Up, Down and Bang

30th August (Saturday) - One more day to National Day and now I come in early on Saturdays so that I'll be able to go back early. For starters, I'm back at the usual ward and guess who's calling super early in the morning? You guessed it, the same old lady and her companion. Ahhhh. Dear God, please let the lady get well soon so that she can be independent and spare us all. God, now she has a maid to care for her, unfortunately, her maid doesn't have a single clue on how to take care of her and she kept demanding me to teach her maid. Truly, I sincerely wanted to help, unfortunately, it was a bad timing since I have to handle the other bed lady. She's able to do things on her own, the only downside she's slow, so I usually have to stay near her in case she falls and she keeps saying that she wants to change room and since now the maid has come in, she's furious because the maid caused her whole commode chair to get wet. I told her gently that every room only has one bathroom and for patients in double bedded or four bedded, they have to share with their roomies. The lady just shake her head and literally beg me to change her to another room, and I told her that I'm very sorry, there are no double bedded rooms at the moment and I do not have the authority to change her room if there is one available. Only the Sister and the prof has the authority to do so. After giving her her shower and just as I was about to make her milk, I got called to go to another ward due to shortage of staff.
Sigh, so after apologizing to the lady and telling her that I am unable to attend to her, i handed over to one of the senior staff and run up to help out. Up there is even more panicky and everyone is rushing around and my poor friend have to take care of the whole ward due to all the staff being super busy with their own tasks, assignments, medicines, doctor rounds, sending patients to the OT and reports. Apparently, they didn't have much staff til nearly everyone had to double shift. Since being in this ward threw me entirely, I have to rush to get the patients' diagnosis just to get an idea and then run attending the patients.
Since there was a senior staff on duty, she took me to observe her dressings. PICC and a scalp dressing. The scalp dressing is the one that kind of cause me to go, !!!!! Cause it's on a boy. Yes, a little boy who ended up having a scalp injury and underwent a skin graft to fix back his scalp. The nurse told me that if I have been here on the first day, it would've been much worse. Now that's left is a clean and dry wound with some granulating parts so it isn't too bad. I really hope if i ever encounter cases like this, I'll be strong.

FOC

29th August (Friday) - It's Friday already? Holy, this means I've been working for nearly a month. Wow, this also means my mo-neh should be coming in very soon, hopefully on the 31st. According to everyone, it usually comes out on the end of every month for not confirmed staff.
Today, I came early as always. Today I'm posting at the FOC. Free of Charge. No, I'm joking. The acronyms stands for Front Admission Counter. Basically, I'm supposed to just sit there, tag with one of the staff and observe what they do. I'll admit, I'm only good with admission, discharge and appointment. But if you're asking about registration, sorry, I'm the wrong person to ask. I'm useless at registering patients, but when it comes to answering the patients' questions regarding about wards and operations, I'm your girl. Most of the patients do ask questions about the ward settings, visiting hours and operation times and fasting. Good thing I was there. The front office counter staff are Layman so they can't give full details of the ward.
There's really not much to talk about to be really honest. Besides admission, payment is also done at there. Patients give their charge forms, or wait for their folders to be processed and then pay with either cash, credit card or insurance claim. Simple right?
I went to settle my APC and guess what. I gotten the wrong example and foolishly followed the whole postal order and burned twenty bucks.Darn it. Long story short, I have to rely on a friend to help me buy. I hope she gets it on time because Tuesday is the deadline.
I'm heading to the wards tomorrow and darn it, the Sister jokingly assigned me to that old lady again. Nooooooooo.

Insanity and Comedy

28th August (Thursday) - You're probably wondering why is there insanity involve in this post... Well, if you keep  reading on you'll find out. Today, I was given the assignment of going to the pharmacy. So I waited and waited and waited for someone to come. The lights are all on, but there's nobody in sight. Finally, I saw a clerk went in so I told her that I'm posting to the pharmacy and she just went, "You shouldn't have come early, girl. The supervisor usually comes in late."I told her it was okay and I'll just wait inside. Then when the clerk was tidying up her folders, she saw the date and went, "Oh no. The supervisor's not coming, girl. Because today is her annual leave." Oh man, is there even such a thing possible? I suggest alternates to her : I'll follow the other staff on their topping up medications rounds, I'll help prepare their medications, can't I follow the big boss instead? She shook her head at each suggestions and said only the supervisor's allowed to teach. The others aren't allowed. So I'm not allowed to come to the pharmacy. I went to find the sister in charge of my roster and after helping out in the usual ward which I'm familiar with when there was a phone call from the downstairs Sister who asked me to come and post to her ward. Seeing as how I don't have any other choice, I went down, just in time to help them for a shower. One of the nurse wished me luck and I asked her why, and she merely replied, you will find out.
So I went into the room and found this old lady sitting on a chair. My first thought is, Oh, an old lady, maybe she really does need help. Big mistake. She, I'm sorry to say, is uncooperative and acts like a total helpless person. When I tried standing her up, she moaned and said she was in pain. The attendant who was with me told me she had been living there for a month, and she never helps herself. I then asked her how does she usually bathe and she said that she can do it herself but refuses to do so. Then the lady moaned that she was in pain and the attendant told her firmly to help herself and then she made a big noise about us being selfish and refusing to help her, and the attendant shouted back at her which seems to add fuel to the fire. Then she actually did stood up and managed to walk with the walking frame.What the- Something about the way she talks makes me think back about yesterday about an incident where the CI mentioned to me that there was an incident where a patient said the nurses treated her horribly to her son, whom in turn, complained to the professor, and whom in turn screamed at all the nurses til the Sister and the CI have to lower their heads and humbly apologize. Oh dear. I have to force myself to swallow all of my annoyance and keep a cool head as she kept moaning that she's in pain and that she's a helpless old lady who needs someone to carry her. The attendant was losing her cool and I kept distracting the lady by keeping her occupied with the shower. Since I'm just a new staff, whom am I to take sides on? They probably knew the old lady better than me so I wisely kept my lips shut. And she doesn't let me go. I spent my whole morning all locked up in her room busy attending her. No matter I put all of her possession close to her, she just won't reach out for them. She just kept asking me to take for her, saying that she's in pain. When I finally got out, all the senior staff were laughing and said, "How did it feel?" and I merely gave a sigh of exhaustion and said, "I get it. I get it." But they did congratulated me for being super patient with her and I merely shrugged. 3 years of handling super fussy patients at my previous training taught me to swallow all of my anger and just put up a blank expression. After that, I have to send a patient to billing and handle a shaving for a patient who is going for angiogram. When they asked whether I could handle shaving alone, I merely said, "I'm out of practice but I'll do it." So I spend a while shaving while chatting to the patient, whom I gotten to know well that she trusts me even though we only met for a moment. Then when I finished shaving, I got one of the senior staff to inspect my shaving, she took a long glance, then gave me a thumbs up. "Good job. It's your first shaving right?" Whew, lucky me. I will admit, I never had experience with shaving before. I only made sure there were no hair sticking out and that the area is clean. Before I left, I also advised the patient to wash with clear water to clear any bits of hair that maybe sticking on her skin.
Then, the worst part came. Remember the old lady? Everyone warned me she's an attention-seeker and she will keep pressing the bell every 5 minutes. The lady beside her never presses the bell, but she will call for attention as well, just not as bad as the other lady. Hoo-boy, see what I mean. The moment I get called by that room, I'll be doing a disappearing act for hours. The saddest thing was, she doesn't help herself and she's uncooperative. She can turn, she can use her hands, even though she had slight pain on her leg, she can move with the help of a walking frame... It's just sad. Sigh. No wonder why all the senior staff told me to just sit in that room. Once you start attending to her, she'll never leave you alone. Sigh... The nurses told me I can just make a drama in that very room itself and I told them to get the camera ready. I went in to make sure the old lady eat and she kept shouting that she refuses to eat and that no one can feed her. Recalling a lesson that I learnt back from my time as a student nurse, I told her firmly, "Madam, you can use your hands to feed yourself. And you should feed yourself, because then your muscles won't be so stiff and you can go out of the hospital. Don't worry, I will help you chop your fish and mix your rice together but you must try feed yourself." The patient, after hearing my words, nodded and waited patiently as I chop the fish into bits and mash it with the rice and vegie and curry. And miracles of miracles, she actually managed to eat the fish finish, with half a portion of rice and some vegies. Yes! The nurses saw the result and were like, "Whoa. You managed to get her to eat." and I just said all I have to do is keep saying the word try and she'll do it.
Then noon came. Darn, I couldn't get the report on time thanks to being occupied, nevertheless, I rushed just in time to see a PEG feeding. Wow, it sure brings back memory when I used to do PEG feeding for a regular patient. You commonly see NG tube feeding but PEG, super rare.
As I got out of the room, I happened to pass by my friend who is struggling to measure the height of a tall patient who just came in. She barely reached over his chest and I just said to her that I'll help her. Then the patient looked at me uncertainly and I asked him to bend a little and managed to put the plastic plate on top of his head and pushed it slightly up as he straightened. And we managed to get his height. And he was like, "What??? I'm that short?" And I went, "No, sir. You're actually considered quite tall." Considering I have many guy friends who are taller than him, um, yeah, he's quite tall.
Going to the Front Office Counter tomorrow. I hope there'll be no more dramas going on.  

