th shot of Tequila with goateed trucker hat. unsurprisingly, goateed trucker was still rather rationale and clear-headed.

it was roughly 3.30am then and the party at dbl O had ended, so trucker hat offered to take all of us to the VIP lounge in MOS for more drinks. and i admit, i had quite a few drinks as well and wasn't really thinking properly. i also admit that i offered to be April and Gina's 'cock block' in case anything untoward was going to happen to then. with that, we found ourselves in MOS within a half-hour. it was there that i discovered the uncanny concoction of Chivas and green tea. i thought it was a horrid waste of good liquor and requested that they plied me with unadulterated Chivas instead. of course, with that amount of Chivas in me, it wasn't exactly easy being a 'cock block'. by then, the two girls were already fast falling asleep at the VIP lounge.

it was then that i started making conversation with another girl who was dragged into the VIP lounge by the guy who opened the bottles of Chivas and mixed it with Pokka Green Tea. maybe it was the soft lighting, or maybe it was the good conversation or maybe it was the fact that we were rather tipsy. but just as we were about to leave MOS with trucker hat who offered the girls a ride home (he didn't offer me one... chee bye), the girl pulled me aside and asked me the all-traditional local question that begins the ritual of courtship:

'Hey, can i get to know you better?'

i can't help but connect this particular question in my mind with three kids, a five-room HDB apartment, some in-laws and a hell of a boring time at the Registry of Marriages. and besides, i'm gay and she has breasts. it's okay, i'm not interested. to which i told her that and hoped that she would just leave it at that. but she just had to ask the next question of 'but, why??' which signifies rejection, being scorned and a whole lot of other negative feelings. and this is my killer line which i have only used only once on anybody till this day. do note that i was tipsy and wasn't thinking straight (not that i was ever thinking straight to begin with... but you get the point).

'Honey, i'm gay'

'Huh... you're gay ah. but you don't look like one!'

sigh, maybe it's time i started wearing sassy pink tank-tops and tight shorts that say 'you want some of this?' on the behind.

(NB: i didn't fulfil my duties as a cock block in the end. i was ego-tripping on the whole experience and a whole lot of alcohol. i let trucker hat give the girls a ride home. according to April and Gina, he tried to bring them to the nearest Hotel 81. the good thing was that April managed to muster up some vomit and threatened to vomit in the car. and for some people, Hos may come before Bros. but for others, their Hondas, come before their Hos)


Saturday, October 27, 2007

project 355: a nurse counts his blessings

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do you believe in destiny and the fates? do you believe that somehow, there's a Guy up there who arranges our life in nice chronological order so that all things work out together for the better good of us? do you even believe that somehow, you are reading this post right now, not by random chance but because of a series of fortunate events that led you to this point in time? these days, i'm somehow inclined to believe in this ideology. you see, picking nursing as a career choice has been one of the best decisions i have made for myself in this life. not only because the salary's somewhat decent (i will never agree that it's competent with the amount of work that we do), but i get to do some good in this selfish world while at it. a job that pays and racks up a whole lot of karma points, where else can you find something like that?

after my 'O' levels, i took up the first job i've ever worked in my entire life. what's that you say? oh, you want to get technical eh? right right, given my perverse nature it was prolly the second job that i've ever done (the first being a 'blow' job). none the less, it was ironically an administrative job at the current hospital that i'm employed with. i worked as a medical records clerk in 2004 for several months. it was mindless, back-breaking work that involved looking for dusty medical records in dusty shelves in an even dustier medical records office. it was there that i learned several things about the big picture of the hospital and the working world.

like for example, i learned that there were petty people who didn't like others to help them with their work despite the fact that they were swamped. i also learned that going for lunch with someone else's girlfriend is a criminial act. of course 'someone else' here is with reference back to the same group of petty people who were swamped with work and refused my help and were thus unable to go for lunch with their girlfriend. one of these petty people pulled me aside one fine working day and told me to stop 'breaking their rice bowl'. and so i did just that. i stuck to polishing my own rice bowl till it shined like a black guy's ass on a nudist beach. eh... wait. how often do you see black people tanning on a nudist beach? there's an irony to this though. the lunchtime girlfriend? she took up nursing too and we got to see each other occasionally during our course of education. good times, good times.

more importantly, it was during this time that i got to explore the hospital inside-out. i learned of the underground routes the hospital used to transport dead people to the mortuary. i learned what happened administratively after a patient was discharged. i got to see the place where all the hospital charges were keyed in and tabulated. i basically got to see the clockwork of the hospital and how everything was run. but the most important life-changing bit of all was that i discovered the hospital and their offer of a three-year bond/scholarship. they were offering three years of employment with a bond of $32,000 for people who decided to make nursing their career choice. i was immediately hooked. money, as you might have already known, is a very strong incentive in life.

at that point of time, nursing wasn't exactly a very popular choice. the general thinking of the local population went something like 'why be a nurse when you can be a doctor?' in fact, there were only two types of people who took up nursing: people with the passion for saving lives, and people with a passion for bad results during their GCE 'O' levels. i belong to the latter category. i had horrid results, was aiming for an education in Mass Communications and only managed to get an interview with the course that offered a diploma in 'Film, Sound and Video'. i preferred the written word more than the visual. so i rejected FSV and took a random gamble for nursing. i figured that i was not going to waste my life with the mainstream by gunning for course in business & finance, marketing, engineering or IT.

