Today is the first day of tagging at emergency department. The concept of tagging is as usual, you go as early as 7am and get back home at 10.30pm (thanks to DG who just made this official). But the environment is totally different, of course. The most obvious one, there are no wards. Meaning no ward round. There is one small observation room, just enough to place four patients at once, but that does not need a rushed morning round as in my previous postings.
I arrived at the department at 7.15am today as the passing over session at casualty starts at 730am, wearing a pair of black court shoes, having already been warned by a friend to wear dark coloured proper footwear - I sort of aware of the shoe rules two years back when I was doing my elective there. Then I was chased off to go and get the formal letter telling I have passed surgical and allowed to move on to the next posting. I went to SOPD for the letter and saw my favourite Miss there, and undecidedly asked her again whether I really passed my viva the other day, as I knew I did very badly in the viva session I wish I turn back time to do it all over again. Worst, I feel so ashamed to see Miss, having not been able to answer her questions to standard. I am sure she expected more. She gave me her cute smile "yes Afifah, you passed". Good. But still feeling so ashamed.
But anyway, came back to casualty with that piece of precious paper, and I felt like every eyes were on me. Unplanned, I introduced myself to break the silence. Right after that and after a few further questions about previous postings etc, I was told to attend a BLS (basic life support) course on Thursday and an MCQ session today! Goodness gracious, first day of new life, and an MCQ is something that is out of expectation, seriously.
Time runs very quick in the morning. I happily and confidently volunteered to insert a central venous line via the IJC, ultrasound guided - it was a failed attempt though, the specialist took it over from me and easily passed it through. Then get myself out for a brief lunch, hurried back and clerked a paeds case before attending the CME & MCQ. It was my first paeds case I clerked after the posting in final year which was probably 3 years back by now. So horrible, I do not know how exactly I am going to survive paediatrics as my 6th posting.
Attended CME on cardiac arryhtmia. Suddenly being reminded of those wavy lines, which if they go flat, every lay people would also understand that it means the heart stops pumping. In medical term, we call these lines ECG (echocardiogram). They might be easy to read at some points but interpretations can be quite mean, and I can hardly recall all those medical management learned in medical posting for those haywire lines. One thing I should start focussing on. To make things worse, there was this one specialist who really do fancy asking questions to taggers - I have already been given a homework on how to do a carotid massage.
Then the MCQ begun. 25 questions, each with 5 true or false statement in 30 minutes. Some are surgical based questions eg trauma management, not too bad as I just came out of that rotation, but paeds based? Not so helpful. I answered them quickly (as this was only meant for a baseline pre-posting mark, I supposed) so I could go out to perform my Zuhur prayer before the discussion started. When I came back, half of the questions were already discussed, upset as I wanted to know the answers! It might come out again on my real exam to pass the posting, you see. The miracle is, I passed. Just borderline pass, though. But better than expected. It does not mean anything though as I will still need to pass another MCQ in 2 months time. Or even worse, as they would expect that after 2 months duration, the marks should have gone higher. Huh.
It was nearly five. Then was pretty much helping other H.Os and M.Os, it si quite good around here. This is where I see quite a great teamwork. Whenever a patient passed through those double door, someone will go and clerk, others will go and set IV line, take blood, fill up forms and call the relative for registration. I think this is what I like about casualty so far, although I think I myself was not that useful to others - I kept wasting time when people asked me to get something, I just do not know where things are! And I am not practised to be well aware of those who still need blood takings done etc. Briefly, still disorientated to how it works here but slowly getting there. There are cases like MI, UGIB that ended up with intubation but I think the most horrible case that I saw today was a thirteen year old schoolboy who came with a nail stucked in his right sole. Please watch where you step on. Please. Oh, I should have captured a photo of it, some of my colleagues did.
10.30pm sharp, and they started chasing me out of casualty. It was the time to go back (so good they all!). Tomorrow, there will be an audit done in our department and I am supposed to read on the four main CPGs - dengue fever, NSTEMI, asthma and DKA but here I am, for whatever reason, feeling so eager to write while searching for the answers to my new homework - I guess, starting to write again in the last few days has fueled my interest in writing again.