Orientation Near-End

27th August (Wednesday) - The day started off with bed-making and sponging as usual. As a bonus, we are given our new uniform and we get to wear it. Oh yes, those who had seen us walking around in the previously worn blue shirts were like, "Wow, you all look smart..." "You all look so different..." "Now you all look like real staff nurses..." My father jokingly said to me when I came down to eat breakfast, "What? Are you taking up waitressing? Cause you look like one." Ha-di-ha.
With the usual morning routine done, then comes the next wave of routine. Doctor Rounds, or to be more precise, Professor Rounds.Since all wards are short-staffed due to unfortunate circumstances, everywhere is a mad rush. Even though I'm still a newbie, the senior girls were like, "Here come Prof So-and-So, new girl. Gogogo!" I'm not complaining but... The prof(s) handwriting looks like worms, squiggles or chicken tracks. You can spend hours turning the whole paper 360 degrees and it still wouldn't make any sense. The first time I was rather blur and just let a prof ran off without confirming his orders. Arghhh, I'm so pathetic! Then some nurses told me to never let a prof run off without confirming his orders. They told me, "If you can't get the prof's orders, tackle him til you get it." Well, okay. So for the next two, one I managed to read his handwriting which isn't so bad, the other one I asked him since he looks like a nice guy and he just said to me, "Yep, planning for discharge and follow up in 2 weeks. You got that?" Lucky me.
Then after all the prof rounds, I was asked to assist a dressing. So I asked why and the senior nurse told me to help because the dressing is heavy. So I went in and...what a shock. The wound is huge, I mean, really huge and bloody, like a huge hunk of meat with visible muscles mass and bones, with external steel reduction
and large pins and bars. And the patient is in constant pain. I asked the staff nurse whether they gave him any pain killers and she said the med nurse already gave him a shot of sub cut morphine.Even so, when I asked him whether he felt any pain, he nodded in reply. The staff nurse brought very little cotton balls, so I asked her whether she wants me to get some more and she said to go right ahead. So I opened tons of cotton balls (6 packs at my last count) and I poured nearly all of the 500ml of Saline solution just for cleaning itself. If you think that's bad, wait til you hear about the part why I'm there to assist. I have to lift the patient's leg up. Easy task? Not! Even though the patient has received his morphine, he moans in pain. And you can't lift his leg by ordinary method, his younger sister, who is an Orthopaedic doctor herself, told me to lift him by the reduction. I counted mentally to myself and ups-a-daisy. Ohhhh, my shoulder is screaming in pain and I have to hold his leg for about 5 minutes or more. I have to use the foot of the bed as a support and tip toe a little so that I can hold his leg up higher so that the nurse can clean efficiently and wrap his bandage around. I should've eaten some more to boost my stamina. I even strained my eyes and could feel beads of sweat on my forehead. But at the end result, I'm really happy for the patient cause his wound is all cleaned nicely and everyone's happy.
Then I have to rush for my late lunch but who cares? If we don't eat, we'll end up fainting. And this is something that I'm familiar with during my time as a student nurse. If you don't eat enough, you'll end up fainting form hunger or become tired til you don't even have the strength to help your patients. See, break is important. Don't always say, "I have to help the others so I can't eat." That's bull.
The rest of the day pass as a blur, but the CI said since a month has passed, we're no longer under orientation, and starting from next week, we'll be entering the wards. Hoo-boy. Here we go into a whirlwind of being a real staff.

Run, Runner, Run XD

26th August (Tuesday) - Today was supposed to be the day of following the CI, but due to sudden unforeseen circumstances, I ended up becoming a runner whereas my other two friends become runners in the other ward. So, the day started off with sponging and doing bed-making. After that, because we were short on attendants, I have to transfer the patients back and forth (usually with a senior staff, and also as a chance to get to know the place well). Since I'm a runner, I also need to do admissions and observations. Today originally we have very little patients at first, but then admissions keep coming in. Some for op, some for medicines. So I was running one admission after another after I complete each one. I'm also expected to write reports. Because the senior staffs are all busy, I have no choice but to rely on my wits and apply what I had learnt.  I guessed my report must be good enough since none of the senior staff said anything.
I was also given the chance to follow a professor on his rounds. He looks really worn out, all sweaty as though he had been running a marathon. Bless him, apparently he literally ran from the other side of the building to the wards. Well... That explains it.
After each admissions are done, during noon time, I alternate between answering the phone calls and answering the call bells. Usually to assist patients in something or picking up phone calls and answering the request or taking a message.
During my lunch time, which I'm horribly late due to last minute admissions before lunch time, I talked to one of the senior staffs who was drinking lemon water. She said she often squeezes keeps slices of lemon to make lemon water to help in her digestion of oil and protein. If you had often been to Chinese restaurants, you'll notice that after oily food like fried pork, the staff will serve you tiny glass of lemon juice to help in digestion of the oily protein. I replied that it's a really nice idea, except lemons are really expensive.She then told me instead of throwing your lemon slices after one round, you should always keep re-using them til the slices are all spoiled. What a great idea. I'm going to keep all my lemon slices from now on. Then somehow we got to the topic of going outdoors, and I told her that when I was a student, I was often frightened of going out because my college was in a sort of end area surrounded by really bad... according to the staff nurse's words, sickos. She said she had been there before, and she said she felt sorry for us. And especially in the Shah Alam area where there are really horrible people that targets young girls and drag them into their car. They don't care if you are plain or pretty, rich or poor, just as long as you are female. The worst part of all is they do not want your money. Oh no. They only want to...to put it in a word, spoil you. Or defile. The nurse shake her head sadly and said that's the problem with society these days. And because these people were high on drugs, their sexual needs become high. How horrible. I guess that's why my parents never let me go out alone, even if it's for going out to a nearby shopping complex to buy books.

