Betul ke Sarsi boleh Legakan Batuk?
2 hours ago
Trust Me, Nurses Deserve More Respect:)
December 30, 2018
Vital signs - blood pressure, heart/pulse rate / temperature / oxygen saturation / respiratory rate (how many times you breath per minute) / pain score
"Dr, SpO2 patients tak dapat pick up ni. Dari tadi 90% je. Akak up kan bagi nasal prong taw" "Dr, BP pakcik X ni mencanak-canak ni. Nak kata stress, dia relaks je. Nak bagi ubat stat apa-apa tak?" "Dr, GM (glucose monitoring) patient 2.6 je ni. Nak bagi apa-apa?"
Survived 6 Weeks of Medical Posting :)
December 17, 2018
Just because I love sunset and beaches, make it understandable to have this picture to be the introductory one :)
Hi guys!
I know it has been a while. I miss my own blog too, I miss writing so badly even though I literally 'write' a lot in patients' notes for daily progress. Lol. So lame, Nina.
Anyhow, I am currently in my 3rd posting - Medical / Medicine department, claimed to be the heart of medicine, which is very true. I always adore colleagues who have passed medical as I can obviously see they are calmer in handling rough situations during working. They know what to do in what situations and they always be among my references in the previous postings. Somehow, it makes good reason for me to decide to choose medical as my third posting. Confidence and loads of experiences.
I didn't chose my previous two, anyway. But, still I am glad I love O&G and Ortho, passing them beautifully with good relationships with colleagues, MOs, nurses, other staffs. I hope I will pass this one as well, with more experiences and tougher physical and mental.
Medical posting is hard, to be honest it is the hardest among the rest so far I have been through. T_T
The environment is very good - supportive colleagues, helpful and understanding MOs... just the workload somehow make me slowly becoming exhausted. I am still tired the moment I am writing this even though I have slept hours to recover my lack of sleep through out the week.
Working hours in this department is challenging.
6 days of work with one off day. Same with other posting though. Just in this posting, it is rare to be able to go back on time. I tried to speed up my carry outs but nehiiii, going back on time is so precious to get. Haha.
I just hope and pray all my efforts to help the patients in ward be blessed, regardless how sincere I do my job.
Oh Allah, please always give me sincerity, physical and mental strength to go through the day everyday. :) Ameen!
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So, let me share experiences so far - which can actually be obtained in other departments as well.
1. Blood CM
CM means coming morning. Every time you see CM, you need to prepare to do it the next morning. Usually the blood CM will be taken by oncall people, starting usually at 3-4am and on good days, it can be settled within 1.5hours if we have two HOs doing oncall in one ward. However, it can take up to 2.5-3 hours if you oncall alone.
Just imagine to take blood from patients in the whole ward (among 30-35patients), adding doing alone... is one of the most terrifying task. If I oncall alone, I will definitely start taking blood as early as 3am, at the same time PRAYING HARD there will be no difficult blood taking, no detached branula (which need to have a new branula insertion), no other issues in ward like patient collapsing / complaining chest pain or difficulty breathing etc.
I know this situation is hard to understand if you haven't been warded or you don't have much friends in medical field but hehehe just read and buat-buat faham je lah taw. :D
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| Example of blood coming morning to be sent to lab. Results are expected to be available during morning round at least with MO, otherwise you need to add 'Trace & review blood investigations taken today' in one of your AM review's plan. T_T |
2. The precious C&S bottles.
If you saw doctors inserting blood into these bottles, keep in mind they are sending blood C&S (culture and sensitivity) to check if your blood has any bacteria or not. Taking blood C&S is compulsory before starting any intravascular (via the blood stream) antibiotics. The results can affect the plan of antibiotics to be used - either to change type of antibiotics according to type of bacteria or to decide on duration to take the antibiotics.
Just, the bottles usually to have shortage of stock in ward. The concept is when we send one sample of bottle, we need to exchange with a new bottle - that's how to keep the bottle to always be available. But, trust me, sometimes the lab can be locked during non working hours or we simply forget to exchange when sending samples.
Keep in mind - ALWAYS MAKE SURE TO EXCHANGE THE BOTTLES!