and life can sometimes have quite a bizarre sense of humour. you see, i've never got to take up mass communications as an education, but i've managed to get quite a good taste of it. my best friend Sunanthar, had to complete a radio interview with an interesting person of sorts as an assignment. and what other interesting person than a male nurse? it was there that i sit in a somewhat professional radio studio for the first time in my life. cut the long story short, Sunanthar got an 'A' for her assignment and i got a compliment from the lecturer that my voice was very 'well-suited for the radio'. and the irony of it all? i got to do this radio interview thing twice. another acquaintance from secondary school was doing the same project and decided to rope me in about a year after i did the first interview. you've got to hand it to the Guy up there and his arrangements.

the blessings of nursing didn't just stop there apparently. during the days of National Service with the army, i made quite a substantial amount of cash. i was enrolled into the Medical Corps as a combat medic. it was there that i volunteered for a thirteen month overseas posting. i went to Brunei, served my time as a medic and went on plenty of adventures. i got the once-in-a-lifetime chance to ride in combat helicopters, see the sultan of Brunei, climb mountains, mingle with all sorts of snakes, scorpions and reptiles, walk round half an army encampment in boxer shorts and singlet and generally have a hell of a time with other like-minded servicemen. and i did all this with quite a substantial salary labelled 'overseas allowance'.

fast-forward to today. i have been employed and working for this current hospital for quite a few years. and as much as i dislike some of the systems and process of the way things are done here, i can't help but still love the hospital. it's a bit like a love-hate relationship with more lovely good times than bad. i have kinda influenced a lot of people in my family to make nursing a career or business choice. one cousin has taken up nursing because of me. my brother has taken up nursing because he saw the grotesque amount of money that i made during my schooling day. unfortunately, he didn't get a bond because of his results that were even more grotesque than mine. he took up nursing at a time when it was becoming popular.

my mother, she's an enrolled nurse with a different hospital from mine. she's applying for an extension of contract with a diploma course at a local polytechnic currently. she's an efficient worker and her boss likes her. chances are that she will get the contract extension. and one of my paternal uncles, John Chua's father to be precise, has just opened his very own post-basic education centre offering tie-in courses with various overseas universities. one of these post-basic courses is a direct-honours nursing degree with a relatively reputable UK university. and since blood is thicker than water or any other bodily fluids that come to mind, the uncle has offered me a place with an outrageous discount to boot. plus, the first batch of students get a free Dell laptop as an incentive (i'm giving this new laptop to the father).

so you see, it seems that as long as i follow the path of nursing, i have nothing much to worry about. i have many other jobs that i'm passionate about. i want to be a writer for a local publication. i want to do stage management. there was even a time when i wanted to be a dancer (that was after watching 'Honey'). but destiny and the fates work in really mysterious ways. everything and everyone in life seems to be connected in some sort of way.

if i didn't work in the hospital as a medical records clerk, i wouldn't have found out about the bond. if i never discovered the bond, i wouldn't have taken up nursing. if i never took up nursing, i wouldn't have become the person i am today. if i were never the person today, i would never have had the guts to write so much scandalous stuff about myself. if i never wrote so much scandalous stuff about myself, i wouldn't have started www.spankthemalenurse.blogspot.com.

and if i never started spankthemalenurse, you wouldn't be reading this post right now.


Monday, October 22, 2007

project 355: perhaps there's a bigger blueprint out there

frankly speaking, i've never thought of birthdays as really exciting things to happen in one's life.

of course, this is coming from a person who has yet to celebrate his birthday with a party. believe me when i tell you that i have never, and will less likely plan an official gathering of acquaintances, friends and loved ones around champagne, canapes, confectioneries and candles. because, really... who needs another reminder that they are officially one years older and perhaps one step closer to their deathbeds? plus it'll be really awkward gathering all my different group of friends together. the gay people will clump together. the englishy crowd will less likely mix with the cheena-piang. and don't get me started on the 95% of colleagues in the hospital who don't know that i'm a cock-sucking homo. there's gonna be booze and cigarettes at my party (if i ever have one). it's gonna be hard to explain a drunken gay acquaintance butt-grinding against Pangkeng, though when i think of it, i'm sure Pangkeng wouldn't mind, really. still, some things just shouldn't mix.

well, this is one of them.

truth be told, i can name you more exciting aspects of my 23 years of living than a birthday. like gay sex for instance. or perhaps the 25th of every month - payday. or the day i started smoking (18th or the 19th of August 2006, i think). or how about the first time i saw a tray of cadaveric feet during my nursing biology lessons ALA Saw-style? point is, perhaps the whole idea of a birthday is a tad overrated. be it 21, 22, 23 or even 40. you can go celebrate your birthday with a bang or with a gang (or even with both). but i don't think i'll really make a big bonanza out of it or force people to accompany me and sing that dratted birthday song.

i'm not saying no to the birthday gifts though. after all, if a birthday blog post nets you 45 comments, then i'm all for monthly if not even weekly birthdays. all that said, sex coupons with labels like 'one free blowjob in (insert public place here)' or 'free one-hour full-bodied session' are most welcome. keep them coming.

and i will keep you coming.

