Wednesday 20 December 2017

It has been a year of HO

Assalamualaikum n hi everyone,

(lap2 habuk tebal kt blog bersawang ni.)Alhamdulillah, genap setahun jd houseman n Alhamdulillah dpt completekn 3 killer posting Medical, O&G and paeds this year. Only Allah knows all the struggle, hardship, sweat and tears, kilos of weight loss during the past year.


But also, the joy of seeing your patients recovering with Allah will, the happiness of getting the blood from the first poke or after few attempts , receiving gratitude from the relatives for taking care of their loved one and others. Not to mention, all the scoldings which actually make up the learning process to become a competent doctor, sleepless nights where you have to be on foot and attending unstable patients till morning and then rush to the clinics to see patients when all you think is sleep. (pernah jgk hampir tersengguk dpn patients) sorry makcik! and also the endless drama in hosp which I'll not describe further. hahaha

So, things have changed a lot for the past year. I have moved into  a new house since my exhousemate just get married and have moved to another house (actually sebelah rumah). Having new housemates n new environment, just settled and I'll be entering a new posting this Thursday, surgical! woot2.

One of the best doa that my friend shared to me which I recited everyday. Also amalkn bace alfatihah,ayat kursi, surah dhuha, doa p keje ni n selawat byk2 sepnjang jln nk msk hosp tu.




So, I just would like to share some of the tips and tricks and maybe what are the few life lessons which I gained from each posting. Let's begin shall we:

MEDICAL:

huge workload, have to mentally and physically prepared to go through this posting, Because most of the days, the ward will be busy, never ending admissions, blood taking for the whole ward (30 patients), postround order where you have to run to the radiology department requesting for urgent CT brain to rule out for haemorrhgic stroke (example), assisting your MO to perform LP, doing CPR at the early morning and breaking bad news to the relatives. this are of course just to name few. because ho jobscope is kinda wide, doing discharges properly, review patients, clerking new patients and giving a proper diagnosis and managements!

So, this is where the knowledge, experience and skills came along. I learn a very important lesson which my specialist once said "you are a doctor too!" after trying to rectify my mistakes that I depend on the management of my MO too much where in fact you should be also actively manage that unstable patient. find the cause! not just giving conservative management. for example, if patient complain of shortness of breath, don't just give oxygen! find the cause of SOB and treat the underlying cause!

Priority is very important! Teamwork is second. Be a good teamplayer, a leader and a humble and eager leaner. READ3X all the common topics especially after encountering that case. for eg pneumonia, what the managements, TB, COPD, asthma, Acute pulmonary oedema, MI and others.


O&G:

Workload is actually bearable because there's only 4 important questions you need to ask, contraction pain, show, leaking, good fetal movements? and of the other relevant info. investigations, examinations and management also quite similar. for eg, early labour, after ve if less than 4 cm, send to ward for FMC/LPC. shortforms mmg byk. memula asyk dok tnye je sbb xtau.lama2 nt ok iA.

Tips no1: learn to work fast and efficient from clerking, examinations, inv etc. because every seconds counts. kalau lmbt inform if ctg xreactive abes la.. kalau lmbt inform pt high BP, n xwt pape abes jgk. basically before nk inform pape, make sure do the necessary things first, examine, know the case etc.

tips no 2, read up the latest guideline RCOG, NICE, perpetua etc. cover all topics in logbook especially the common ones, pre-eclampsia, miscarriage etc. and kne ade good teamwork jgk.

PAEDS:

Babies are cute and very special in the type of fluids, how they present, managements etc. so, need to pay attention to the history. from presenting complaints smpi la diet history sume kne specific. kalau x, abes kne bambu. kiki. sbb sume benda ni akn help with making the correct diagnosis, adakah dia ade failure to thrive secondary to inadequate carbohydrate intake or too much milk taken a day etc.

common conditions cm asthma kne cover btol2,thallassemia, nephrotic syndrome, bronchiolitis, pneumonia to name a few &other cases dlm logbook tu. haha. learn to examine child confidently and properly. build rapport with them. again CME and teaching xbole miss. very important utk viva etc.

last but not least, drama in paeds is the norm. bare with them n just follow je ape depa nk(harap xd yg bce blog den) haha. n in shaa Allah, you'll survived.


ok rsenye tu je setakat ni. gotta start some serious reading from now on, as my specialist already ask how much is much you wanna learn in terms is skills, knowledge etc? hahaha..

wish me the best! till then, bye. =)

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