3. Exposure to diseases.
To be honest, my health is affected much in this department, despite I always try my best to wear masks, always try to wash my hand with hand sanitizers etc. It is not that you are not exposed to diseases in other departments, just I feel like medical wards have more than others T_T
Please, think thrice at least before taking your child to visit anyone in the hospital. Even adults are fragile, what else children?
There was one day when I have temperature spike - 38.2 degree Celcius and I was contemplating of taking MC, thinking of how my colleagues will be affected much with my absence. End up, I decided to still go to work and dragging my heavy head around.
In medical, you will understand how hard the day will be for the rest when someone taking emergency leave / MC. You have the right to take MC anyway, it depends on you to take or not.
I feel bad for myself, but I feel even bad to the ward. But, if situation like this ever happen again, I think I will consider taking MC. Working in bad health is very challenging. T_T
So far, medical posting is very interesting as it helps me to try to relate stuffs together, try to come out with my own diagnosis and plans before the MOs come and reassess the patients. It feels good when bosses agree with the plan we have come out but trust me, they have more experiences to change our plans accordingly. Don't be sad if MO's plan is totally different that ours but try to understand the reasons behind their plans - even though it is hard to search for the reasons. Usually I ended up asking the MOs him/herself.
Pray for my health and success in this posting.
Till next one, ameen.
Byeeee.
SM, Perak, Malaysia
181217
Upon Reading 'Why I Quit My Job As A Doctor'
September 26, 2018
Just remember, human is a unique species.
I have friends who really wants to be a doctor but they are fated to other professions.
I, myself who don't really put doctors as my future life, but here I am.
There are even people who are extremely excellent in medicine, but decided to continue working in other professions.
There are people who are not medicine-based staffs but they are very good to entertain people to live a healthy lifestyle.
And towards many others to mention here.
I respect her decision to quit. She knows herself better than us, so don't judge but give words of encouragement instead.
Sometimes, I encountered similar situations in the real working life. I am not an experienced doctor yet, but I do have approaching-7-months housemanship experiences. Trust me, it is hard. Doctors are totally not how they are portrayed in Malay dramas. Only those who have doctors as family members, friends or they have been in-patients and have been seeing doctors regularly will roughly understand the life of doctors.
"Doktor, dari pagi semalam saya nampak doktor kat sini. Tengah hari semalam pun doktor jugak. Petang dengan malam pun. Ini pukul 5 pagi, doktor lagi. Doktor tak balik-balik ke?"
Common. This is very common to hear.
Responsibilities. Working environment. Workload. Pressure. Stress. People's lives.
I am not here to share much about the struggles as you can appreciate those in the posts shared by the author. But, here I would love to share what can be done (or maybe what I have done) to prevent my life to be even miserable. So far, I am satisfied enough not to have that quitting thought.
1. Surround yourself with good friends.
Sometimes, in some places, it is very hard to find good colleagues - people who will not sabotage you, people who will back you up in darkest time, people who will know their responsibilities and willing to evenly distribute the workload, people who will help you with extra works.
But, honestly, they exist.
Search for them. And most importantly, try our best to be the one for them. They need us as well.
2. Always learn.
Another honest confession, no matter how good we are in theories, working life is beyond our imagination. I am not saying I am the best student but medical students usually have their own struggle to complete the course - be it 5 years or even 6 years.
Masuk telinga kanan, keluar telinga kiri.
Apa yang baik, simpan dalam kepala.
Apa yang buruk, buang dari hati.
Be tough, be strong. And always learn. Medicine is an evolving area, things keep changing for the good.
I already have juniors. Even though I believe I am still a newbie, but once you become a senior, people expect more from you. Learn faster and teach faster. Remind ourselves, we are helping community with people's lives and health.
3. Tawakkal
Every single time I step out of my room, I will try to practice this.