--

i spent my birthday doing the night shift with two permanent night staff and another favourite colleague of mine. i have never related any stories about this particular colleague before. i mean, you've read about Pangkeng. you've read about Fat Boy Slim. you've even got to know about Plain Jane, The Blurness (she's resigning as of this month and i'm partly to blame for it; another story for another time) and My Beautiful Preceptee. well, now let me introduce to you someone new: The 53-year old Virgin.

now, The 53-year old Virgin holds a special place in my heart. i don't really know how to put it down in words, but V53 is the kinda guy that you would want to take care of you when you're old and dependant. he's patient, he's kind, and he will do things outside of his job scope. he's prolly like that because he has led a really, for lack of a better word, 'deprived' kind of life. he took care of his aged and dying mother till she passed away from cancer several years ago. he's unmarried, fifty-three years old and living by himself religiously. and now, his daily lifestyle goes something like this (and this is really what he tells me):

V53 starts the days with his morning prayers (he's Indian and a devout Hindu), followed by a meal of Gardenia Fruit & Nut Loaf slices (he has this for breakfast every morning). he has vegetarian meals on the religion-specified days. when he's on the afternoon shift which starts at 1300 hours, he arrives in the hospital at 1115 hours for a forty-five minute lunch. he'll arrive at work forty-five minutes earlier than the stipulated time. there's always a competition between him and me regarding arrival timings. i'll normally start work thirty minutes earlier to socialize and poke fun at colleagues and catch up on the latest word in the ward. V53 will arrive at 1215 hours to WORK. and he's a really good worker. because of his age, people respect him. and he always has a wise word to say, mostly stuff that he has learned from his 'guru'. yeap, he's religious, like i said. so you see, what's not to like about him?

and this is the most interesting bit about him. he doesn't earn that much as a Patient Care Assistant (the lowest-ranked staff of the health-care setting), but he invested in his own Portable Pulse Oximeter. he spent $1,200 on his very own Oxygen Saturation machine! he has his own stethescope. he comes with his own tympanic thermometer. he even buys his own thermometer sheaths. he's not willing to spend on himself, but he's willing to spend on the patients. this is truly the kind of guy i would like to take care of me when i die of cancer or AIDs or some deserving death that i have coming.

and karma truly repays him for all his good deeds and intents. he strikes the lottery on a monthly basis. it may be a token sum or the occasional large sum. he buys 4D (lottery based on guessing four random single digits) with inspiration from the hospital settings. a patient that he took care of once dreamt of four numbers. he told V53 the next day. V53 bought the lottery ticket with the relevant numbers and won a thousand dollars the next week. both Pangkeng and i got a treat from him at Delifrance the following week.

that's the 53 year-old virgin in a nutshell. i have always enjoyed working with V53 as he's the dependable sort of guy whom you know will do his utmost for the patients. doing the night shift with him is bliss, because we will take turns to answer the callbells in the fastest possible time. i have done the night shift with him before and we've never had any major problems. he doesn't go for breaks. and neither do i. so we just sit around and share life stories and wise sayings from his guru. so why am i sharing with you about V53 then?

well, here's the coincidence that i've never expected: my birthday is on the 16th of October. V53's birthday is on the 17th of October. you've really got to hand it to the Guy up there who works out the most bizarre of coincidences in the blueprints of our lives. my night shift and birthday were very peaceful because of V53. in fact, V53 treated the permanent night staff and me to McDonald's (they deliver fast food at night). to which V53 had this to say: 'the last time i had McDonald's was six months ago, and i only had an apple pie'. on my insistence, he had McNuggets and an ice lemon tea this time.

so this is an ode to The 53-year Old Virgin. happy birthday. without him, the 23rd birthday and night shift would have been hell and boring.


Monday, October 15, 2007

project 355: go shorty, it's your birthday

every time i think of birthdays, i can't help but get myself all confused and perplexed. let's say one's birthday is on the 16th of October (which is tomorrow) 1984 (which is technically twenty-three years ago), is one allowed to say sexually-innuendoed sentences like 'having had twenty-three years of experience under my belt' or should it be more like 'i have twenty-one under my belt and when the clock reaches 00:00AM on 16th October 2007, i will be having twenty-two.' because of my horrible logic skills (i actually have trouble winning at Solitaire & Hearts) and the fact that i've garnered a B4 for my 'Elementary' Mathematics during the GCE 'O' Levels, i take at least half a day to figure out that if one starts out at 0 years in 16th October 1984, he/she will surely be considered twenty-three in the year 2007.

which then gets me thinking again, can a 1984-born person really be considered 23 in 2007 if you factor in the fact that most people do not actually remember anything from year 0 to the end of the first year? i mean, do you actually remember memories of breast-feeding or formula milk (fun fact: i was formula-fed)? or diapers? or being throw around by relatives? or being kissed by your local Parliament Representative? come to think of it, the beginning of my memories has always been a mediocre trip to the Genting Highlands Indoor Theme Park when i was four years of age. that was in 1988... meaning a whole memory filled with bad fashion, bad music, pinball machines and too much neon lighting. it's a tad like Rodriguez/Tarantino's Grindhouse, minus the zombies, spurting pustules and paralytic wrists.

