Story of my life #1 ;

#asanursingstudent

Note : A lot of medical jargons are used here. I'm afraid you will not understand what I am saying here unless you google. It's okay if you skip this, but if you insist on reading, you're welcome to!


Semester two ;
One word to sum it all : BASIC.
All my first time was dedicated to these 10 precious weeks of postings.

Vital signs, bed making, bed bath, perineal care, subcutaneous injections, blood glucose monitoring, giving oxygen therapy, disposing urine, recording I/O chart, TPR chart, dengue chart, positioning, assisting patient in activities of daily living, handwashing and so much more.

For my first 5 weeks at PD,
I had familiarized myself with procedures like bed bath and perineal care because in PD, you get plenty of those procedures (during my time) because there were quite a number of bed ridden patients. We also have came across patients who are morbidly obese (it was stated in the case notes :B ) and I was always very scared to take blood pressure from them because either the cuff cannot fit or the machine will give no reading. Heh, but it was manageable after that.


Of course, there was a lot of frustrating moments especially when we did things "slowly" and made a lot of mistakes although we had been reminded several times. :(
But all of us managed to buck up and remained positive throughout the posting.
I still remember there was one time this patient was suspected to have MERS coronavirus and I didn't know it. I took his vitals in the morning without wearing any P.P.E. (personal protective equipments). The moment I knew when the staff nurse informed me... 

I was like, holysh*t, sh*t, sh*t. What should I do now??


After the unnecessary worries, the patient was finally ruled out from having MERS. 
The instant relief within me... Phew! *wipe sweats* 

Lesson learnt : ALWAYS know patient's diagnosis/conditions/underlying conditions before attend to patient!

Then for another 5 incredible weeks at Seremban, we also did more or less the same thing.. just that it was way busier at HTJ's medical ward. Time passed very fast there and I was glad to learn many valuable lessons during my tough-stressful time there :)

I had my second and third (and probably fourth) time giving subcutaneous injection at HTJ. Needless to say, I was very very nervous because giving people injection was my fear and I had to face it and conquer it.
Thanks to Ms. A, (although trembling) I had the most strict yet the best guidance under her and strangely speaking, I am not afraid anymore :)

In PD, five of us got the chance to observe abdominal paracentesis and also insertion of internal jugular catheter whereas in Seremban, we managed to look at how a catheter was placed for peritoneal dialysis and also how last office was done by the KKM students. My first time again, and I already felt the coolness being in the hospital! Hahaha #whatnoobyusuallysays

Honestly speaking, I tend to get excited easily when I heard any new conditions. In semester two, Steven Johnson syndrome, psoriasis and eczema sounded really new to me, believe or not I once thought that patients who have eczema can easily spread to other people by contact. But after some thorough research, I knew that I was wrong. #whatnoobysays

Haha, after ten weeks of postings, 6 working days a week, I must say that I was very glad to be back home! Prolly I can't stand the life - the life of having only one day of weekend. /sobs/
Don't know whether I can still move on and get used to the life in the upcoming sems.

-Fast forward-

Semester three ;

Hey ho!
In this semester, we have learnt more in depth about what we learned in semester two.
*Condition
*Pathophysiology
*Investigations
*Treatment (Medical and Surgical) including medications
*Nursing care/responsibilities
*Health education

The systems we learned were Respiratory system, Cardiovascular system, Haemopoietic system, Gastrointestinal system and Endocrine system.
It was pretty hectic but we made through all these five systems and I'm proceeding to semester four (tomorrow), woohoo!

So during clinical posting (or hospital attachments) at dear HTJ,

First day at medical ward : Orientation. Briefing. The environment of the hospital surprised all of us. New curtains, the floor is somehow cleaner and more sparkling than before. Things are neater! I have to give two thumbs up for the major improvement :)

Second day : Observation of BMAT (Bone Marrow Aspiration Trephine) procedure O_O

It was pretty traumatizing for me. I simply can't imagine how the patient felt that day. I'm sure it was a horrifying experience for him too.