Bismillahi tawakkaltu ‘alallahi, walaa haula wala quwwata illa billah
- Dengan nama Allah, aku berserah diri kepada-Nya,
dan tidak ada daya dan kekuatan kecuali dengan pertolongan-Nya
dan tidak ada daya dan kekuatan kecuali dengan pertolongan-Nya
Indeed, it helps a lot to go through the day. Every single day is very uncertain. The good seniors can suddenly be stressed out and vent it out on us, the scary MO suddenly treat us very well. Pray hard that we can endure and cope well with this stress. But, if we can't, please seek help. I understand most doctors don't want to seek help (especially as it can indirectly affect our reputation especially if we have records in Psychiatry department), but please love ourselves. Our body, our mind deserves the best.
4. Enjoy the rest of the day
If you have been friends with doctors, you can see most of us really appreciate every single free time in our life - be it just by sleeping the whole day or travel as much as we can. Common dilemma among doctors will be like....
"nak qadha tidur ke nak keluar jalan-jalan"
When you go out the whole day, you regret of not spending it with proper sleep.
When you sleep much, you regret of not spending the free time outside.
Hahaha.
Use our annual leave, plan properly. Go out and enjoy. Spend time with the community with stuffs other than health-related.
Perform our responsibilities to the family - parents, partners, siblings, children. Most of times it can be stressful to imagine we don't really have the privilege to always be there for family events, even our family members may not understand us. But, keep in mind that we already have tried our best to join but the community need us more. Pray hard that Allah will open their heart to understand and most important of all, pray hard for their safety and health as we are far from them to take care properly. T_T
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However, if you think quitting is the best for you, do so. But, please, prepare well on how you want to do it. Please, meet people who have been there, who already experienced it - seek their opinions. Otherwise, check for other alternatives - what else can be done with the medical degree - though it is quite limited until we have the licence to practice. But, there are few I believe - non-clinical lecturers, researchers, medical-based companies selling surgical instruments etc.
I am still struggling but insyAllah may this journey be blessed.
To dear colleagues, we can do this :)
Fightingggg!
SM, Perak, Malaysia.
180926
Hiking Trip - Bukit Engku Busu, Perak
September 21, 2018
Wahaha. Macam tak percaya je saya berpeluang pergi hiking masa housemanship ni.
So, this time, my friends and I went to Bukit Engku Busu, Lumut. There are at least 2 hills to hike if you come here - the other one is Bukit 300 (located close to Teluk Batik). Going to hike that hill soon, insyAllah.
As usual, need to read a bit about the hill. I honestly read this blog post a long ago, since I was still in Obs&Gyne. Just, I didn't have the opportunity that time. :) And my memory about the things I've read already faded away T_T
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| Our team - Hamizah, Hanis, Haziq, Sham |
Just a little introduction about this hill. It is approximately 331 meters high (1087 feet) and named after a king(?) or prince(?) notsurethough, Raja Engku Busu who was been invited to help eliminating pirates in the area. The pirates were disturbing most of the Dutch, British ships etc. However, he was killed and lost the mission.
Manjung that we know today is actually being called as Dindings. The new name has been used since 1st January 1982.
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| Welcome to Trek Merentas Hutan Bukit Engku Busu :D |
If you read the blog post I mentioned earlier, you can imagine how challenging the route is. Most of it is covered with roots that we need to climb to get higher up. At some slippery areas, there are ropes provided to help us. If I am not mistaken, there are 8 check points to reach the peak.
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| Nampak je mendatar... tapi.... |
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| Feels nice to see this thing in the middle of hiking. Energized. |
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| With Hamizah. |
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| Seeeeee. Roots everywhere. |
Seeing roots like that reminds me of 4 seasons I experienced before. Can you imagine how trees can survive different seasons with different challenges? Because Allah has created them with all the needful preparation. For example, don't you think the roots play a huge role?
"When the roots are deep, there is no reason to fear the wind."
Exactly though.
If someone has deep roots of religion, send them anywhere insyAllah they won't change.
If someone has deep roots of love, go and meet a lot of people - insyAllah they won't stray away.
If someone has deep roots of knowledge, insyAllah they won't be bothered with evolution of ideas and even look forward for more.
Rasa macam dah lama tak tadabbur alam. I think I need to start on this again.
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| Tadaaaa. |
The peak of this hill is actually covered with plants and trees, so don't expect beautiful views from the peak. But, just before the peak, there is a route on the right that we can enjoy the view of the sea and TLDM. People said that we can see Pulau Pangkor as well but I am not that sure which one it is.