so back to the point of years of experience. it's technically incorrect therefore to say that one has 23 years of experience under one's belt in 2007 because of the fact that one can't remember one's childhood memories, no? perhaps, perhaps. and okay for the sake of the famous jazz number - perhaps. all was fine until i one day learned in nursing class the concept of 'conditioning'. not as in shampoo and conditioner (i don't need nursing classes to learn about the perils of dry hair) bur rather, of dogs and bells and Pavlov. we were discussing about the memories we had of our childhood. few could remember, if not a handful. we concluded that the childhood years were perhaps, a time of conditioning and learning innate responses that enabled us to survive society in the later years. infants can identify subtle facial expressions and emotions better than your average Sensitive New Age Guy. '23 years of experience under my belt' doesn't sound so bad now, does it?

i can identify groups of people who beg to differ though. some think that 23 years of experience is nothing. it's peanuts compared to the fact that they have lived for 40, 50 or even 60 years. and anyways, 'what do the young people of this generation know about? we have seen hardship and war and poverty. will the internet help save their lives in times of trial?' yeah, perhaps 23 years of experience is a bit of a boastful statement which makes one seem too puffed up in the ego department. logic fails me at this point. and so does math, Pavlov and Grindhouse. it wasn't until i realized that 'hey, 16th of October is my day!' to simply paraphrase in the words of Clark Gable in Gone With The Wind, 'Frankly my dear, I don't give a damn'

yeap. i was born on the 16th of October, 1984. which once again, loosely translated/paraphrased in the language of today:

'go shorty, it's your birthday'.


Sunday, October 14, 2007

project 355: the bizarre things i see everyday

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it's not the drugs talking, that's for sure.


Saturday, October 13, 2007

project 355: God may be your CEO, but i am the nurse struggling to take care of your dying father, so come help me

back in the days of nursing school, they used to teach us this concept called the Activities of Daily Living (ADLs). it's basically a measurement of sorts, used to assess how well a patient can function in day to day living. sure, it does touch a little on the social aspects like what one does for a living and one's sexual orientation and other fillers that help encompass the human as a whole. however, the main emphasis tends to focus on stuff revolving around one's ablutions and health problems. mobility, communication, elimination (as in peeing and shitting, not people; though i'm sure that most functioning people in society can name a few they would like to), sleeping, personal hygiene. these are just some of the factors that contribute to the general assessment of a person in the ADLs.

i have to say though, the ADLs are a morbidly boring module that i have always skipped since my first year at nursing school. i mean, there's only so many interesting pointers you can discuss about one's defecation, micturition and mastication capabilities. besides, as with all other subjects in the Singaporean education system, the examination material would almost always be taken directly from the course notes. all you had to do was copy the missing information from some other more hardworking soul, make a rather uneducated guess, or just google the damn thing up. after all, how hard can it be, having to guess 'Purposes of Nursing Implementation' when the answer that has been left half-blank is 'To achieve desired __________' (the answer is outcomes or goals in case you're one of those making the uneducated guesses).

truth be told, the ADLs play a major role in the nurse's job scope. to put it mildly, it is the yardstick that the registered nurse uses to assess whether a patient is for for discharge. to put it perversely, it is the noisy ten inch vibrating 'yardstick' that nurses use as a choice weapon against Team Doctors.

you see, every morning when the doctors are making their rounds with the consultants, they start going on a trigger-happy discharging spree (more discharges = more empty beds = more incoming patients = more revenue generated for the hospital = more cash lining my pockets). a hernia case that's able to pee a considerable amount, produce a moderate sum in the shitter, ingest a moderate amount of food, has a wound that looks moderate enough - in the doctor's opinion, that's the perfect candidate for discharge. no wonder the General Practitioner's #1 health-care advice tends to be 'Moderation is the key to a healthy lifestyle'.

of course, the doctors being the busy 'i-have-a-lot-of-patients-under-my-care' health-care professionals that they are, they tend to be rushing for time whenever they see a patient. upon seeing the doctors and the flustered look on their faces, the patients feel bad about telling the doctors any other problems that's bothering them. it could be something as simple as post-surgical pain and them needing one more day to recuperate. or the fact that they can't go home yet because there's no one to take care of them. or worse still, they haven't walked a single step post-op and the doctors don't even know it. whatever the reasons, the patients always end up telling the nurses their worries. and the nurses end up conveying the patient's request for an extension of stay to the doctors.

i can't help but hear the dull 'plok' of the yardstick in my mind when it comes into contact with a doctor's head.

