The Baju Kurung Girl

March 24, 2019

I adore girls with baju kurung in the hospitals, as I can't tolerate the heat much to wear baju kurung at work. The only time I wear baju kurung is when I have the shortest working hours which is normal shift (7am - 5pm), otherwise I will wear trousers with blouses instead :)


One of the thing I wish not to happen on the day I wear baju kurung is "dr, patient bed xx collapse / asystole" (in which I hope will not occur on any day pun actually) 

Because it seems so hard to climb up patients' beds to do chest compression. πŸ˜…

Doing CPR can drain much energy and I pray patients will have fast recovery and discharge very soon. Ameen!

Tempting Veins

March 23, 2019

I am currently in my 4th posting, to be specific I am now in Surgical department. Wahh, time surely flies very fast. It was just a year ago when I started my housemanship and now it is already my 2nd year. I've been trying to update my experiences here, but after quite a while not updating stuffs in my own blog, it feels awkward. Haha.

But, I planned to update a glimpse of my daily life in short posts regularly. I don't have much time to really make posts with something like "3 life lessons I learned from...." T_T in which the one I really miss to create. 


Honestly, working as a house officer need energy - mentally and physically. I am sure being medical officers and specialists require more energy, just... being a house officer is my level for now.

Why the bulging veins?

I don't realized I have them actually. But, whenever I encountered patients with difficult blood taking, I automatically look at my own hands, only then I realized them. Suddenly I wish all patients have these bulging veins, just to avoid the need to prick the patients more than once just because it is hard to do so. 

And actually, after working for more than a year, I can say that blood taking needs experiences, good instinct and sensation from our fingers. Sometimes, doctors can't really see the veins but we can feel them with fingers. 

Such veins are more visible in people with less fat, patients who are not edematous (no water retention in body) and people who workout a lot.

And most doctors have bulging veins, thanks to frequent CPR we need to do, maybe some retraction done during operation... ohh, maybe fundal pressure to help delivering the baby in C-section? Hehe
-_-'

Just a random post, I guess?
I miss blogging, but I think I lost that magical blogging touch. T_T



2018 Best Nine

February 11, 2019

I was scrolling my own blog and suddenly my eyes found my featured post - 2017 Best Nine. Maybe it is too late to share my 2018 Best Nine now, but who cares though. :)




I didn't expect I only posted 13 pictures in 2018. Such a drop in number.


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Completed my tour in Malaysia with Sabah as the last state I went to. Alhamdulillah, finally in February 2018, I managed to go to every state in Malaysia. I always love road trip, although seems like I can't help to sleep in the car nowadays... I can't imagine how my next road trip will be, in view of I haven't drive long distance for quite some time.

But, let's embrace the uncertainty. Too many places in my head, I will catch up on them when the time comes :) with the plus one too, ameen. 



Not many people know about this, but I actually went to Macau last year, during my end of posting leave. It was a last minute plan obviously, bought the tickets maybe 2-3 weeks before departure. Don't care much about the price as I need to appreciate the short holidays that I have and spend them with my parents. 

Macau is a beautiful, small city. Not sure to call it a country or not. Is it belong to China or is it independent? Some said the first one, some other said the latter. Can't afford to write entries on the trip though. I wish I could. 

But Macau is lovely to check it out :D

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Sunset is always one of the thing I will look for especially after I went through any interesting oncall. And the beach with sunset are the best pair to enjoy myself with.


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Somewhere in Pos Kuala Mu.

This place is actually in Sungai Siput, but not that close to my house though. If I am not mistaken, we took at least 1 hour plus to get there and it is actually quite close to the border of Perak - Kelantan. The place is getting famous but not that mainstream yet. :)


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Somehow, I am glad that I didn't take any part time job during the phase of waiting for job. I did some online stuffs to get money too, but most of my expenses that time were from the saving I had while in Czech. 

So, I was unemployed at that time and I must say I had the best few months of my life, exploring Malaysia with my parents. Not just that, I am thankful to have that chance to appreciate meeting and gathering with my relatives in which I don't have the privilege and opportunity much to do so now.




Umrah with my parents. 


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My favourite flower - tulips :) 

This is the background picture of my Whatsapp chat anyway.