Overall, we took about 3 hours plus (I think so) to hike and get back to the base. It was challenging for me but with non-stop motivation of "sikit je lagi", "tu haaa, dah nak sampai dah".... I feel like, yes I can do this. Haha.
Well, biasa la tu. Ayat "5 minit je lagi" dah biasa dalam kamus hiking ni. :D
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| Breath-taking enough. |
To get here;
Thanks guys for the day, till the next hiking trip!
Bukit 300 pulak okay?
M, Perak, Malaysia
180921
I've Been Watching You
September 19, 2018
I was on my way to the thumbprint machine today when I called Hamizah for dinner together. I was ultimately hungry and in need of food STAT. One of the people who will always hang out with me is obviously her :D
At that time, she was actually preparing for a jog. I decided to join her, yes in my working attire. Who cares though. We went to Astaka in Sitiawan which is famous for its huge field (worth 2km run around the field). Finished a round, I decided to stop. Pancit. I was hungry, remember?
But, sorry I can't stay still. I walked to the basketball court to watch a 3-on-3 game. Mizah on the other hand went for another 2km jog. At the basketball court, there was a Chinese uncle playing on his own and I offered myself to join. -_-'' attempting to shoot, surprisingly my skill hasn't worn out yet. :D
Excited.
We talked for quite some time and that uncle even shared few tips to shoot. I told him I am not that used to basketball as I played netball instead during teenagers. He said that the concept is basically similar and I already have the basic skill :)
"You have good hands and you know how to shoot."
Wahaha uncle. Thanks!
Towards 7pm+, he excused himself to leave and took the ball with him. After a while, there was an Indian boy approaching me and started a conversion. He was one of the players from that 3-on-3 game I've mentioned earlier.
"Are you new here? I've been watching you just now. You have good shooting skills. Feel free to join us any time."
Okayyy. Hati bunga-bunga.
Berbaloi rasanya praktis shooting basketball kat arcade. Cumanya static shooting macam tu okay lagi. Kalau dalam basketball game... ke laut jugak. -_-'
Finishing my day at the park with this :)
I miss my childhood era when this stuff is my playground.
I miss climbing.
Adulthood is full of responsibilities. We are surely growing older. May Allah bless.
Ohh, we finally had tomyam campur, somtam and a plate of white rice divided into two. Haha, masing-masing tengah semangat nak jaga kesihatan.
Till then,
Salam.
SM, Perak, Malaysia
180918
I Feel My Leg is Still There
September 14, 2018
I just feel like writing today.
This evening, when I was in the prayer room for Asar, I quietly listened to 'curahan hati' of a relative who is currently taking care of her father. She was actually sharing her thoughts to another random lady in the prayer room, just to lift up the burden in her chest, I guess.
Even though I am an Orthopaedics houseman and her father is actually in my ward, I am now in the peripheral team - which means my teammates and I are in-charge of all Ortho's patients in other wards in the hospital... so I don't know much about what is happening in the Ortho ward.
Okay, let's get back to that lady...
Her father was initially came with signs of inflammation of the right lower limb and our impression is necrotizing fasciitis. After further examination and discussion with the specialist, he ended up in the operation for wound debridement KIV BKA/AKA. BKA simply means below knee amputation while AKA means above knee amputation. BKA/AKA will only take place if the surgeon thinks it is better to do so and after approval of patient during the operation. Upon incision of the lower limb, there was A LOT OF pus discharge and slough - which means infection! The leg was really not in good condition and the infection was already ascending above knee. T_T
Only if you know how the slough / wound smells like.....
After explaining the intra-op finding and the surgeon explained the need to proceed with AKA, the patient was only keen for BKA at that moment. So, we proceed with that.
That was my first experience with BKA as a houseman.
Limb amputation - it sounds easy to say. But if I put myself in that patient's shoes, I can't imagine to see my leg is no longer there.
But, patient's general health is important as well. That limb can be a source of infection that can lead to sepsis / septic shock - many organs can lose their functions and eventually leading to death.