A Fun Monday

25th August (Monday) - Mondays are never really fun, according to most people. Sure, I'm half asleep in the mornings, even if I sleep at 10 sharp, I'll always end up half asleep. God knows maybe I'll have to sleep at 9, like how I used to prepare myself for my government exams. Hm. 25th is the day where the government servants get their payday. I have't get mine yet, sadly. I really want mo-neh (money) to come into my account so that I can use it to buy my beloved books. So many books I really want: Kalona's Fall, House of Night final book: Redeemed, Shopaholic to the Stars, and coming in 2015, The Mediator Book #7 : Remembrance, Princess Diaries #11 : Royal Wedding... Oh, I really want them so bad. Not to mention Final Fantasy Artbooks from Kinokuniya. Ahhhh.
Ahem, where was I before getting sidetracked? Oh yes, Monday. Well, today was a little short-staffed, so we were sent to  help out in sponging and shower. Can you believe we only done two patients and it took two hours? How I sometime love Mondays til Wednesdays because time flies super fast so that you don't have to keep looking at your watch. Today is also rather funny because many patients gave us tons of tidbits: Cupcakes and fruits. Stuff like that.
We were suppose to do discussions today, but because of short-staffed, we ended up being runners. In between, when we have time, we discuss about the hospital SOP (Standards of Practice). Every hospital has a SOP to ensure the standards of their organization are met. Same goes for major companies. Last week I had a chance to send a patient to the DSU on the opposite building via van, so my friend gets the chance to send a patient via ambulance. Nice right? The funny thing was we actually past these group of paramedics who went by us with a stretcher. The ambulance with its red and blue lights flashing outside. So I went to the ambulance to try get the driver's attention. The driver is already at the lobby and he looked stunned to see us. Then he said that the paramedics had already went up. Oh my goodness, we ran all the way down while they went all the way up. There was nothing for us to do except to wait for them to come back down. When they got back down, they transferred the patient over to their stretcher and then she followed her, leaving me and the other girl to become runners in the ward.
Then we moved went back to our discussions of SOP and posting schedules. I hope I'll get to go to other departments soon.

Worst Day Ever

23rd August (Saturday) - Is there ever a worst day in my working life? Of course there is, but it's not regarding about my work.It's about getting my academic transcripts. I got my CPR license safe and sound, but transcript, nope. First of all, I came as early as 7.30 am and the academic office weren't open yet. So I waited alone on the corridor and the lady finally came, but she refuse to serve me until 8 o' clock comes. So I waited silently while trying hard not to look at my watch. I was feeling excited that soon, I'll be able to get my transcripts and on Monday I can pass it to the Sister and finally get my APC, and so that I can increase my salary to a decent value. Seems easy, right? Hell, no. This is my life we are talking about, if things are too east, then something is fishy.
I went in, she asked me about an Exit Form, since I don't have one, she gave me one to fill in. Coming across several boxes with the various head of each departments beside each blank box, I asked the lady what are the boxes for, and she replied it's for the various head of departments to sign. There are five boxes but only four have to be signed, since the fifth one is only for dismissed or deferred students, I don't need to worry about that one. but hostel? That's insane. I asked her why do I need the Head of Hostel's signature when I don't stay in the hostel, and she merely replied, "We had incidents where the students lied and said that they don't stay in hostels, yet when we use the system, we found out they used to stay in hostels for a semester, or they they don't stay in the hostel at all when they did." That is total bull, pardon my French. What a waste of my time. Sorry to say, since I only got pardoned for an hour, I rushed back to work, 5 minutes before the clock struck 9. Yes, my new workplace actually practice a Give & Take policy. If you come in an hour late, you have to go back an hour late; and vice versa. Well, that's nice, but don't do it too often. You have to play fair with your other colleagues.
Because my mood was disrupted by the fiasco, I ended up working with a tense heart. With many discharges coming on, I ended up slamming the appointment cards on the desk, tugging hard at each file binders as I filed and dropping many things (Not important stuff, just papers.) Because my concentration was also disrupted thanks to the usual yelling from my parents after things go wrong, I ended up keying the pending discharge wrongly, fortunately, I was able to reverse it back since I haven't hit the DISCHARGE button yet. Thank the Lord for that, otherwise I'll end up getting another bullocking for the mistake. I get it why people say you always have to sort yourself out before work, with your concentration and emotion disturbed, you'll end up doing mistakes. I just wish my family could be more understanding. No wonder why I always end up running to my friends or the Befrienders when I'm down. What a crisis.

T.G.I.F?

22th August (Friday) - Fridays... One of the most dreaded days in my line of work. Because as mentioned in my previous post, Fridays are the time when patients get admitted so that they can do operations on Saturday mornings, rest on Sunday, and if all goes well, discharge on Mondays. The day started off with me setting my bags down while some of the nurses were eating some Raya cakes. They offered me one but I politely declined, since I don't really like cakes much. Then the prof came and they offered him some, which he took. Then he asked why are we not wearing black. Then I asked him whether is it because of the National Mourning Day and he said, yes. I told him we can't wear black, otherwise the patients might get a panic attack and say we're not nurses, and everyone laughed. Then one of the nurses jokingly told the prof, "If you are doing a delivery at 1030hr, what are you going to do, prof?" And the prof jokingly replied back, "Why, I'll have to stop the delivery for a minute." And all of us laughed. Use your imagination to imagine the scenario... Of course you can. If I tell you the whole thing, it wouldn't be funny. ^^
What's so special about 1030Hr, as mentioned, today is National Mourning Day in Malaysia, as it is the day where all the bodies from the MH70 tragedy are coming back. At 1030 exactly, everything stopped for a minute. The funny thing is, in the hospital, instead of the activity in the ward being stopped, the Internet stopped. So no admissions, discharges and bookings for a moment.
Remember what I said about Fridays being a super busy day cause of the rush of admissions and discharges, well, today, besides 2 discharges and admissions in the morning. Well, not today. After lunch, and settling one patient's bill on my own, there's absolutely nothing to do. Really, nothing... I expected patients to come flooding in like tsunami, but strangely today was quiet. I went a few rounds at the admission front counter and there's not much people in sight. Huh... I sat there for more than an hour, clicking on the computer aimlessly since I'm not allowed to do any nursing stuff when I finally get the chance to do more filings. Best way to kill off time since I was busy filing each papers with concentration. :)

7th Day of Clerking

21st August (Thursday) - On the twelveth day of- Okay, bad pun, but people always seems to like the 7th day of Christmas, except for me it's the 7th day of being a clerk, even though if counted by week, it's already my 3rd week, but do anyone care, no. The big bosses say 6 days, NOT 2 weeks, is not enough to complete my clerk training, which means I'm still stuck. Don't get me wrong, I like following the senior clerk and doing the job, except...when  can I start touching the patients? What about my 3 years of nursing? T^T I don't want to complain but seriously, I feel sad for not doing any nursing things.
Okay, today is really busy, for the morning, anyway.Good thing I had bee practicing with the flow system and computer cause there are many discharges.and admissions. Grab the discharge checklist, patient's appointment card, check the Dr's notes, find the follow up date, run to the computer and set to pending discharge, set the appointment, staple all the prescriptions and I/O chart together, write the follow up dates on the checklist and card,  tidy up the files, and run to pharmacy and billing. Then when the patient come back, record the amount and receipt number, hand their appointment card and relevant documents and voila. Believe me, I first freaked out on the whole system process, but after a few days of repeating the process, I finally got it. Same goes for admissions,
There's really not much to talk about to tell the truth. If you've seen my previous posts on filings, it's more or less the same. When there's nothing to do, file everything. Filing done? Write in the histopathology and HPE reports. Writing done? Tidy up the empty files. Tidying up done? Update relevant informations on the computer. See? Same thing over and over again. Once you get used to things, you can relax. When I'm free, sometimes I get to send patients to diagnostics, tidy up the beds, let patient know the bill is ready, fill up hot water flasks... Yeah, although it's dull, it's still a fun job.
Tomorrow is Friday, so bring on the admissions. ^^