The day I requested to go to this viewpoint and for the first time in my life I saw the scared face of Emak. -_-' hehe, kesian mak kena layan anak buat benda2 gayat macam ni. Still remember when I said to her I would love to visit Macau Tower later and to see Macau for the highest point, she agreed even though she mentioned in the first place that she will only stay around the lift. But to my surprise, she accompanied me around the tower anyway. 

Emak is always the best!


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And I miss hiking now. Hehe.

Towards many more memories in this 2019. And surprisingly I started to snap more random pictures lately. Hope I can share more stuffs in the blog too. :)

SM, Perak, Malaysia
190211




The Thought That Counts

February 10, 2019



I've shared this on my Insta stories but I think I better make a single entry about it, for my own satisfaction and to show how life really is plus to acknowledge awesome people do exist :)



It was the day when I stayed alone in my ward, trying to handle between new cases to clerk and to approach so many "doktor, nak noted patient bed xx, complain bla bla bla...." Well, it is a good thing there are nurses who can update doctor what has been going in the ward because seriously you have no time to really check on every single patient the whole time. And this is obviously a government hospital, please don't expect one doctor and one nurse for one patient basis. No such thing, okay?

I am sorry because sometimes, there are patient's relatives who keep on complaining this and that in which they can obviously help with. T___T

On that day, I received a call from a colleague from another medical ward requesting for one houseman to accompany patient to send to HRPB, Ipoh for further intervention. In view of there was only one houseman in each Ward A and Ward B, 2 housemen in Ward C (in which I am in charge now), so of course we need to help with man power. One houseman to take care of 35-40 patient is doable but trust me, it is super tiring. After informing my MO about the request, she told me to stay with her in the ward instead and to send another colleague of mine to HRPBI.

I wish I was the one sending the patient, especially when I have completed my beds' carry out...haha

So, the day went on.... until 9.57pm, I finally done with clerking the last new case before planning to call the day off. After reviewing the patient with MO, she asked me to prepare to go home after settling the carry out for new cases. And finally it was 10pm, time to go home. 

"Dr, patient bed xx tu GCS* drop, SpO2 pun tak boleh pick up, 80% je"

The patient was already on BiPAP (a device / machine to help with respiration) and I still remember my MO said to me to prepare with intubation if her GCS drop. Rushing to call my MO who was in ED with another new referral, she rushed back to the ward and intubate the patient. It was already 10.40pm when I was offering to manual bag the patient until the anesthesiology team arrived to connect the endotracheal tube with ventilator, meanwhile my on call colleague went to settle with the STAT blood for that patient. 

Since my HO friend was working alone that night, I didn't feel good to leave him. 

And phone kept on ringing, I suddenly remembered I was planning to have late dinner that night with friends. Staff nurse helped to cover while I picked up the phone. Trust me again, talking to a phone while you are bagging the patient is not something you should do. Family members can make viral of you. 

Approaching 11.30pm, finally the anesth came and I passed over the tube to the MO and slowly I went to pick up my bag to leave. Suddenly, I saw my friends walking to the ward, planning to help.

I felt like crying, blessed to have these people. T_T
They even had my meal packed, in case I am too tired to eat outside that night.



*GCS - Glasgow Coma Scale - to rate one's level of consciousness for eye, verbal, movement response. If GCS less than 8, indicate for intubation.

Good people exist!
Alhamdulillah.

SM, Perak, Malaysia
190210

My 2018 in Alphabets

January 6, 2019

To be honest, I can say I seldom took random pictures last year and that's the main reason I can't afford to recall much stuffs that happened in my life the past one year. Been working in the hospital where most of the pictures in my gallery now are confidential work-related, I found it tiring to take out the phone just to take random photos. Haha.

"Jangan ambil gambar ye, ni kawasan hospital."
"Dalam wad tak boleh ambil gambar ye."

Actually, living in modern world, trust me medical staffs need to utilize the technology to make things work faster. Specialists, experts on the other side of world, MO in the other building, while housemen in the ward trying to survive with lesser experiences.... of course we need the technology much to reach the seniors. Most of the updates are discussed via the Whatsapps (especially with pictures and videos as prove)

Wah, such a long introduction.


First time.


Anyway, I read two blog posts on this My 2018 in Alphabetical Orders (here and here) and would love to try one.

Amalina : This is not how my name is spelled as it is Amanina instead. But, I cringed much to listen to the viral Amalina song haha

Back to basics : Adulthood is complicated, with responsibilities some more. I believe taking my time and back to basics to understand stuffs make it simpler.

