Trust Me, Nurses Deserve More Respect:)

December 30, 2018


I am very sad to read the latest 'not our level' issue and I feel called to share my experience about this. Nurses are basically people I meet every day (except my off day, of course) and they are actually the health institutions' backbone, to be honest!

They deserve more respect, more appreciation.
Here, I am not trying to say about respect compared to other professions as I have this belief that every jobs have their own struggle and hardship. But, I want to clarify that nurses deserve better than how they are treated by community. 

Let me share roughly about my life in the ward.

Officially, the schedule of houseman (normal / extended shift) started at 6-7am, depending on hospitals, one of the first person we meet in the ward will be the nurses. Some of them will be at the counter, settling stuffs before handling their pass overs to the morning shift nurses. Upon HOs are doing morning reviews, all the medical notes (or we call them BHT - bed head tickets) are already on the patients' table, together with the observation charts and medication charts. Nurses are the one who distribute the files to each beds every morning while they are taking the vital signs reading for EACH patient 4-6hourly. 

Vital signs - blood pressure, heart/pulse rate / temperature / oxygen saturation / respiratory rate (how many times you breath per minute) / pain score

Just imagine if patients' vital signs are not monitor accordingly, who will be the first person to notice patients' blood pressure drop a lot? Who will update the HOs that patients are desaturating / gasping for air?





After their pass overs, they will make beds - meaning arranging bed linens, giving out new cloths, changing pampers etc AND at the same time, some others will check and records the next vital signs monitoring. Some will distribute the medications while checking the glucose level (for diabetic patients)

Just imagine again, how patients' progress will be if nurses don't serve the medications on time, or how the sugar level will be if no one pricking the fingers of patient and check for it?

"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?"


Then approaching 8am, medical officers and specialist will be around to check progress of each patients. Morning rounds can end as early as 9.30-10am, but some complicated cases may delay it to 11+am. After round with bosses, HOs will carry out the plan, TOGETHER with the help of nurses.

Carry out can means a lot. It is either active or passive. Active means you need to do it stat / right now as the delay can affect the patients much - urgent blood takings, urgent scan requests, urgent referrals. To be honest, passive carry outs are important as well T_T. Why? They need to be done within working hours (minus the lunch break) - referral to physiotherapy / diabetic nurses / dietitian / speech therapy / pharmacists / hemodialysis / ECHO / scans.

Not to forget... tracing stuffs - it can be either old notes (documents from previous hospitalization in the same hospital / details from hospitalization in another hospitals / baseline blood results etc)

As simple as this, really show how doctors need nurses A LOT. They will always reminds us of our carry out, for the sake of patients. 



I will never forget my very first day of work. I was in O&G department at that time, trying to figure out how to do proper vaginal examination. Doing it as a medical student is not the same as when I am already a doctor. I feel blessed to have good nurses around to guide me around with so many new, first-time things in working life. 

Nurses have more experience than doctors, especially the one who have worked for years. Experiences vs knowledge - very subjective isn't it? Doctors may learn more through out the 5-6 years of study, but nurses have better knowledge via experiences. :)

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All in all, medical staffs need each other. I am here to support the nurses!
And trust me, human beings need each other. That's why we live in the same world, right?

Respect others as much as we want people to respect us.
Love others as much as we want others to love us.

And lastly, this proves that we need to expect nothing in return, just blessings from Allah for whatever people don't see.

Much love for you guys. <3

SM, Perak, Malaysia
181230

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

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
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