Week two, third day : Observation of liver biopsy done by a specialist, a nice and kind hearted doctor :))

The rest of the three weeks : I had my first try on NGT (nasogastric tube) feeding and removal. I was lucky to get to carry out one of the blood transfusion procedures in the ward. 
Not to mention, I had plenty of chances doing ECG at cardiac clinic. Ohh, there were a few echocardiography and stress tests for us to observe as well :) Then the normal routines (which I practised in semester two) was carried out as usual.


Anything more interesting?
Well I guess it's a yes because there was this one day I finally encountered with a 'brilliantly' smelled stool called, Melena stool. I don't mean to be rude but I almost fainted that morning when carrying out perineal care with my colleague and my dear tutor. What's worse was, the patient can't stop passing motion because the night staff nurse gave him enema which I believed he was scheduled for colonoscope in the afternoon. :/

Other than that, I guess it was so far so good. The learning experience was awesome as we get to relate better with patient's condition, investigation, and also our responsibilities. 

Some new conditions that I came across this semester include : Nasopharyngeal cancer, mitral stenosis, thalassemia, pantocytopenia, malathion poisoning, myeloid leukemia, sickle cell anemia, patient with Charcot foot, Noonan syndrome, acute myocardial infarction (Killip classification) , Meliodosis and many more.

Under ms. V's guidance I have learnt tremendous amount of lessons - about patients, patient's conditions, our nursing roles and also about life.

The one thing I must say that I have great respect for her is the professionalism in her when she's at work. She gave us a lot of motivational and constructive comments which helped us a lot in improving our skills, theories and also as a person. /very very grateful/ 

"There's a diamond in each of you right here *in your heart*. As you go forward, you'll get better each day. As you move forward, the diamond will be slowly polished and soon,

 you all will be shining"

..................... Moving on to another 5 weeks at surgical female ward,
I went with zero expectation and came out with countless of amazing experiences.

The ward was way more relaxing than medical ward, nonetheless.
I had many chances to carry out dressing for different types of wounds - fungating breast, bed sores, venous ulcer, pinsite, etc.
Sadly I didn't get the chance to carry out wound packing YET. Hopefully in the coming semesters I will be able to do that dressing :)

As our clinical assessment was approaching, we also took opportunities to practise health assessment as much as we can as a preparation for the coming exam. 
Thank god, we all did fine on the actual day of exam (though I must say I was very nervous). Still, whether it was good or bad I am thankful for their overall comments. :)

I guess the highlight of my working experience in surgical ward was catching maggots from a wound, cleaning fungating breast (wound), giving enema to an elderly patient and also removing staples from a patient's surgical wound.
Removing staples wasn't really tough for me. As I tried to remove using the technique learnt, I comforted the patient at the same time, trying to ease the tension and nervousness. In the end I managed to remove at least 8 of the 30 staples, whereas the rest of the staples were removed by my fellow colleagues :)

I am sure you are intrigued when I mentioned catching MAGGOTS from a wound. Yes reader, you read that right.
I swear it was one of the most disgusting moments I've had but it was fun! lol #whatnoobysays Hahaha, out of nine big FAT maggots which love sloughy tissue so MUCH, I managed to catch 3 out of the 9 big FAT maggots. Not bad for a first timer huh, self achievement unlock! #whatnoobysays :B

On another note, I WISHED I had the chance to change colostomy bag for at least once but too bad I hardly get any. Just managed to observe my friend doing it :) 

And for the last two weeks at surgical ward, we had our time to visit endoscopy rooms to observe colonoscopy, endoscopy, ERCP, and insertion of PEG tube! Didn't have the privilege to observe bronchoscopy though :(
The time spent at scope rooms wasn't as boring as the time I had at cardiac clinic, to be honest. At least, I get to see different type of images when the specialist was doing the job, haha. The best part was when the surgeon explained to us and probed our critical thinking by asking us questions.
It's something I will not forget. The humor, the experience, the 'first try', the interaction.. Thank you, Dr. M :)


All in all, I enjoyed my posting very much. I even felt reluctant to come back, can you believe it?? #whatnoobysays
Hahaha neway, I want to thank tutors, fellow classmates and medic students (friends) who are willing to guide/teach/discuss cases with me. It was fun learning from each other, hopefully we'll do the same for the rest of the semesters and during our working life of course :D


Hehehe, more exciting stories to come (I'll blog about it if I have the time)!
Thanks for reading, dear reader. Till then  :)