"Pakcik, saya minta maaf sangat-sangat. Tapi ibu jari kaki pakcik ni sebenarnya dah tak hidup. Kita kena keluarkan dia. Yang mati tak boleh bersama dengan yang hidup, kan pakcik?"
I still remember one of my MO's words towards another patient who came with gangrenous big toe, which means he need rays amputation of the great toe.
Yang mati tak boleh bersama dengan yang hidup, kan pakcik?
This sentence kept on playing in my brain.
Same goes to life. There are some things or people that are not meant for us or things that are actually harmful to us no matter how much we love them. This is when we need to remove them in our life, otherwise they will affect us, physically and mentally - eventually can destroy us.
It is hard to let go, but we need to try and live with the fact. And believe that it happens for reasons.
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I think I lose my writing skills much.
T_T
I miss blogging though.
SM, Perak, Malaysia
180914
180914
Sisters at Heart
September 3, 2018
Both are the youngest in the family.
Both are the only daughter.
My beautiful cousin, Farah.
I am very happy for your marriage, Fa. :) Although I can't be there physically to help through out the plan towards your D-day, deep in heart I am wishing all the good things for you.
And I am ultimately happy to be granted with 3 days off just to be there on that day, to witness the akad, the reception and to be your bridesmaid :) Still remember the day when Mak Yang helped with video call on your engagement day when I was too far away.
Thanks for being a good sister.
Thanks for sharing ears to listen to my stories.
Thanks for praying the best for me.
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| azrenfarah |
May you have a blessed marriage in this world and still be together, happily towards the Hereafter. :)
Ameen ameen!
M, Perak, Malaysia
190303
Just Because It is August :)
August 2, 2018
Time flies fast, honestly.
I don't even realised it is already 1 year since I finally arrived home for good, saying my farewell to Czech and goodbye to long haul flights. Gonna experience them again as soon as I finish housemanship, insyAllah ameen ameen.
Things honestly changed a lot through out time.
Since it is August and turn out August is my favourite month (well, who doesn't love their birthday month though?) :D, I am gonna share this thing here. Well, it is actually the same piece I've shared on my Insta stories. But, I don't feel like describing much about it there.
Reading this tweet makes me re-scroll of my review of 2017 and to re-check how did I summarize my 2017 and what I look forward for 2018.
1. Stop complaining and appreciate how lucky you are every day.
To be honest, I complained a lot about work to my good colleagues - people who will also share their complaints but at the same time, will support each other to go through the day with good heart and hope.
Alhamdulillah, despite the tiredness and uncertainty at work, I hope I can maintain the feeling of good to help others - no matter of helping patients, colleagues, hospital staffs or even random people I met without the thought of quitting.
I know it will be hard to stop complaining but I'll reduce it. Housemanship is a struggle, I am sorry to say this but I deeply understand housemanship's hard life is for my own good, for my survival skill when I will be left somewhere without proper facilities soon. So, bear with me if I complain anything, I am just trying to get the frustration out of my head in a good way and proceed with life as none of it happened. Haha.
Anyway, I am grateful enough with my life - blessed with understanding family members who sacrificed a lot for me. T_T I am lucky enough to have places and people to go if I want to share stuffs. Allah helps me a lot by with beautiful beaches in few minutes drive away.
2. Commit to the goals you set and never look back.
I do have goals. But it was still hard to never look back to previous goals that I need to turn away from. Things will never be the same anymore.
Things changed.
People changed.
Our life changed.
Goals are changeable as well, to be honest, depending on what suits best at that time.
But, for me it is better to set goals and live our life towards them. It always feel good to go with the flow but I would still rather have goals and moving around with that goals :)
3. Saying goodbye to the people that don't bring positive energy into your life.
Yessss, this thing helps a lot!
Keep in touch with people who you know will love you, including the one who will guide, scold you for reasons. I meant it. People who want the best for you will help you but in return, do the same to them. Support each other.
Ignore those who bring you down, whom you feel you lost your self worth.
After all, don't ever bring them down, don't ever lose their self worth. They will get something in return eventually, just not from you. Allah will help doing so, to make them realize what they have done. Just, don't be the one who do bad to people.
4. Sweat every day to boost your mood.
I sweat a lot while working through out the day. Can it be counted other than sweating via exercise? Hahaha.