--

it's ironic that the main focus of the ADLs: Dressing, Eating, Ambulating, Toileting, Hygiene, forms a mnemonic - Death. because when one is in close proximity to the end, that would be the time when one has problems with the ADLs.

the ward recently had the bad luck of accepting a difficult 'overflow' oncology patient. 'overflow' meaning when the ward that's supposed to admit their department's patient is full, they flow over to other wards that have available beds. the patients will be temporarily lodged in the other wards till there are beds available in the original wards. i used to tell an awfully crude joke to whoever was willing to listen. it's loosely paraphrased from the Dawn of the Dead tagline: 'when the colorectal wards are full, their shit will overflow to us'.

without having to reveal too much medical information, let's just say that there are issues at hand that make our working lives extremely difficult. in fact, these problem can be summarized in one simple word: The Relatives (okay, so that's two words).

i'll be the first to attest to the bane of relatives in the ward. in my entire nursing career, i've seen the best and worst of Singaporeans. there are the fussy ones that want things done their way despite their methods being rather medically-incorrect (solution: teach them the right way, and then compromise a bit and do it 50% their way and 50% the right way). there are the 'knowledgeable' ones who derive their information from The Mayo Clinic and wikipedia (solution: show them your nursing diploma and rub it in their faces). irritating ones who have five different relatives asking for five updates at five different times within a single shift (solution: emphasize the concept of a main spokesperson and guilt them into a corner by looking very flustered and busy). and even more irritating ones the come with sixteen other relatives, five of them being children who run amok in the hospital corridors (solution: 'you kids keep up that running and i will call the policeman' and i will go to hell for this because i still call security all the same).

combine all the above and you get this particular overflow patient's relatives. they don't trust the nurses. my other colleagues are always quarrelling with them. and prolly because they are so cynical and helpless and bored of sitting and staring at their loved one dying, they try their best to find fault with the nurses. the patient has total dependency on the staff to help with his ADLs. which i would be more than willing to help if not for the fact that each ADL-associated task will come attached with a stern-looking relative sitting on the armchair, watching you do your job. they refuse to partake in the changing of diapers. they refuse to tube feed their loved one despite the fact that they have done it at home for nearly half a year to come. and worse still, they constantly criticize the nurses and 'correct' their mistakes.

i can tolerate back-breaking and single-handed work. i can tolerate all the name-calling. but for some reason, i simply can't take irony. one of the 'taskmaster' relatives who sits in the armchair has been reading a book named 'God is My CEO'. and well, you know how scorned i feel about Christianity and Christians and people who don't uphold the good name of the Lord. each time i change a diaper, 'God is My CEO' stares right back at me, mocking me. i can't help but feel ashamed of having been a Christian in the past. if this is the way Christians these days are turning out, then perhaps 'till kingdom come' is really coming.

and this is the straw the breaks the camel's back. we can't transfer the patient back to the original oncology ward. namely because of his infectious disease issues. the patient has a history of MRSA sputum during the previous admission (which was only last month). during this admission, he has ?MRB sputum with two positive lab results so far). the oncology ward does not have enough isolation rooms to accommodate their patient. ditto that for the infectious disease ward. we've roped in the help of the supervisors. we've tried asking the doctors to personally book a bed for the patient. falling short of a letter to the Ministry of Health, we've tried every possible solution. well, it seems that the relatives and us nurses are gonna be stuck together for quite some time. ten days into the hospital stay and we're still fighting.

perhaps it's time to focus 'plok-ing' away on these relatives' heads rather than the doctors.


Wednesday, October 10, 2007

project 355: initial D

i have to admit that i awfully enjoy working with Pangkeng, the ultimatum in tough love. when there's a stubborn patient who refuses to take a toilet bath, Pangkeng will be the only one who can convince him (though i sometimes think it's more like coerce). if there's a patient who's being an outright pain in the ass, Pangkeng will be there to 'counsel' the patient. he's has already gained a reputation for being one who pushes the limits of boundaries. and nobody at work's saying anything about it. not because they don't give a shit or they are terrified of his huge frame and looks (though i can name you a few who have such an innate fear). but rather, because he breaks through the barriers all in the name of the patients. simply put, he gets the job done when others don't want to do it. he who hath not sinned and all that stones.

we make the perfect tag team when we work together, with him being the muscle and me being the brains. if you own an Xbox360 and have experienced Bioshock and the Ayn Rand-inspired city of Rapture, well... he's my big daddy. you wouldn't believe the stupid shit that we do in the ward. smoking in the ward, self-phlebotomy, getting lucky numbers from patients for lottery tickets (this one's Pangkeng's department, i don't play 4D, hell, i don't even know how to, but he has struck lottery before via this method), most of which is pretty much frat boy-inspired youtube-worth stuff. i guess the both of us are simply people who don't play by the rules. which is perhaps why both of us have the guts to do all this crazy shit that borders on us losing our jobs in the hospital. it's sorta like an open secret, except that no one has ratted out on us yet.

well, recently Pangkeng and i were working together again. and we both decided to go fetch a patient back from a procedure at the radiology department by ourselves. now, fetching patients back from procedures can be quite a pain sometimes. it's all in the problem of manpower. you need at least an Enrolled Nurse (one step below the Staff Nurse on the career ladder) and a porter to bring a patient back. it's a 2-man job in a 'every man in too precious to spare' kinda working environment. apparently, the radiology department didn't have any porters to spare because 'our porter has gone for his lunch break and our other porter is on medical leave'. so naturally, Pangkeng and i who have the patient's best interest at heart, dropped everything we were doing and immediately went to fetch our patient back. of course, we went to have a smoke together before we went to the radiology department.