Craving : Craving for good food has been one of my top priorities on free time. I am still surviving to balance between work and my very own body needs. And don't you know, doctors sometimes need to live an unhealthy lifestyle despite counselling patients to do the opposite? Caffeine at night, eating dinner at 3am. Occasionally. 

Doraemon's pockets : 'Poket Doraemon' is another name for lab coat's pockets. Haha we have many stuffs in the pockets, from pens, staplers, dawai kokot, scissors, laboratory forms, medication charts, phone, powerbank, rough papers and not to forget, blood samples.

My version of Doraemon's pocket - baru lepas exchange C&S bottle.


Empty : Half filled glass vs half empty glass. I choose half filled glass, how about you?

Files : My 2018 has been filled with lots of files. Writing every single day but my handwriting doesn't improve much when I need to rush writing during round with specialists. Haha. Every single minute is precious!

Good job : I always tell this to myself after I encountered difficult task. "Good job, Nina. You did great and you've done your best."

Hospital : Hahaha. I am glad I didn't rent the hospital hostels. Why? The hospital is already like my second house. Spending at least 15-18hours a day in the hospital make me tired to even have a glimpse of hospital on my off day. Working in hospital is fun and doable, insyAllah. But I am still a human being who does feel tired. 

Inconsistent : Urut dada je rasa bila jumpa patient macam ni, with inconsistent history. -_-' Kejap pernah kena stroke, kejap tak pernah. Kejap pernah operation, kejap tak pernah. Doctors are not magician and we instead need patients' help and good history to provide good treatment. And we hope people know that sakit kepala and pening kepala are 2 different things?

Jonah : This is a term to call someone who experience a hectic day with lots of admission or eventful days. "Jonah betul kau ni". On good side, working with 'jonah' colleague helps a lot to experience many new cases and new experiences. Otherwise, it can be you, the jonah one. Haha. Jonah is okay, but honestly tiring. Just look at doctors' postcall faces and you can judge their oncall nights. #personalexperience Hahaha.

First meal of the day at 11pm.

Known case of: Usually, we presented the case with 'This is a 64 year old Malay gentleman, with known case of hypertension, diabetes mellitus, dyslipidemia. Currently presented with fever... bla bla bla. Otherwise, we use the word 'underlying' instead. My daily meal of conversation.  

Let it out : Being a houseman, to feel stress is normal. The most important, let it out and I will try my best not to burden my heart with any bad feeling. Talk to someone I trust, let it go.  

Marriage : Have thoughts and discussions on this in 2018, may Allah guide the way and make it real in 2019.

Nausea : Riding an ambulance is no joke, guys. T_T I thought I don't have motion sickness but to be in ambulance, rushing to get to other hospital is challenging.

Okay boss : Frequent way to reply the bosses :) Haha

Phone : I need a new phone. My phone is slowly deteriorating, from camera's quality to battery. Can you imagine from fully charged phone at 6.30am can drain to 0% at 11am? T_T Phone is life, like how I describe in the introduction.

Quality : Quality time with family is beautiful, especially when I just manage to spend few hours with them. 

Red : I occasionally wear tudung with red flowers on top but I will try my best not to wear red to work. I know people said it is khurafat to think this way. But for me, in hospital, red symbolizes blood and emergency. I still wear red and pink blouses outside tho.

Sleep : Something I love to do, every where. I believe my family already get used to see me dozed off, in the car and even at family gatherings. "Eh, mana Nina, senyap je budak ni." "Tu ha, dah lelap dah dia." In medical, I will avoid driving home (balik kampung) after my night shift... well, can you imagine, even at the traffic light in front of the hospital, I accidentally dozed off while driving. Alhamdulillah for my safety so far. 

Time : Time is very precious, I learn this the hard way in 2018.

Uncertainties : Embracing uncertainties was my motto for 2018 and alhamdulillah, I think I did a good job choosing it and it eventually guide my brain and heart to expect the unexpected :)

Vacation : In need of vacation stat.

In need of this.


World : Dunia ni memang sementara. Witnessing death as daily routine make me numb to it and I hate that feeling.

