Wednesday, November 2, 2016

Next up!

Today's the last day of my second posting, medical. I got the day off, so I thought I should pen down how's stuff so far.

So far I've gone through Orthopaedics and Medical. When I entered the medical department, the people leaving were cheering us on, you know, wishing us luck and all. I remember them saying, medical is fun, at first it is overwhelming but towards the end, it's fun. Today is my last day and I honestly dont know what they mean. lol.

It's goddamn tiring. I think the most heavy part about being in medical is that you have to wake up early. If u arrive at 6.30, it's usually considered late. Unless like you're super fast with your job, or you know there's not much case, or you already know your case because the MOs will come at 8 and then you start the routine (rounds etc). The thing is you don't cover the same cubicle/ward at all times. You switch and you must be able to just suddenly go to certain places and review patients, know their progress, carry out plans etc. Though I must admit, the MOs and specialist doesn't really scrutinize you if you don't know the case because usually they know better. Because they're in charge of the ward and they see the patients everyday (except on weekends if they're not oncall).

It's physically tiring but i must admit that mental torture is definitely not an issue here. Most of the people in the department are nice people unless you do something stupid then kena marah but if memang it's your fault then you have to accept la. I would always remind myself that there can't always be sunny days. Of course you would make mistakes every now and then, be a bit lazy especially when you got too comfortable.You'd feel super shitty when that happens but hey, must pick myself up each time.

Housemanship is supposed to be a period of learning and collecting experiences. I want to have the attitude of greedy to acquire all that because if you think about it, some of the specialties will be the last time you encounter them during this time. So gotta make it count, a lot. I felt bad for not making the extra effort to study or enhance my medical knowledge during this posting because I'd usually just be lazy on my offdays like kerja days super penat kot! But after a while, while walking back to ward carrying abg result after cpr only to do yet another cpr, I gave up and told myself, you know what, f this. I just wanna get things done,  I'll learn and study some other time during the more free posting.

It however made me really appreciate ortho posting. Like they really wanted you to know. We'd have cme almost everyday at the clinics and during our assesment they asked loads of questions and they expect us to know most of the important orthopaedic stuff by heart. I felt like I wouldn't be doing orthopaedic in the future, so I was really semangat too to learn about ortho just so later, I wouldnt have to revisit the subject because I already know (I have pretty good memories).

The downside of it though, they really like blame you, scrutinize you if you dont know stuff/ dont know your patient/ dont know urea counts by heart, dont memorize the important numbers because we're in charge of much less patients so they expect us to be super thorough. but like how the fuck are we supposed to know what's important for this patient and not this patient you're the specialist and we don't share the same brain how we supposed to know what u wanna know. We're here to learn so teach us. Like I know it's frustrating houseman comes and goes and you have to keep repeating the same stuff cause you worked in this department for years and we've just started a few days/ months. I guess being teachers are hard. So you either want to teach us and be patient, or get shit done yourself/know the patients yourself and not be annoyed with disappointment with us all. ok. Lebih kurang mcm tu lah. Pretty much summarize why ortho hsa is a bit annoying. lol

What I appreciate in medical hsa is they dont really practice 'grand ward round', like everybody has to follow the specialist round patient to patient for the whole ward. You're free to carry on with your work while they are reviewing in other cubicles you're not in charge with. So there's definitely no standing for hours listening to what? here (aint nobody got time for that!), but of course there's definitely LOTS of walking and running around. Besides haemato and dengue ward, there's no division of specialty here. Like in Penang they'd have like 2 cubicles for cardio only, nephro only, endocrine and so on. Here, these patients could be in any bed. I mean it's good exposure but all these specialties do rounds and review at their own time with their own respective orders so like you have to be alert for never ending plans in your cubicle on top of your ward specialist round in the morning.

Honestly though, I can understand if people would have respect for houseman from hsa because we acquire the ability to get shit done fast even though most times we dont know jack what we're doing. If they say refer now, you must pick up the bht, go to the counter, call the operator for the extension number, flip quickly through the case and Sometimes when you're working night and you're covering the whole 1 block (4 wards male medical for example), how are you supposed to know who that patient is, but know you must. When you wanna go ask for scans, because the radiology department is some walk away, you kumpul the whole ward punya request (once you're more experienced), which includes those who are not your patient, get short and sweet history from ur colleague and then finally go down to save everyone's time and effort.

They say requesting scans is like mission impossible. Initially mmg pun especially when all these people request ultrasound for no strong indication, like seriously you also dont see the point like how to fight for it. But after a while you realise the radiologists are not stupid and they are people too. They know if you don't know and they'll mess with you. When they mess with you and you dont know what to goreng, don't proceed further with the goreng session. lol. that's when you simply beg. haha. kalau tak dapat jugak and your MO jenis yang mcm mana pun kena dapat jugak, walaupun he knows it's stupid request, I'd call my MO and ask them to tell me what to say to them, or  request them to speak to the radiologists themselves :P

You also must be able to seriously multitask. If you're calling the operator waiting for them to pick up, if you're not doing something (fill up lab forms, label blood, document stuff in bht, do discharge summaries etc) you'd feel super jittery! You have so many pending works to do and you can't just sit around waiting for the operator to pick up the damn phone.

I developed severe stress acne. I've never had this much acne before in my life. Initially I was worried, bought some products, basically lost it and spent so much. After a while though I notice they'd improve after a good night sleep so I thought, meh, let it all out, I'll deal with this after housemanship ends.

So yeah, I think that's ok for now. See what next posting will bring to me. Housemanship is exhausting but to me it's not as stressful and dreadful as studying time. At least you materialise and practice your knowledge and you see the results. You know you're progressing somehow and only have to be patient before you get better at this. Unlike medical school, you'll never know if you'd actually get through, pass and become a doctor. It's all still so vague.

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