Inhumane and Curry-phobia

20th August (Wednesday) - You're probably thinking why is the title awkward... I'll come to it in a while. First, since we came rather early, the nurses asked us to give a hand in bed-making and sponging. Okay, at least the day won't be dull. The first bed making was done for a cute little girl who's being discharged today. Then there's a sponging and bed making for another patient. This patient...he's rather stubborn. He refused sponging or  bed-making, even though there's a really strong odour in the air. I thought about leaving him to continue with his sleep and come back at around 10 or so to give him his sponging. But my friend, who has been working in private nursing care, is much more firm and pushed with a little force to get the patient to let us sponge. In the end, he complied but not whole-heartedly.
First of all, he's has a fractured arm. The littlest movement is enough to cause him gasp in pain. Then when I asked him whether he's comfortable in a position that is nearly the same as one of my regular patient, he said that he can't feel his legs. Hmmm.... So the other two girls, a friend and a staff nurse cleaned him while I helped him with his teeth and face while changing water for them. The water... The moment they dropped the cloth into the water I saw dark colours and tiny black spots. I took a look back at the patient and I felt sadness. How could anyone be so inhumane? The patient's skin is filled with dark crusts and poor hygeine. Then I found out from the staff that he has been bedridden for two months and no one bothered to care about him. Is something like this even possible?! Can anyone be so insensitive?! And for the two months, no one bothered to turn him and as such, bed sores have developed. In all of my three years of nursing, I have never seen a bed sore as bad as this. Wounds, yes, but bed sores, to the point of necrosis, once, but this is worse. It took us three rounds to sponge him clean, and again. we cannot move him too much cause of his arm, and because he couldn't feel from the waist down. All of us were the same size, so it took a lot of man power. Remember, he wasn't wholeheartedly helping us from the start. He often say he can't move and because of that we have to turn him together with the linen. At one point, we needed to sit him up because he couldn't turn. When I asked him to grab the railing for support, what happened was he grabbed... ME!!! He grabbed my arm so hard til I could feel my arm being crushed by his strong grip. My friend and the staff was outraged that they told him to let me go. I swear to you, it took a while to get the feeling of my arm back, thank God there's no blue black bruises. That's the one thing I'm scared off since I was once gripped hard by a patient back in my first year and it took 3 people to get him to let go off me. Anyway, after an hour or so, we finally got him freshly cleaned and his bed all tidy up. Thank goodness for that, and he went back to sleep once we are done. Funny guy. :D
Then we were given a chance to observe dressing by the staff nurse for the little girl who has a foot brace. I entertained her by using her little snail doll to distract her as the CI and staff nurse try to remove the bandages and dressings that has been wound tight all around. She didn't cry at first. But at the last part, she started screaming and crying. My friend and I tried comforting her but she's really scared and kept crying til the Sister and her mother asked me to get a supp Voltaren. While I managed to get the med nurse and went to get the medicine, another staff called me to take a patient to the clinic for a biopsy. It's my first time taking a patient to the clinic and i hoped I don't screw up. I was hoping to see a biopsy unfortunately it;s taking a long while and I couldn't be away from the ward for too long. So, once I handed everything over to the day-care nurse, I walked back. Yes, I walked back on my own since it was taking too long for the van to come back. I will admit I'm a little scared because there were cars all over and some guys laughing,wolf-whistling and leaning on the horn at me as I walked down the pavement. Precisely why I don't like walking alone back to the hospital, but there's nothing else that can be done.
When I'm back, there was a Hari Raya feast to be held, so we were all rushing around, carrying the furnitures, cutting the food into bite sizes, tidying up the cups and plates and cutlery, decorating and such. Sadly, I have to confess one thing. I don't like spicy food, and most of the feasts are sambal and curry-based. In other words, my kind of nightmare. However, I feel so bad for not eating anything so I took a chance and tried curry mee, the only thing that seems okay to me. Big mistake. Because I haven't eaten anything, my stomach was empty and the moment I ate curry, an hour later i ended up having major stomach cramps and running to the washroom. The Sister was very worried and asked whether I needed any medicines or a professor and I begged her no. Ugh, at this rate, I'll never touch curry ever again!!! :( Curry-phobia. I wonder if it's something to do with the excess coconut milk in it...

Running Here and There

19th August (Tuesday) - Few more weeks til the end of the month of August. I thought I was going to end up being a clerk again, but since the CI is unable to attend due to circumstances, so we were sent over to the other ward to assist in a sponging. The patient suffered multiple fractures on the left side so he's having a hard time to take care of himself. We assisted him in feeding and then we gave him a thorough sponging. Have to watch out for the left side though since every little movement on the left can make him yell in pain. In the end to prevent him from being tormented in pain, we left the fractured arm free from the sleeve of the gown.
How sad to say, after the whole sponging, I was called back to the ward by the Sister to be a clerk... D: Oh, I know I swore to myself that I won't mope about my clerk job, but-but... What about my 3 years of Nursing??? As I was given 5 files to file in the Medical Records, the Sister approached me and asked that I should observe a Lumbar Procedure procedure. Finally, something that makes my day worthwhile. So I was sent to go for an early lunch so that I can make it back on time for the procedure. During lunch, I planned to get roti canais (Indian flatbread) and waffles as a standby, unfortunately when I reached there by 10.50, it all ran out. HOW???? HOW CAN THEY BE SOLD OUT???? Outrage... Sigh, I have to make my way all the way back to the second floor to get...nasi lemak again. Sigh, good thing I ate early cause one of the staff nurse told me if I wanted to see a procedure known as Pleural Tapping. Hee, that's something you don't see everyday.
So off I go. Just in time too, as the professor was just starting his prepping. A few swabs of Povidone and Saline and we're good to go. I even got a chance to assist the professor. ^^ Even though I'm a total newbie, he taught me some things, reminding me to be careful not to contaminate his equipment as I peeled open the sterile packaging for him. It took roughly about 30 - 45 minutes since we have to wait for the pleural fluid to be drained. I have to squat to make sure the fluid is running since the professor is unable to leave his position from his stool. After that he had to insert branulla for the patient for a CT scan.And that's the end of the procedure. I hope one day I'll be experience enough to assist too.
After that, I rushed to collect a patient back from Endoscopy, do a quick report and vital signs check, and run just in time as the Dr. just finished prepping (again). Unfortunately, after 3 attempts on different spots with the huge lumbar needle, the Dr. is unable to get the spinal fluid. He said he managed to slip the needle in between the spine but for some reason when he pushed the needle further in, he is unable to get any spinal fluid. If he had pushed the whole thing in, he'll end up... driving the needle into the bone. Yeouch, Not even several Lignocaine can help dull the pain. The Dr. then said that in this case, he'll have to do it under a scan. So in short, the procedure is a failure and has to be done at Diagnostics.
All in all, what started off as a dull day became a happy day. Well, til the last part. Because we were all busy rushing up and down, we were late for a CNE talk about the care of chemo. The saddest thing was... One of the head accused us of coming in late just for the sake of our points, not for the knowledge. It caused a lot of hurt and outrage to everyone, including me. It's not as though we didn't care about the talk, we were busy rushing after our patients and our report ended late. How unfair, how can she say something like that? Next time, we'll log all our diaries for CNE talks on Tuesdays and Wednesdays so that she can't accuse us of something like that again.
Before I was going back, a long term patient was in need of new bed because he's so tall and his feet often rest uncomfortably on the foot of the bed. He's such a funny guy and he laughed as 5 of us struggled to carry him together with the bed sheet, especially for those of us who are short til we have to climb on top of the bed to pull him over. His family was grateful til they gave us mini bags of snacks, even though we refused, but they persisted. So we just accept it gratefully, thankful for her kindness even though we just done a small thing.