it was while wheeling back the patient that suddenly, Pangkeng said, 'Jon, you want to see what is Initial D?' in case you're not Asian or you're not familiar with anime, Initial D is an anime-turned-movie that features street racing in Japan, a lot of hills, meandering roads, drifting cars, and delivering tofu while street-racing at the same time (the protagonist works as a tofu-delivery boy). awfully boring film if you ask me. but then again, i don't have a driving license and have never liked the Need For Speed series of games.

i assumed it was one of his millions of lame jokes, so i just shrugged my shoulders and gave some nonchalant reply along the lines of 'whatever'. before i knew it, at the next corner which required us to make a left turn with the trolley (NB: there was a patient in the trolley), Pangkeng swerved the bloody thing violently (NB: with the patient still in the trolley). the trolley went from position A to position C. i'm too lazy to put it in words, but all you need to know is that the trolley was still standing upright (NB: and the patient is still in the trolley).

'fuck,' was the first thing i said, 'what the fuck was that?'

'Initial D,' Pangkeng replied with a grin.

the patient in the trolley who prolly must have watched that accursed film before, laughed along with us.


Monday, October 08, 2007

project 355: a father's pride and a preceptor's wit (part 2)

any customer service officer working at a random reception counter can attest to the challenge of providing service to a whole barrage of human equipped with a wide spectrum of emotions. you have angry folks, indecisive idiots, unreasonable pricks, demanding bastards and just plain ol' motherfuckers. now couple this with providing service in the hospital where issues like ethics, morality, life and death and dealt with on a daily basis and you have some hot soup in the boiling. you have to agree with me that this particular bowl of soup is not exactly to everyone's liking. it's actually quite an acquired taste. having to waddle through the mires of emotions that dying patients are put through. in the hospital, it's not so much about whether the room service is excellent or the thread count in the bedsheets, but rather 'will i die during the operation?' or 'how long more do i have?'.

this is perhaps why i find that aside from clinical skills, perhaps it's the Life Lessons that are equally, if not more, important than anything else. two more lessons therefore, before i bore you any further.

3) Seeing the Morality in X-Rays

there are a total of three new preceptees in my section of the surgical ward - Fat Boy Slim, My Preceptee (braces & innocence) and one more whom i have never mentioned before. not because i don't interact with her or anything like that. to put it simply, she's a Plain Jane. i'm really good at seeing the unique bits of people. it could be a mole (i once saw a mole on a colleague's breast; it has stuck in my mind ever since), pen preference (ball-point or gel ink?) or even handwriting. Plain Jane however, eludes me. unless you consider labelling stationary with cutesy stickers of one's name on it to be unique, there's simply nothing defining about Plain Jane. but i kinda like her as a colleague because she's one of the few people who can understand puns.

none the less, she approached me one day with a dilemma. she had a patient who needed to get a Chest X-Ray (CXR) done. problem was, the patient (a female) was fit enough to go down via the whole bed pushed down, but not well enough to go down in a wheelchair. and when a patient has to go down via the whole bed, it's extremely time-consuming. the whole process from the ward down to the radiology department and back to the ward can take up to forty-five minutes. and forty-five minutes translated into ward time, can be used to accomplish many nursing-related tasks. of course, there was the option of calling for a portable x-ray to be done. and when i say 'portable' here, i'm talking about an x-ray machine that can be pushed up to the ward level. it looks rather cool actually. i would love to have sex with a radiologist on one of those machines, if not for the fact that an accidental push of some random buttons would release a blast of electromagnetic radiation and fry my fertility to nano bits.

i've never liked making decisions for people because i already have problems deciding sometimes (should i have the honey milk tea or the peppermint green tea today? and extra pearls? or maybe i should just go home and make a cup of bloody Earl Grey?). which is why i decided to pose Plain Jane a few alternatives as to how she could approach the matter.

'It's a simple problem filled with solutions that involve one's morals and integrity. to start with, you could do it the right way, by faxing your CXR form to the radiologist's and send the patient down via the whole bed and spend a big chunk of time waiting for the x-ray to be done. on the other hand, you could be a bit of an irritant by faxing the CXR form for a 'whole bed' just before the afternoon shift takes over in the hope that they send the patient down instead of you. or even better... if you care about your patient and yourself, ask the patient to act all weak and lucid, put on an oxygen mask to conjure images of pity, and fax for a bloody portable.'

i never got to find out what she did in the end. but knowing Plain Jane, i think she went for the route with the most moralistic returns. if it were up to though, i would have gone for the portable. after all, i'm a person with a deficiency in morals.