Alhamdulillah, I am very grateful of my working hours in Ortho as I mentioned before. I have more time for myself and family. I even have time to play badminton after work despite the need to wake up early morning the next day. Adaptation slowly helps anyway. :)
Embracing uncertainty :)
SS, Perak, Malaysia
180802
Hello, Orthopaedics!
July 31, 2018
I just feel like writing today.
It's been a while, I know.
I have successfully completed my Obstetrics & Gynecology posting, alhamdulillah. :) Missing it the moment I am writing this post. O&G was my first in encountering almost everything. My housemanship basically started from zero, there. But, to complete these 2 years, I know I need to move on to another postings.
So, here I am, on my way to complete the very first month in Orthopaedics.
Honestly, I don't have specific postings in mind to choose what is going to be next though. So, I am gladly accepting this posting :) There are few life lessons I learned here (so far in 1 month).
1. I need to be physically fit.
Orthopaedics is more about musculoskeletal stuffs - involving fractures of bones, dislocations of joints, diabetic foot ulcers any many more. And this is a surgical based - so, expect operations every single day. Operations are almost 100% different than O&G. They took hourssssss (the longest one I have been in... was 7 hours straight - with 20 minutes break for me in the middle because I was hypoglycemic). But there was one time when there were 4 operations planned to be done that day and it was going one after another from 8am to 5.45pm and all of us there were basically standing the whole hours.
MO: "Hanis, take a break, pergi makan kat pantry. You need energy to assist me."
Full respects to all of my surgeons, who are very committed to reduce all the fractures, to debride all the wound, to explore the area etc. T___T
One day, I was helping the medical assistant to lift up a full right leg of a 150kg man to secure the best position of it so that the surgeon can have the best view and space to do operation on the leg. Once upon a time, I was a person who could lift a 30kg luggage up to 4th floor with stairs - but I assume not anymore. I don't know why but seems like I am losing most of my energy and strength.
So, back to the story of 150kg man.... my hand was literally shaking upon lifting the leg. The surgeon realized this and ended up asking a PPK to exchange with me.
MO: "Hanis, the moral of today, you need to eat more and exercise more."
Me: "Okay, doctor."
Thank you doctor for being considerate enough to a newbie like me.
2. Expect the challenging response.
There was one fine morning, raining cats and dogs at almost 6am, when I still remember the azan was berkumandang. It was time to take blood coming morning (means as an oncall person, we need to take any blood needed for the whole ward early morning that day).
I pushed the blood taking trolley towards a bed - who was known to be very hard to take the blood. But, what could I do? Blood is like an identity to us. Other than physical examinations, doctors can know what is happening in the patients' bodies via blood - how the liver functioning, how well is the kidney, is there any chronic infection going on, are the antibiotics working out yada yada.
So, the uncle said to me. "Doktor nak ambil darah ke? Muak dah tengok muka doktor-doktor asyik nak ambil darah je"
I am so sorry to have this inner thought, "Ingat doktor tak muak ke nak ambil darah?". I proceeded to do so, because this is my job. No matter how much the patient hates blood taking, I am doing my job and trying to make sure to get my job done so that I can feel satisfied for my pay. Keberkatan gaji is very important to me.
I ended my shift that day at about 2pm and later at night, my colleague told me that patient passed away towards the end of the evening. I was not in charge of him but I feel bad for my inner thought that morning... astaghfirullah T___T
3. Get my work done first and only then, help others.
In this department, we are assigned to beds - which mean we need to take care of the specific patient through out our working hours that day. The beds may be the same from the previous day or the next day, depending on how the oncall shift people distribute the beds.
I need to remember, other colleagues may help me but usually all people will focus on getting their carry outs done first.
I need to do the same.
And I need to remember my favourite MO mentioned to me a long time ago, "Hanis, I know you are very nice to help your friends. Keep that attitude but in reality, most of the time, you need to save your a** first."
Life is very subjective. There are colleagues you don't mind to spend your extra time to help them out, but there are some whom you will feel you need to get out of there as soon as you've done your job that day.
Keep being nice, Nina. You can do this.