Anxiety

18th August (Monday) - Ever wondered why when you go to every hospitals every nurses are exactly the same, except for the system flow? Cause all nurses follow the same Code of Conduct. I will admit, during my students years, I have never heard of the Code of Conduct til my final year. But when you think about it, it makes total sense. You don't see nurses walking up and down the street in full nursing regalia. There's a lot of things in the Code of Conduct that we aren't supposed to do. Listing everything down will be too long and I'm sure no one wants to know whole Code of Conduct from A-Z. It's just basically the do's and don'ts of being a nurse.
If you have been following the blog so far, you'll noticed I haven't been doing anything much that is related to nursing. But good news is... We are allowed to do admissions ( No names allowed, strictly speaking). After my two friends were given the chance to do, I was given a chance too as there were many admissions. Just nice for each of us. I got a Chinese Christian lady and... I was worried she don't speak much English since she greeted me in Cantonese, I used Mandarin instead to communicate with her. I'm still not sure how the room is supposed to be, but I think I managed to more or less cover all the key points. The only part which I needed help is on the time swap on surgery cases. Don't ask me why but that's how things are, and it's a good thing my friends were there to back me up so that we are able to reinforce the point.
Fast forward to after lunch, we were given a preview of the yearly appraisal evaluation sheet. Looking it form back to forth, I felt a slightly sinking feeling in my stomach. The past three years of college life should have prepared me for evaluations, especially on an every 6 month basis, but this is ten times scarier. It basically evaluates on everything, from the assessment to the planning, to the care given, to how you carry yourself from punctuality to appearance, to your documentation to your skills to your critical thinking and etc etc. Yikes.
Before the session ended, we managed to observe a patient on chemotherapy. Well, it's just basically health education and giving him care. I never knew chemotherapy have so many things to care for, besides the usual pain, fever and basic care. Chemo drugs are high in toxicity and has to be run fast. I wished I had gotten the chance to meet chemo patients during my student time, but I fear it's a little too late. Now my heart can't stop jumping at the thought of handling chemo drugs. ><

Off The Hook, Not...

16th August (Saturday) - Sigh, if Fridays are bad enough, wait til Saturdays come.No, it wasn't as bad as Fridays, but it's definitely busy, especially in the morning til noon. For a start, I came early as always, and while the nurses are busy with the usual routine of bed-making. I am stuck to my clerk routine. Grab the files, update the census, update the computer system, not even 8 o' clock and the phone ring. As always, I chirp away like a parrot and it's either Endoscopy calling me for patient labels to print, or fixing up several months later appointment; OT calling for me to get ready patients; the next door ward calling for attendants help. Others will come later, but even so...
Then, the professor came. He's a really good professor in O & G (Obstetrics and Gynaecology) but his temper...well, if he doesn't have much patients, he'll be in a good mood. But when he has many patients, roll out of the way (Wait, it's the same thing with every doctors/professors). He got 6 surgery cases to do so he came early first thing to  get all his patients ready. In the midst of all this, the other ward called me and asked whether he's there. I risked a glance at the professor and he's in a really bad mood, grumbling and writing his notes at top speed. So I told the other ward that he's really busy but they said it was urgent and to please get him on the line. Knowing that I'm definitely going to get my head bitten off, I swallowed my fear and :

Me : Erm, excuse me, professor, sir.
Professor : What?! ><
Me : (Panic feeling in heart) There's a phone call for you from the other ward.
Professor : Tell them I'm busy! You all keep interfering with me and I won't be able to finish my work on time! *grumbling to himself and went back to his notes*
Me : I'm really sorry. He's really busy right now. May I take a message?

Few minutes later, I passed a paper with the message scribbled over to a staff nurse, who passed it to him.

Professor : What is it now?!
Staff Nurse : It's the message, Professor.
Professor : *grumbling* Tell them that I'll be around tomorrow at 11.
Staff Nurse : You heard him , girl. Call the other ward and pass the message over.
Me : 11 o'clock, tomorrow. Okay, got it.

*This conversation is edited due to certain confidentiality.

After the professor had gone down to perform his cases, phone calls came ringing and two admissions of his are coming in, also for surgery, bringing the grand total to 8!!! Holy, that's a lot. I saw the OT list and he's working one case of another. Oh my goodness.  My dad told me that when surgeons became too old, they don't have the endurance to take so many cases at once. (I'm not being ageist here) Well, all I can say is, poor professor, although all the staff thought I was mad for sympathizing him (They meant it in a good way, not a mean way).
As you should know by now, I worked in a multi-discipline ward, which means it's not Surgical, Medical, Cardiac, Paeds, GIT, O & G, Onco... separate departments, but it's all-in-one. There was baby admitted with a really interesting case: Hyposapdias Chordee. I took the diagnosis in memory and went back to Google search to read up about it. Really interesting, You can try googling it too.  
Once the admissions were all up to date, it's back to filing for me. And the occasional tube shooting to the various departments, including the baby's pampers, which I must say, fit just nicely in the capsule tube. Ignore the pretty blue and white cartoon patterns that you see through the tube display. ^^
On a sad note, I thought being a clerk for 2 weeks means I can finally start doing nursing staff, but my senior asked me to check the roster and I found myself still being a clerk. WHY?!!! TT.TT

And Disaster Keeps Ensuing

15th August (Friday) - I used to really love Fridays. Didn't people always say T.G.I.F.? Not me. Ever since I started work, Fridays are nothing but madness. Yep, because everyone keeps coming on Fridays so they can proceed to early morning operations on the following days. Argh. Why? WHY? WHY????
After the usual clerk start up job, update the admissions and discharges with the census, then comes the discharges. Here we go, another round of discharges, one after another like yesterday. Now I have to increase my speed because these patients, the moment they hear the D word, they jump and are eager to rush to get home. Problem : They do not have the patience. If they aren't shouting at the nurses, it's the counter. I get their eagerness and all, but couldn't they just give us a break? We are really doing our best to rush their discharge but seriously, there's a limit to everything.
Remember how I yesterday joked about getting knocked by the cupboard? Me and my big mouth.I was asked to get the OT files, and because I was, um, too hardworking at preparing so many OT files, they were all piled up so high in the cupboard. Because I was too short, I didn't dare risking taking any of the file in case I end up toppling the whole thing like dominoes. Even so, I tried, and bam! I knocked my head on the cupboard. Silly me. In the end, the nurse understood my problem and helped me brought one of the higher stack of file. Note to self : Do not ever curse/ jinx yourself.
Today, there is also an admission coming in the noon. The admission counter gave me a ring and asked me whether the room is ready, so like a good little worker, I ran to check the room, including the toilet, except the sheets aren't placed and the toilet...there's something inside the toilet bowl and it reeks, plus the TV in the room is still on. I turned off the TV and hurried back to the phone to inform them. So I did, and told them that the room is not ready. The girl then said she'll call the housekeeping staff to go over. No sooner than five minutes, I received another phone call from the admission counter, not the same girl, and she practically breathed fire at me, demanding me to just get the sheets onto the bed and they'll bring the patient in. That I can do, but the toilet isn't READY!!! The staff took pity on me and got the cleaner to take care of the toilet while holding off the admission counter, who may I add, is basically demanding us to work it, and that the patient had been there for hours. Argh, if the patient come in right now with the toilet in that kind of state, we'll get another yelling, this one will be from the patient. Sigh.
After hurrying the cleaner, we hurried to the phone and called the counter, and you know what happened? The patient LEFT!!!! I can't believe this! No, I took in the patient and acknowledge his admission, but instead, he ran off back home to Klang to take his meal and get something. HOW CAN THEY LET HIM RUN OFF JUST LIKE THAT???? I even banged my head on the counter, and the staff gave a sigh and told me to cheer up. What a fiasco.

