~Do not give up. The beginning is always the hardest.~
Already 6 days of becoming taggers in medical department,
changed my life a lot. Here I just want to share with those who are going to
start their HOship later.
So, first day of work means you already have patients you
have to take care of, means that you have to be function.
You have to clerk the case for new admission, review the
patient for am and pm review, presented to your specialist, and carry out those
things that had been planned for the patient.
If patient need to be treated with antibiotics and any other
drug, so you have to endorse them in the system, same if your specialist want
to do lab investigation for the patient, you have to order it in system, manage
the order, take blood and send to lab via hand or pneumatic tube. If the sample
is urine or stool, we just ask staff nurse to settle it Actually, I kinda like
go to the lab, so that I can free my mind for a while from the hectic in the
ward. Certain investigation you have to fill special form or get authorization
from specialist.
The hardest thing is when your specialist ask you to refer
the patient to other department or request radiology, either CT, ultrasound or
radiology report. So you have to present the case perfectly and convincing, so
that they will approve your request. My first experience of referring case was
very bad and not confident, but the doc realized I’m the first tagger, so he
gave me a chance to read back the case and recall them again. But certain
doctor will shout over the phone when we presented it badly. Same for the
radiology, the stress comes when you can’t complete your specialist plan just
because they didn’t accept your request.
About the review, just imagine you have to change your
cubicle everyday. So, you’ll see different patient everyday and have to understand
their case as much as you can. So, because of that you have to come early. Some
people come at 5.00 am to make sure they review their patient perfectly, so
that they can present well in front of their specialist, that sometimes come as
early as 7.00 am. Just imagine if you get the patient with too many underlying
diseases, or too long staying in hospital. Nangis T.T
If the doctor discharge the patient, so you have to rush for
discharge advice and endorsing their prescription. You have to settle the mc,
the referral letter to other hospital (means you have to write them). After
that you have to settle the discharge summary for the patient within 48 hours.
Sometimes we stay back up to 12.30 am to complete them. If not, our name will
be announced there.
The hardest one, if your patient has problem. The staff
nurse will inform,
“Doc, the patient’s bp is high.”
“Doc, the dxt hi.”
“Doc, your patient fits!”
“Doc, your patient complains of pain.”
Then, you have to correctly manage them. If out of your
capability, then you can only ask your MOs or specialist.
Senior Ho taught us how to deal with certain simple
situation, what they call them placebo. For example if patient complain of pain
(so many and same patient), just go, ask some history, do the physical
examination, and gave paracetamol. And no more complain after that. Haha this
is for those patient which we completely know it was nothing significant, and
just want to attract our attention.
In a week of tagging, I’ve two patients need to be intubated
(it was difficult intubation), and actually this is my first time watching how
to deal with desat situation. And I only helped to take and prepare things je for
the first and second time.
And dealing with dengue patient will be a lot different from
other cases. I’ll update later insyaAllah. Haha the first time I reviewed
yesterday just to get scolded because didn’t put how many hours of defervescence
phase.
Once, the MOs asked me to take the patient’s blood in front
of him and will have to pay the patient RM10 if I didn’t get in first shot. And
know what? I have to pay him. T.T But manage to get in the second shot.
So, the first day of work I only able to eat bread for the
breakfast, and no more lunch or dinner, going back home at 11 pm just to
directly have a bath and sleep. Second day, I have rice for breakfast and no
more lunch or dinner. Third day, I have my lunch box. Forth day, my collegue bought
me a bread during lunch. Fifth day, he helped me to get wafer during my lunch.
Sixth day I bought myself pau kaya and daging for lunch. So, there are
advantages for those staying at home and has someone to prepared the food. My
sister will cook or but me food everyday. So, I’ll have them before going to
work.
Once, we stay-back until 11pm not having lunch and dinner
just to present new cases to specialist to get their signature so that we can
complete our off-tag assessment. And she started to ask three of us, if we are
having meals or not. She showed her care and advice us to treat ourselves well.
She also shared her experiences as Hos before covering 30 beds, come at 5 am
but still wearing heels and feeling that Hoship is the most exciting time in
her life.
And also when I finally can’t control my emotion and started
crying in front of another specialist. She told that during her Ho time, she
abled to manage MI as her first case although the symptom was too vague;
patient just complained of bluish of toe.
And when my radiology request finally approved when she
found me cried in front of my friend after being rejected. Because I have to get
it urgently that time and had been pushed by the MOs.
Haha many more things to be shared but next time insyaAllah.
J
Pray for me I’ll get off-tag on time and not having
extension for this department.