4. Ortho ward is full of patients with infections.Honestly, I feel bad for all babies and kids who come to the ward. I am sure that there is a big notice in front of the ward that we don't really recommend the parents to bring the small kids and babies inside. I know you want the kids to visit their grandmother, grandfather etc.
But, isn't your children's health more important?
Trust me, babies and small kids' immune systems are not that strong compared to adults. They are still literally growing, their immunity is still maturing. If the infections are strong enough for normal adults, don't you think they are extremely harmful for your little buddies?
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All in all, the posting is honestly full of dramas. Belum masuk kisah-kisah patients yang nak masuk wad tapi taknak masuk wad, nak operation tapi taknak operation. Hahaha. Adoi laaa.
Embrace them, Nina.
Absorb the best parts and let go of the bad ones.
Nina,
You are still learning, try hard to avoid doing mistakes. But, if you do any, acknowledge and analyse the mistakes and try not to do them ever again. If other people blamed you for something not your fault, back yourself up with valid reasons so that they can't fire back at you. But, if they still blamed you for no reasons, then it is their problem, not yours.
I love the working hours in Orthopaedics anyway. :)
One of the best things here other than very helpful senior housemen and MOs who are willing to guide and teach.
M, Perak, Malaysia
180731
My Different Version of Eid
June 24, 2018
To be honest, 2018 is my very first year to celebrate the first day of Eid Fitri away from my family. I had expected this to happen this year, so, my heart was well prepared for that. 6 years staying abroad, alhamdulillah I managed to go home every single Eid Fitri :)
But, life changed. I have new responsibilities, new environment and I look forward for more changes in my life, insyAllah with an open heart.
Night of 1st Eid, I was on call at the labor room. It was uneventful, I mean the oncall was bearable with few admission - tolerable much. Well, who wants to get sick on the night of Eid, you tell me. -_-'
I had something I could not forget, two different cases that really caught my heart on how people perceive the hospital admissions.
1st case.
There was a lady, primigravida (first pregnancy) who came to Labour Room (LR) at 0200H (2am) with complaints of contraction pain and show. Upon further examination, the CTG (reflect baby's condition in the womb) looked reactive (means normal), the os was already 2cm and time contraction was 2x in 10 minutes that last about 30 seconds.
Based on my previous experiences, we will admit this patient to the ward for further observation - in view of:
- she came at 2am
- her house is quite far away from the hospital.
Even though she was just primigravida (the labour process is usually longer for primigravida), she could still deliver the baby ANY time!
But, she was really keen to go home instead of being admitted.
Well, I do understand she did not want to celebrate Raya at the hospital, but this was out of her control. If it is fated that her baby to be delivered on 1st Syawal, let s/he be. So, my MO allowed her to go home and asked her to come immediately to the hospital if the contraction pain becomes stronger or if there is any leaking liquor (air ketuban pecah) or if she feels any reduction of fetal movement.
2nd case.
After the previous lady left the LR, another lady, G7P6 (means she is currently pregnant of the 7th baby and already delivered 6 babies) referred from the Emergency Department for PV bleeding (per vaginal) with diagnosis of incomplete miscarriage.
Incomplete miscarriage means:
- the 'baby' or better to be called as product of conception - POC (hasil persenyawaan) is already out
- but some of the POC still remain in the womb
We need to evacuate the POC otherwise patient will continue have a lot of PV bleeding and abdominal pain.
Upon per speculum with the MO, we managed to remove the POC at the os and upon TAS (transabdominal ultrasound), the endometrium thickness (ET) was <10mm. Usually, we need to proceed with ERPOC procedure (evacuation of retained product of conception) if the POC cannot be removed from the os and if the ET >15mm.
In this patient's case, our final impression was complete miscarriage - she did not have to undergo the ERPOC. However, we admitted the patient for observation and told her if her bleeding is minimal, we can allow her home that morning. She agreed with that - 'saya ikut apa yang doktor rasa terbaik'.
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Here we can see how patients perceive admissions to the ward. Trust me, no doctors want to admit patients to the ward without reason. Most doctors care about the patients even though admissions will increase the workload. But, that are for patients' sake and our responsibility.