Pandemonium

14th August (Thursday) - Wow. Look at how the time flies. Soon I'll be entering my third week. Oh... I just feel that I'm not ready yet. >< Today started off okay, but when it came to 9, ohhh, the discharges just kept coming. One, two, three, four. And each had to be sorted out into their own individuality. I had to shuffle them rapidly and staple the pages together, then carry tons of files with the papers on top to be sent for billing. I ran to the pharmacy to drop off the prescription slips, then to billing to drop of the files so that both side can total up the grand amount. Then I have to run to the computer system and make sure I discharge the patient fully so that housekeeping can come and clean the room for new admissions. It does not help that tons of professors had also chose this moment to drop in. Mayhem.
Let's just say after hammering down tons of filing and documenting later, I begin to suffer from fatigue, not from.lack of sleep but due to exhaustion. How do I know this? I tripped over the chair God knows how many times, and I dropped several things many times, like empty folders that I need to tidy. Everyone was like, "Oh, do be careful." It was when I was tidying things with the clerk that I ended up getting knocked on the head by stacks of paper. Thank God it wasn't heavy, if it is, I would've been KOed. Can you imagine it making it into the CNE talk? Issue in Nursing Practice : Do not go under the cupboard, otherwise you will end up getting KOed by falling stacks of paper. That's when the clerk told me to get a rest.
Speaking of KO, my friend escorted one client down to radiography. She was asked to send him down and then come back up. Instead, what happened was, the patient was asked to get up, and he fainted. YES! He really did! It was drama and the doctors and senior nurses rushed the boy the Emergency Room (ER) and gave him drips. Apparently the poor boy fasted from midnight and his body couldn't take it. No wonder she didn't came back up right away. If she had, she would've ended up in big trouble, leaving a patient behind.
After lunch, everything was back to normal, or so it seems. When I came back at two, the four discharges were taken by another four admissions. One of which is a regular customer whom I met few weeks back. So there was another mad rush on admissions and the computer system. And it did not help with the lightning and rain, causing the power to jump a little and the internet system to become slow, causing several crash on our system. Yikes. Then there's the whole mouse unable to move, no matter how much I get down on all fours and went to adjust the wires. Eeesh, could this day get any more nuts like pandemonium? At least I managed to nail down the whole OT thing by grabbing the patient's file, set it in front of me and flip to find the right info while answering the OT folks on the phone. Yay, at least I got something right.

Stress and Laughter

13th August (Wednesday) - Oh man, oh man, I've must been really stressed out. Cause I ended up accidentally sleeping while I was reading my Code of Conduct. Argh!!! Thank God no one's about. I've been having trouble sleeping lately. Today is also the day where I gotten my employee version of a student nurse's cross book. No photos, I'm afraid, but it's just like a cross book, only instead of crosses, it's signatures, I guess we should call it an autograph book. ^^ Bad pun. And did I mention instead of 3 years, you need to take a certain period of time which totals up to 1 year? Argh, I can't believe this. Total bummer, as a patient used to me.
There's also the Code of Conduct about the Do's and Don't s of being a professional staff nurse. Well, it's all straight forward, but according to the CI, majority never ever bother to read it, which is why they ended up doing... odd things when they are working. Today, we get to see a professor performing a really rare procedure : Chest tube removal. I always thought it was an underwater seal removal, but the senior staff corrected me and stated that underwater seal and  chest tube is totally different. Anyway, to the point, a staff was assigned to assist the professor, so she had to prepare a suture set. I couldn't see what she do, but according to the CI, she tried to rip the packaging in half. Sterile packets, even though I haven't done it before, can never, EVER, be torn into half. It contaminates the inside, pure and simple; hence tearing it open by the flap. Anyway, back to the point, the CI nearly had a heart attack when she rip the packaging in half, sending the whole tray set flying. Literally. No wonder the professor was like, "Which towel fell off?" Thank goodness there's another spare in the package. So the professor used the clean one as a protective sheet, and thus we were able to proceed. Throughout the whole procedure, the patient was crying and kept asking us to hug her, which my friend did. Poor them. The patient was frightened and terrified of pain til she grab at my friend so hard til she was wincing in pain. Long story cut short, through the many laughter and shrieks from the patient, the removal was a success and everyone cheered, with the professor laughing with relief. At the end of the drama, it was a good thing I did not throw the sterile glove on the messy trolley. The professor just took the glove from me (I held it out with the flap peeled apart like how one would peel a banana) and took the gloves on his own. Whew. I will not put the whole thing up here because it'll be much too long. But I'm sure you get the idea ^^

Protect Yourself and Others

12th August (Tuesday) - Today it's a really slow day. Well, okay, partly because I'm really sleepy from reading up old nursing notes. Oh yes, nursing is an everlasting process. You can never stop learning. Good thing I kept my old notes and textbooks. See why I refuse to sell them to my juniors.It's not being selfish or anything, but it's because you'll need them for future references, especially those important topics like Cardiovascular, GIT, Endocrine and Musculoskeletal. It's impossible to know every single thing in 3 years. As mentioned before, nursing is a very large field. It's all touch and go; furthermore, theory and practical are really different.
Okay, we were taken to the other side of the ward (No power blackout this time) and we had the chance to observe a wound packing. Really different from previous hospital training, but oh well. Who says everything is in a straight line? Different hospitals, different practices. Because I was still the new one, I was introduced to the various equipments and was given the chance to play with some of them. The sterile machine (autoclave), the suction machine and a drain. I get it why we have to learn how to use them, because once you're a nurse, you're expected to do everything smoothly. We were also taken to the HDU to learn the Emergency Cart, especially for Intubation. Since an accident or emergency may appear at any time, we have to work fast, not time to think. I was so nervous til the staff assured me that it takes time. Well, okay.
Because the talk took several hours, by the time we're done, we only have an hour til lunchtime. To kill off the time, we sorted out cabinets of papers. Ugh, all of them are mixed up like mashed up omelette. Finding a paper is also like finding a needle in the haystack. The CI saw us sorting through the papers and just sighed, saying why can't people tidy up things in the ward. I even saw the catheters that we have tidied up last week were all messed up. Great, I hope the professors won't chase us if we couldn't find the equipment on time. ==
Then we have a CNE talk about documentations. It's more or less what we have covered back in Sem 6 Management in Professional Development, but we have to adapt to the current hospital writing style. Back in the good old days, I used a sort of paragraphing style which is traditionally used, but now it's the PIE format. Of course, documenting is super important. Not only as legal issue, but it's to act as an evidence to protect both yourself and the patient. After all, in standard protocol, within 7 years a court case may be taken up if negligence is found. I won't say more from here to bore you the details. And tomorrow is going to be another busy day. Wish me luck. I'm really going to need it.