I arrived at the department at 7.15am today as the passing over session at casualty starts at 730am, wearing a pair of black court shoes, having already been warned by a friend to wear dark coloured proper footwear - I sort of aware of the shoe rules two years back when I was doing my elective there. Then I was chased off to go and get the formal letter telling I have passed surgical and allowed to move on to the next posting. I went to SOPD for the letter and saw my favourite Miss there, and undecidedly asked her again whether I really passed my viva the other day, as I knew I did very badly in the viva session I wish I turn back time to do it all over again. Worst, I feel so ashamed to see Miss, having not been able to answer her questions to standard. I am sure she expected more. She gave me her cute smile "yes Afifah, you passed". Good. But still feeling so ashamed.
But anyway, came back to casualty with that piece of precious paper, and I felt like every eyes were on me. Unplanned, I introduced myself to break the silence. Right after that and after a few further questions about previous postings etc, I was told to attend a BLS (basic life support) course on Thursday and an MCQ session today! Goodness gracious, first day of new life, and an MCQ is something that is out of expectation, seriously.
Time runs very quick in the morning. I happily and confidently volunteered to insert a central venous line via the IJC, ultrasound guided - it was a failed attempt though, the specialist took it over from me and easily passed it through. Then get myself out for a brief lunch, hurried back and clerked a paeds case before attending the CME & MCQ. It was my first paeds case I clerked after the posting in final year which was probably 3 years back by now. So horrible, I do not know how exactly I am going to survive paediatrics as my 6th posting.
Attended CME on cardiac arryhtmia. Suddenly being reminded of those wavy lines, which if they go flat, every lay people would also understand that it means the heart stops pumping. In medical term, we call these lines ECG (echocardiogram). They might be easy to read at some points but interpretations can be quite mean, and I can hardly recall all those medical management learned in medical posting for those haywire lines. One thing I should start focussing on. To make things worse, there was this one specialist who really do fancy asking questions to taggers - I have already been given a homework on how to do a carotid massage.
Then the MCQ begun. 25 questions, each with 5 true or false statement in 30 minutes. Some are surgical based questions eg trauma management, not too bad as I just came out of that rotation, but paeds based? Not so helpful. I answered them quickly (as this was only meant for a baseline pre-posting mark, I supposed) so I could go out to perform my Zuhur prayer before the discussion started. When I came back, half of the questions were already discussed, upset as I wanted to know the answers! It might come out again on my real exam to pass the posting, you see. The miracle is, I passed. Just borderline pass, though. But better than expected. It does not mean anything though as I will still need to pass another MCQ in 2 months time. Or even worse, as they would expect that after 2 months duration, the marks should have gone higher. Huh.
It was nearly five. Then was pretty much helping other H.Os and M.Os, it si quite good around here. This is where I see quite a great teamwork. Whenever a patient passed through those double door, someone will go and clerk, others will go and set IV line, take blood, fill up forms and call the relative for registration. I think this is what I like about casualty so far, although I think I myself was not that useful to others - I kept wasting time when people asked me to get something, I just do not know where things are! And I am not practised to be well aware of those who still need blood takings done etc. Briefly, still disorientated to how it works here but slowly getting there. There are cases like MI, UGIB that ended up with intubation but I think the most horrible case that I saw today was a thirteen year old schoolboy who came with a nail stucked in his right sole. Please watch where you step on. Please. Oh, I should have captured a photo of it, some of my colleagues did.
10.30pm sharp, and they started chasing me out of casualty. It was the time to go back (so good they all!). Tomorrow, there will be an audit done in our department and I am supposed to read on the four main CPGs - dengue fever, NSTEMI, asthma and DKA but here I am, for whatever reason, feeling so eager to write while searching for the answers to my new homework - I guess, starting to write again in the last few days has fueled my interest in writing again.
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