X-ray : In case you come to the ward and hear people said 'SHOOTING' out loud... go run and protect your organs. X-ray is something common in hospital. If patient can walk or stable, the staffs will send the patient to the radiology department if any x-rays needed. Otherwise, we will call for portable x-rays which mean, the radiographer will come to the ward with portable x-ray machine to shoot one.

You : Thank you, good people for coming into my life and make my housemanship bearable. :)

Zeal and zest : Good bye 2018, you have been great!

Will share my wall of memories 2.0 later once it fills up with more sweet memories :D



p/s - Now I miss random photos. T_T

Towards an adventurous 2019, fighting!

SM, Perak, Malaysia 
190106 


Trust Me, Nurses Deserve More Respect:)

December 30, 2018


I am very sad to read the latest 'not our level' issue and I feel called to share my experience about this. Nurses are basically people I meet every day (except my off day, of course) and they are actually the health institutions' backbone, to be honest!

They deserve more respect, more appreciation.
Here, I am not trying to say about respect compared to other professions as I have this belief that every jobs have their own struggle and hardship. But, I want to clarify that nurses deserve better than how they are treated by community. 

Let me share roughly about my life in the ward.

Officially, the schedule of houseman (normal / extended shift) started at 6-7am, depending on hospitals, one of the first person we meet in the ward will be the nurses. Some of them will be at the counter, settling stuffs before handling their pass overs to the morning shift nurses. Upon HOs are doing morning reviews, all the medical notes (or we call them BHT - bed head tickets) are already on the patients' table, together with the observation charts and medication charts. Nurses are the one who distribute the files to each beds every morning while they are taking the vital signs reading for EACH patient 4-6hourly. 

Vital signs - blood pressure, heart/pulse rate / temperature / oxygen saturation / respiratory rate (how many times you breath per minute) / pain score

Just imagine if patients' vital signs are not monitor accordingly, who will be the first person to notice patients' blood pressure drop a lot? Who will update the HOs that patients are desaturating / gasping for air?





After their pass overs, they will make beds - meaning arranging bed linens, giving out new cloths, changing pampers etc AND at the same time, some others will check and records the next vital signs monitoring. Some will distribute the medications while checking the glucose level (for diabetic patients)

Just imagine again, how patients' progress will be if nurses don't serve the medications on time, or how the sugar level will be if no one pricking the fingers of patient and check for it?

"Dr, SpO2 patients tak dapat pick up ni. Dari tadi 90% je. Akak up kan bagi nasal prong taw"
"Dr, BP pakcik X ni mencanak-canak ni. Nak kata stress, dia relaks je. Nak bagi ubat stat apa-apa tak?"
"Dr, GM (glucose monitoring) patient 2.6 je ni. Nak bagi apa-apa?"


Then approaching 8am, medical officers and specialist will be around to check progress of each patients. Morning rounds can end as early as 9.30-10am, but some complicated cases may delay it to 11+am. After round with bosses, HOs will carry out the plan, TOGETHER with the help of nurses.

Carry out can means a lot. It is either active or passive. Active means you need to do it stat / right now as the delay can affect the patients much - urgent blood takings, urgent scan requests, urgent referrals. To be honest, passive carry outs are important as well T_T. Why? They need to be done within working hours (minus the lunch break) - referral to physiotherapy / diabetic nurses / dietitian / speech therapy / pharmacists / hemodialysis / ECHO / scans.

Not to forget... tracing stuffs - it can be either old notes (documents from previous hospitalization in the same hospital / details from hospitalization in another hospitals / baseline blood results etc)

As simple as this, really show how doctors need nurses A LOT. They will always reminds us of our carry out, for the sake of patients. 



I will never forget my very first day of work. I was in O&G department at that time, trying to figure out how to do proper vaginal examination. Doing it as a medical student is not the same as when I am already a doctor. I feel blessed to have good nurses around to guide me around with so many new, first-time things in working life. 

Nurses have more experience than doctors, especially the one who have worked for years. Experiences vs knowledge - very subjective isn't it? Doctors may learn more through out the 5-6 years of study, but nurses have better knowledge via experiences. :)

---------------------






All in all, medical staffs need each other. I am here to support the nurses!
And trust me, human beings need each other. That's why we live in the same world, right?

Respect others as much as we want people to respect us.
Love others as much as we want others to love us.

And lastly, this proves that we need to expect nothing in return, just blessings from Allah for whatever people don't see.

Much love for you guys. <3

SM, Perak, Malaysia
181230

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