4) God Created Chairs with your Buttocks in Mind

i have no idea why but the average staff nurse dislikes taking a seat. perhaps it's the nature of the job which requires a lot of manual labour. i mean, how do you change an elderly's diapers while sitting down on a chair (ask me to demonstrate, i'll show you how)? because of this constant lack of rest for the limbs on the job, many of the older generation of nurses have developed unsightly varicose veins. you know those bizarre-looking bulges that you commonly see on women's legs.

i vividly remember my primary three mandarin teacher was one of those poor unfortunate souls with a very bad case of varicose veins. each time i saw her legs, it was like looking at a giant sea monster fused with a very hairy WWE wrestler wearing a pair of beige stockings ALA robbery style. she neglected shaving her legs, which prolly accentuated all the uneven bulges on her calves. and she wore really ugly stockings, sometimes with holes in them. she was quite the fashion disaster too, pairing those stockings with open toes sandals. so you've got ugly calves, ugly stockings with holes and even uglier footwear. Pixar really needs to make a new animated movie featuring my primary three mandarin teacher's lower limbs. Ugly Feet anyone?

there are of course things that one can do to prevent varicose veins. remembering to occasionally rest one's legs, stretching, etc. falling short of wearing the rather uncool compression stockings which to be all the rage amongst the health-conscious of nurses, i've therefore decided to teach my preceptee the sacred art of sitting down. in fact, i think i'm the only crazy person in the ward who tries to get everyone to sit down, constantly pulling chairs around for people to rest on. and my smart-arsed tagline to accompany an invitation to a chair?

'God created chairs with your buttocks in mind.'

come to think of it, it sounds rather right too when i reverse the order of the chairs and buttocks:

'God created buttocks with chairs in mind.'

it's a bit like a chicken and egg question. which came first? but i digress. there's more to sitting on a chair in the hospital than just health considerations. i've always believed in taking a little bit of time out to sit on a chair and update the patients on what's going on with them now and then. i don't know why, but i find patients friendlier and more open when i sit down on a chair and talk to them. same goes for blood-taking and wound dressing and all the many other clinical skills. before you know it, we're talking like old friends who have known each other for like ever. the only thing missing is the bucket of ice and some Tiger Beer.


Sunday, October 07, 2007

project 355: a father's pride and a preceptor's wit (part one)

i can't help but get giddy with pride when i see my preceptee fast turning out to become a fine specimen of a Registered Nurse. and i have to say she's quite the charmer with all the male patients that she nurses in her line of work. to begin with, she's quite pleasing to the eye. she's as thin as the 'i' in thin. she's currently contributing to an orthodontist's pockets. and the defining factor about her that makes men (including the homosexual me) weak in their knees in that surreal air of helplessness and innocence about her. braces, innocence and a pretty face, what more could a man ask for?

i find myself irresistibly helping her when she starts getting panicky about her workload. it could be filling up forms, or writing reports or even changing a diaper. falling short of killing a patient, there's nothing that i wouldn't help my preceptee with. with regards to the panicky bit though, she's a bit of what we Singaporeans would define as a 'kancheong spider' - a person who gets flustered rather easily, especially at work. don't ask me why a spider because i can think of many other creatures roaming this planet that are more kancheong than a spider. like say... an ant threatened with a magnifying glass perhaps? and anyways, 'kancheong ant' just ain't got that oomph and pizazz to it.

all that said, i still feel rather satisfied with the way that my preceptee has turned out actually. come to think of it, this satisfaction is rather comparable to a father's pride and joy at seeing his daughter at her High School Graduation ceremony. well, not the mainstream father that you're thinking about that changes nappies, grounds his kids and brings them to gran's place during the weekends. but rather, a divorced father of sorts who realized that the vage just wasn't his cup of tea and that the only cups he preferred were the types shaped like athletic supports. you do realize that the divorced parent without custody of the kids always seems to be the cooler one, no? well, that's me teaching my kid/preceptee the deviant and realistic way of life.

my colleagues are the ones who uphold the law and teach my preceptee that right way to doing things. whereas i'm the one who teaches her the 'right' way of doing things with a pinch of salt and perhaps some chopped up spring onions for garnishing. you see, in the hectic working life of the typical registered nurse, there's simply too many things to be done. one could of course attempt to accomplish the daily tasks via the straight and the narrow, doing things by the book and constantly halting at the bureaucratic red tapes. but it's generally tedious and really not worth the current salary that they are paying us nurses.

which is why on top of teaching my preceptee the administrative and clinical stuff, i try to imbue in them a 'work smart' culture. not because it makes me look darn savvy and cool (it does actually), but because at the end of the day, it's not about how you get it done, but how much you get done. it's sad but the local nursing culture is more quantitative-inclined than qualitative. your performance and chances for scholarships and promotions are all judged by your 'productivity rate'. 'productivity rate' here referring to, of course, the number of sick leave you have taken in this work year alone. i have basically overshot my allotted amount and even eaten into my annual leave, all thanks to my tonsils.

my chances of promotion from Staff Nurse I to Staff Nurse II this year? kaput. thus i've decided that since i'm not gonna be going far this year, might as well help a few others up the career ladder. this is in the hope that there will be a lot of preceptees pulling me up the career ladder in the following work year. it's an altruistic act with selfish intents, which basically makes this an oxymoronic statement of sorts. but then again, i'm not exactly very light to begin with.
all the more i need to teach the preceptees some random lessons like these:

Life Lessons That Jon Teaches His Preceptees (part one)

1) Drawing lines yourself
my preceptee (braces, waif-like, innocence) started one morning shift with me several months ago. she was barely a week into ward life when she started to complain about how heavy the general workload in the ward was. there were phone calls to be made, diapers to be changed, urinals to be cleared and a whole lot of other pungent and smelly things to be done. most of which had to be followed-up with strict charting and report-writing. it just didn't make sense to her that one had to touch faecal matter and a pen after clearing up the shit (it doesn't make sense to me either).