And to make the night more interesting, the first lady delivered her baby just few hours after she left. Luckily she managed to return to the hospital T___T.
Birth before arrival (BBA) to the hospital is another issue.
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On the day of Eid, I was in charge of post natal ward and guess what, the ward round ended at plus minus 7am! And the housemen managed to settle all documents for discharged patients as early as 10am! Wahaaaaa. The MOs were considerate enough to allow patients home very early so that patients can celebrate Eid with family. :)
My shift ended at 1pm and I decided to drive home immediately after that. Arrived my aunt's house at almost 4pm and I ended up sleeping for the rest of evening. T_T
Went to my uncle's house that night and I ended up with sleeping on the sofa.
The end of my first day of Eid. :D
 |
| 2nd day was better. :D |
Selamat Hari Raya everyone!
Although this maybe quite late, but I wish you have the memorable Eid :)
If you are reading this, please pray for my success for tomorrow's assessments. I will be leaving for another department very soon and hopefully I pass this O&G - Obstetric and Gynecology with good achievement. Ameen.
M, Perak, Malaysia
180624
Good Things Today :)
May 24, 2018
After working 105 hours straight, finally I have an off day - which was spent for another medical program called Neonatal Resuscitation Program (NRP) 7th Edition. Haha. Although I was a bit sad at the beginning to think that I didn't have time to drive home to visit my parents or have a day off from the hospital... however at the end, alhamdulillah, it was a good off day. :)
1. I woke up feeling fresh after 10 hours of sleep yesterday.
Being a doctor, I need to train myself to always search for opportunity to eat and sleep whenever I can. To be honest, it was a bit hard from the beginning. During my first few oncall days, I felt bad to sleep at night thinking I am paid to take care of the patients at night. But, I learned that I need to take care of myself too. Doctors are still human being and we can't function well without enough sleep.
I must say that most of my MOs are excellent doctors to be able to think wise in the middle of the night and that is something I need to learn as well.
Still finding tricks to function well under sleep-deprived condition. Haha.
2. I passed my first Neonatal Resuscitation Program (7th edition).
Neonatal Resuscitation Program (NRP) is a program that must be attended and passed by all housemen to be able to attend babies either freshly born or the one in the Special Care Nursery (SCN) / Neonatal Intensive Care Unit (NICU).
As a houseman in Obs & Gyne, this course is important too. There must be at least a reason to call Paediatric team to attend newborn at the Labour Room or Operation Theater - like babies of mothers with diabetes mellitus, meconium stained liquor, fetal distress etc. Paeds team will not always be there to stand by in advanced if there is no indication.
So, doctors and nurses of Obs & Gyne need to know at least basic stuffs of what to do with babies if suddenly they are born flat (not crying, no muscle tone) before Paeds team rush over to attend.
3. I had iftar with good friends (although they are leaving the department soon sobss)
It is not hard to know new friends but to maintain a good relationship is not that easy. There are people you know you can rely on and you can also put aside your own problems just to help them as well.
Working in this field is energy and mental consuming. I am glad that I can still survive so far. It is not easy but insyAllah let's just pray hard Allah will guide us throughout everything.
I am a bit anxious to think about the seniors who are leaving in few days - as I will be one of the most senior housemen in the department soon. There will be colleagues (from other departments) coming in and I hope I can help them to adapt efficiently plus all of us can work in a harmony environment - though I am still adapting myself to work fast.
4. I received a postcard from Lithuania.
It has been a while since I last exchanged postcards. I miss writing my thoughts on them and share with others but it was a bit challenging to find time to look for good postcards around. To be honest, I went into lots of book stores and came out with nothing. Fortunately, I decided to visit the Tourist Information Center (my current town is a tourism site) and the lady gave me 12 pieces of postcard for FREE!
And sending a postcard from Malaysia is EXTREMELY CHEAP I AM TELLING YOU! only 50 cents for the stamp! It was at least 25kc (RM4-5) just for the stamp back then in Czech :D
5. I received my 2nd salary!
Gaji dah masuk oh yeah. Haha. I don't really put much thought on the salary to be honest but... I just knew it is a beautiful feeling to see the account balance.
M, Perak, Malaysia
180524
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