Seeing Anew

11th August (Monday) - How quick the time flies. It's already the second week of working life. And I finally managed to find my way up and down to the ward and found decent enough food besides waffles with chocolates. Today isn't a dull day but as we all know, I follow the CI on Mondays to Wednesdays. She review back what we have learnt so far. Admissions, discharges, booking appointments, normal documents to pre-op and post-op check lists; to patient's own medications and the basic do's and don't s in a normal ward setting. I can't believe there are tons of patient's own medication that were never taken back. Really, there's a whole carrier bag full of medications that were not taken home. Poor patients. Medicines don't exactly come in cheap, you know.
Then as we were all learning about the basic protocols, a staff nurse asked us whether we want to see a blood taking procedure by the Dr. Now, back in the good old student days, lab technicians were the ones who take blood samples. Here, Dr. are the ones who take blood. Oh yes. SO we were given a clear picture of the procedure. Since it was a blood C + S, it's considered sterile. The Dr. put on his sterile gloves, and performed a sterile skin prep with Povidone mixed with Normal Saline. Povidone stings, that's why it has to be mixed with Saline, especially on open wound. The Dr., er I mean, Professor, was really kind, teaching us and the nurse the procedure, like why he is using a sterile method, and he kept reminding the nurse to tighten the tourniquet as hard as she could to get the blood. Once she got it tightened enough, the Professor insert the needle in and... BLOOD!!! 10cc syringe of beautiful, shiny, crimson, vermilion blood. Then he split them equally into 6 bottles, 2 of which are of utmost importance. Okay, all of the bottles are important.
Then as we got into the room to do a discussion, I was greeted by a blast of cold wind. Then the CI quickly adjusted it to 25 and joked that if it keeps getting colder, I'll end up being frozen. Then she said I probably didn't eat enough. I asked her whether eating a lot of hot and spicy food will make you stand against the cold and she answered, "Eating lots of spicy food has nothing to do with it..." Ha! I knew it. My mom says I don't eat spicy food like curry, asam laksa and chili, that's why I'm always cold. Hmph. I knew it was fake. What my CI meant is... When you eat spicy food in the middle of a cold, your body will be hot for about, say one to two hours, depending how much spiciness you take. And vice versa. Then we were given a list of medicine conversions and calculations to do, to be readied to be handed up on the next day.
Seeing that we are often stuck in the same ward forever, the CI took us to the other end of the ward, which is so much, well, there's no other way to put it, neater, and much busier, fully equipped with sterile item sets and a mini sterilizing machine/oven to sterilize small stuffs like scissors and forceps. Aww, why don't we have it on our side too? The only not good thing is...the power often jumps. Half of the corridor is basked in darkness til the nurses have to carry torchlights, causing a Lady with the Lamp pun, or in this case, torchlight. Hmmm.... tomorrow there'll be talks on documentation and to collect APC points in preparation for next year's license.  

Chasing Dreams

9th August (Saturday) - Hello :D And yes, it's a Saturday and yep, working day. Welcome to the League of Working People (LoWP). So far I wasn't asked to work on a Sunday yet, but I can assure you, once I start doing ward shifts, I'll be working on Sundays as well. So I'm going to enjoy the Sundays that I have.
Anyway, I worked on Saturdays before back when I was doing my management course, it's just that I miss having weekends off, oh well. It's my third day doing a clerk's job, but since it's a Saturday, I have to multi-task once more. I finally got the whole admission, discharge and booking appointment computer system down, but I can't seem to log in to use the system. Ugh, first my thumb print clocking in, now this. I really don't get this at all.
First, I was given a bundle of clothes and was instructed to attend to a new admission. So I did. The moment she saw me. she sat up from her bed and the whole conversation went like this:

"You're Chinese!"
"Um, yes I am..."
"I been in this ward regularly but I had never seen you before..."
"Oh, well, I'm new. Are you a regular patient, madam?"
"Yes, I am. I've been here for so long but this is the first time I've seen a Chinese nurse in the ward."
"Ah, I see. Anyway, here are the clothes, madam. If you need any help, just press the bell and we'll come right over."
"Alright, dear. I hope to see you in future."

Just a simple conversation, and yet her words touched me. She put some faith into me. I was having second thoughts whether I can last til the end of my probation but hearing her words, I feel a tiny hope growing in me. I'm going to give it my all for all the patients' sake.
Since it was a Saturday, there are 6 OP cases going on. With not much attendants, we're in mayhem. As soon as we sent one down, we have to run back up for the next case. And since I'm doing my clerk job,
every hour I'll get a call from OT, chasing me to bring down the next case or chasing me to get the patient up to the ward. Eesh, and I thought Saturday is a day where you can stay a little calm. Ah well, that's a different setting.
Moving on, since we didn't have much time to do filings on weekdays; the clerk and I spent most of our time filing and arranging documents in preparation for the folders the weekdays. She then talked to me as we sorted out folders after folders.

"I've been meaning to ask you, girl. Why did you pick up nursing?"
"Well, originally I wanted to be an artist or a journalist."
"Why didn't you, girl?"
"I really wanted to. But my parents scared me into saying artists or journalists can never ever make a living."
"What? That's absolute nonsense. Who says artist or journalists can't make a living?"
"Oh well, it's not that I've given up on them. At least I managed to get my nursing license and cert."
"That's true. Nursing is a guaranteed profession, you'll never go out of job. At least, you have a safe job and you can pursue your other dream."
*mumbling softly to own self* "Actually... I already did..."

And I'll keep doing it until I can't write any more...

And The Files Just Keep On Coming...

8th August (Friday) - And second day of being a clerk. I'm a little sleepy so I took a nap before I get started. Since the clerk in charge was a little late, the moment 8 o' clock came, the phones start ringing and once again, I became a parrot. And because of shortages of staff, I ended up multi-tasking. The staff nurses are busy running up and about handling their patient's care, and because there's no attendants, I have to bring the patients up and down, do admissions and discharges, scrawling at top speeds to write in various books and appointment cards, filing documents, answering phone calls and taking messages, bed makings and lifting patients to a comfortable position.

One thing I learned, never underestimate Fridays. It started off normal as usual, not too many patients, but not too little either. But by the time an or two hour passed, we had a full house. Yes, all 20 rooms, including the VIP rooms, were taken and occupied. I asked one of the staff when we were having our tea break, and she told me Fridays are always busy because one, most of them are coming for surgery. Two, tomorrow is a Saturday, henceforth, the professors get to do their cases early. Three, on Sundays, the Operating Theatres are closed; so people usually rush in to on Fridays to complete the procedures on Saturdays, so that they can rest on Sundays. When you think about it, it's like a link of chains.

Then, because I haven't learnt how to slot in last minute surgery cases for booking, the Sister took me for a round to the OT Manager, and what a shock, it's my old tutor form college who taught me GIT (which I flunked miserably til the finals when I finally scored a B.) She was really surprised to see me and I told her that I didn't expect to see her either. I failed nearly all of the interviews I went for and this one is no exception. Lady Luck must've been really been smiling upon me to grant me this job.
Overall in all, nothing much happened. It was just a busy day with tons of admissions coming in til we don't have enough rooms, nor do we have enough discharges to fulfil everybody with a room. And we don't even have enough housekeeping staffs to clean up all the rooms. Disaster. >< 

Phones...Filings...