'I feel so stressed!' she lamented to me, 'it's like i have to do everything!'

i was rather cranky because it was 7.20am in the morning, i had only four hours of sleep (insufficient) and i hadn't had any coffee to begin with. on a side note, i had had two sticks of cigarettes, just enough nicotine to jump start the registered nurse in me. i was mindlessly drawing out lines on A4-sized rough paper. i normally do this because it's not only therapeutic, but it's for work as well. i divide the paper into twelve boxes - twelve patients under my care - for jotting down notes when the previous shift passes over their reports later on.

'You know, you need to stop complaining about how heavy the work load is and start focusing on how you can resolve the work!'

'But how?!' she gasped, 'there's just so much to do and so little time!'

that was when the crankiness hit me like a gorilla armed with a sledgehammer. and in jon's brain, crankiness, wit and spring onion garnishings are very good sex buddies.

'Okay, take this piece of report that i'm drawing out now. it's rather tiresome drawing lines when you've only slept less than the official eight hours and haven't had any coffee to start the day with,' i explained. and this is the killer line that i can't believe my brain came up with till this day:

Why draw the bloody lines yourself when you can get others to draw it for you?

this was the point when i positioned my pen at the bottom of the paper and asked my preceptee in a nice and friendly tone to pull the paper towards her. and lo and behold, there was one beautiful line drawn with some help from a fellow colleague. of course, there were several more lines to draw before there would be twelve boxes, but i think she got the point.

'By the way, can you pull the paper the other way so that i can get my lines drawn?'

'You're so full of shit at 7 in the morning,' she replied.


2) The patient has a thing that's leaking some stuff over there

a major problem with local nurses is the fact that they are bad at descriptions. i mean, things are not exactly very vivid when terms like 'there', 'something' and 'reddish-looking fluids' are used. perhaps this is why the doctors get so frustrated when someone who doesn't introduce themselves over the phone, makes a call describing a patient who has gone for 'an operation' and is complaining of 'pain' and thus 'can you do something about it?' (typical doctor answer: panadol, stat). most doctors and nurses spend time playing a verbal version of telephone charades, trying to guess what the other party is trying to tell them. when i first started out as a Staff Nurse, i was a major irritant, describing the wide varieties of fluids i see in the ward daily using common beverages as visuals (eg. it's a bit like pearl milk tea except that it doesn't have the pearls in it).

Fat Boy Slim (the fat preceptee with the girlfriend in the same ward as him) approached several doctors one day, asking for help with a patient under his care.

'Eh doctor (he talks like a thorough-bred mat), i've got a patient who's complaining of pain at this thing that he has over here,' with which he pointed at a very general area.

the general area in question? his left pectoral.

and Pangkeng and i don't call Fat Boy Slim 'Fat' unless his pectorals were the size of Manhattan (and i don't mean this in a good way). '?' was the only legible response i could think of that the doctor gave. i was writing my report at that point of time and was waiting for my junior nurse to return so that i could go for a smoke break. once again, the crankiness and a confetti of spring onions overwhelmed me and i just had to give my two cents worth about the 'pain' over 'there'.

'Eh,' i said in my best mat tone of voice, 'where are you referring to when you point there seahl? because 'there' covers a wide expanse of body parts. are you talking about the nipple? are you talking about the areola? or are you even talking about the axilla (a professional medical term that health-care industry people use to replace the layman's word 'armpit')?'

'There lah!' FBS pointed once more to his expansive pectoral. i couldn't help thinking how many dragons a tattoo artist could fit into that gargantuan portion of meat. 'Bang,' i said, as in ah bang, which is the malay term for 'brother' and not anything related to a group of people having sex, 'the doctors have no idea what you are referring to. you've got to be more precise lah. the nipple and axilla don't live in two seperate continents. they are only one hand's span of each other okay!' i followed-up with my own finger-pointing this time - the surfer's hang ten hand gesture (hand in a fist except the thumb and pinkie sticking out), one on the nipple and the other on the axilla.

to which the thorough-bred mat in Fat Boy Slim exclaimed: 'fuck seahl!'

in the end, Fat Boy Slim simply brought the doctor to the patient's bedside. he was talking about a Tenckhoff catheter (go google that up if you're not medically-trained).

(blogger's note: apologies for the medical blunder. and thanks to Dr Brachy for spotting the mistake. it's not a Tenckhoff catheter that Fat Boy was referring to, but rather a temporary dialysis catheter. on a side note, my maternal uncle just had a Tenckhoff inserted in the abdomen. it looks pretty cool actually.)

that's all the life lessons for today. come back tomorrow for more lessons. and when i say tomorrow, i will definitely post something tomorrow. the threat of the nipple jpg still looms.



About Me


Name: the nurse
Home: Singapore
About Me: i'm a nurse, i'm gay, i smoke, i play the piano, i patronize the theatre, i flip through glossy magazines for no apparent reason, i love sex, i am a left-handed libran, i watch art-house films mostly, i love house music, and did i say i love sex?
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