7th August (Thursday) - What a stressful day. First of all, I took my usual small breakfast of malt chocolate with oats and left quite early than usual. And what happens? An hour of jam in the highway.Oh yes, God knows what's going on today but it's a major jam. As I've always said, if you stay in Selangor and you need to get to KL or PJ, you need to move early. so lucky me, I arrived at 7.45 and clocked in without a minute to spare, then it's time for me to face my worse enemy : The phone and computer.
Okay, you may think it's strange that I hate phones and computers: the phone is mainly because during the time when I was a student, I used to pick up the phone and BOOM. I get screamed either by patients or doctors. If it's at home, I always get yelled by whoever is on the line cause I usually double and triple confirm who they are before I proceed on to the next stage. The computer, on the other hand, is an absolute nightmare. I can slam Microsoft Word, Powerpoint and Paint like nothing, but to key in patient's personal documents, tracing results and doing discharges and admissions... Heh, I feel like crying. Fortunately, to keep myself from crying and being photophobe, I wrote down the steps on pieces of paper so that if anyone ever ask me to handle the computer, I can take a quick peek at my "cheat list" instead of banging my head on the table.
As the clerk, I am also forced to remember every single extensions (No joke.) which I am unable to do so, so far, again, I have to use cheat list. Phone numbers are never my strong point. I can only remember my own phone number, but when it comes to others, I'm sorry to say no matter how many time I force myself to memorize numbers, it always ends up failing. Maybe I should try fish oil. Ohhh, and the phones. Every single minute, the phone will be ringing and I'll be going, "Good morning. <insert name> Ward. How may I help you?"  til my throat goes sore. Then it'll be various people from various departments, sometimes professors and I'll go, "May I know who's/ on the line/ calling..."; "I'm sorry, So-and-so /is busy at the moment/ not here...Would you like me to take a message for you?" I'm sounding like a parrot. And the gas pressure often beeps for no reason so I often have to slam the switch to turn off the noise.
Then there's the filing. Total nightmare. Every single papers are thrown in my way and I have to bite back form screaming as I arrange every single paper and file them in. And it's not only medical records, but results, care plans etc etc. And I have to run to billings whenever a patient is fully discharged. Ugh, I feel like an office girl.
Want to know what I often see wherever I go? Doctors. Everywhere doctors, with their shiny white lab coat and stethoscopes and their name tags pinned or hung around their neck. And they often come in like waves of pristine white tsunami. Really, there's no end to them. As I wait for all of them to go by so that I can move, I say it's raining doctors. We sure won't be having any shortage of doctors. =D

Conflicts and Awe

6th August (Wednesday) - Second day in the ward, And I still have to prove myself to the hospital that I'm capable. Which means I have to do all sorts of funny things: Being a receptionist, assisting patients, being a concierge, a runner, a pharmacist, an admission clerk, even working in the *gasp* LAUNDRY. No, I'm not allowed to complain, it's the policy of the place. Everyone told me the only key to get through it's to stay patient.
Let's see, the CI said we needed to refresh all of our skills (big surprise, since I was out of commission for about a month) and so she asked us to assist her in NG insertion. Oh yes. Back in the days when I was a student, you don't get these procedures easily. But S.T.O., Bone Marrow Aspiration (BMA), Lumbar Punctures are very common. Back to the point, she showed us how to insert an NG tube for a stroke patient and he was kind to let us perform. This is the first time I get an in-depth look to care for a stroke patient and it's a nice feeling. A simple thing like comforting the patient and just changing his pillow over makes him so happy til his wife gave us a large bag of M&Ms.
After lunch, I was given my task to be a receptionist til Saturday, so I was asked to try reading medical records to get the feel of it. Can I just say whatever I learnt in the past 3 years, it feels like I have to throw them all into the bin. NG tube procedure... No gloves needed. Inserting cannulation... Forget about the IV Tegaderm. We use only a small piece of tape. Clamping the tubing... There's no clamp. You have to press on the needle as you spigot it otherwise you'll end up getting sprayed with blood.
Even though I'm still a newbie, I seen really interesting cases. A Japanese child going for a burrhole (Brain surgery), a lady with Uterine Prolapse, stroke -and as I was going down to fetch some patients-, mentally ill patients (YES! It's like Tanjung Rambutan all over again!!!) and many others. They even have patients with open heart Surgeries but I have yet to see one.
Okay, off to bed now. Tomorrow I'm going to be busy filing and answering phone calls til I go nuts.

Small World

5th August (Tuesday) - It's my first "official" day, not fully in the ward. I was given a brief overview on how the system flow go, together with questions on the basic normal and abnormal signs and care. Here are some random ones that I've been asked.

CI : Is 140 a normal reading for blood pressure (BP)?
Me : 140 is considered borderline. But if it's above 140, it's an early sign of hypertension.
CI : Some books do say 140, some say 130, nevertheless, it's a good answer.

CI : What is the very first thing that you do during an admission?
Me : Greet the patient, and introduce yourself.
CI : Yes, that's important. I know people often say check identity first but greeting and introducing yourself is the most important.

CI : When patient's glucometer reading is 3, what will happen to the patient?
Me : Tremors, fatigue, sweating...
CI : And these are the signs and symptoms of...
Me : Hypoglycemia.

As an added bonus, I ran into an old friend from college. She's been working there for a year now and she's really good with her job. Finally, someone from my batch. That's a big relief. I asked her whether the environment is stressful and she answered, "If you like doing procedures, then this is a fun place to work with." Yes, not much paperwork, I hope.
I was also given the chance to join one of the staff for an admission procedure. Not much difference from what I've learnt, but it involves a lot of talking at certain areas which I need to get myself familiarize with, like how the costs are separated and certain items needs extra charge. Again, not easy, I've never been that good with costs. Argh.
I've also befriended with two other girls who are newcomers in the ward, except they had been in the ward two weeks earlier than me. They took me to the food court located beside the main building and holy, it's
a food paradise. Seriously, nasi lemak, plain rice with sauce and side dishes like meats or vegies, sandwiches, burgers, waffles, ice cream, curry noodles, asam laksa, cakes and pastries. I can see why many people love going there. The price are reasonable and there's a lot of variety to choose from.
After lunch, we were sent to the medical reports room. I thought we were going to end up like errand girls, running back and forth with the thick files, instead, we were given a brief theory about the importance of medical records. Especially if it falls to the wrong hands. I'm sure you know it too without having long dreary explanations. That's all for now.

Lonely Orientation

4th August (Monday) - I said I am excited, fully? It would be a total lie. Who wouldn't be nervous, at least, on their very first day of job? For me, it's a really big step. I couldn't even manage my breakfast, just a cup of malt chocolate with oats will do. I arrived early to beat the highway traffic and sat in the cafeteria til time's up. Then we were taken to the little conference room to the side to get briefed.
There were the usual speech about the place, what to expect and such. I won't bore you with all the details. First, our documents were collected and we needed to scan our thumb and index to get our attendance. That's something new. I used to sign in and out. The reason is because that way no one can escape or do something equally sneaky. Then I was taken to the department which I am assigned to. It's an absolute shock to find out that I'm the only person who got into ward. Apparently many had applied for OT, or clinics and some others, but ward...zilch. I thought being a nurse is all about ward if not OT.
After lunch, I was taken to the manager who did a Q&A session with me. Starting with my personal history. The reason, she said, was to get a clear idea of me so that I could plan my leave. She even jokingly asked me whether I'm going to get married any time soon and I answered I'm too young to marry, and I don't have a boyfriend. She then said there are some at my age who are planning to get married and that I shouldn't be so surprised. Because she's worried that if I have to take leave, she may get her hands all full. Oh, okay. Got it. Then she asked me tons of stuff what I learnt and I try to explain as best as I could, seeing how I have to dig up 3 years worth of hell to answer. She said she needed to know because it's the first time she's getting employees from another place. Then she asked me a lot of questions whether I know about the benefits, bonuses, parking rates and etc. The one thing that impressed her was when I answered leaves because I read the whole benefit booklet just to make sure I avoid getting tricked. Then, she took a look at her list and shake her head, saying that there were suppose to be five, and I was the only person who turned up. I must've shown I feel kind of sad, cause she hastily said, "Well, working in OT makes you robotics cause all you do is stare at the tools. No communication with patients." I think she's just saying it to cheer me up, but it does little, since majority are in groups or pairs.
Then I was taken to my department and the first thing that registered my mind was, "Holy..I'm the only Chinese here." But that was bounced out off my mind when the staff there were kind to greet me warmly. The manager warned me to be humble and polite and nothing can go wrong. She also asked me to prepare myself for tomorrow. Being in a new environment, I will be thrown around the entire place to get to know each departments so that I won't get lost.