Third year semester 1.
I finished my exam. It's time to go out to the real world and start internship.
I was attached to KTPH for MS placement. Before that, we've heard of one legacy:
"If you survived ktph, you can survive anywhere."
Isn't that scary? Yes. I was scared by this! But being a student with a fresh memory on spine module and just passed the practical test under Audrey, I'm full of confidence that I can do well in this placement. And thus I'm excited to answer questions and start to see patient. But, maybe I'm too robust. I didn't really do well. I always get the feedback of "bad subjective assessment" not systematic, questions all over the place, missing secondary information and my tone especially.
Twas a tough time. Every time I finished seeing patient I'll get almost the same feedback from sups. If your subjective assessment is a mess, then your objectives and treatment is a waste.
I cried in front of them (so embarassing) after I got my first week eval. It's all failed except for professionalism. I'm doomed. How'd I survive and pass this placement? This is just the first attachment, there's two more ahead. If I failed this then how about the rest?! I panicked and worried every day and night.
I kept on asking God. And I kind of frustrating about it. Why God? Why you put me here? Isn't that you know my ability? Why put me here when I can't even meet their expectation! I was downhearted and depressed. Even though I share this matter with a lot of people and asking for help. But I'm still depressed and everyday thinking of how to improve more and more. But it's all in vain.
Then I joined the navigator camp in September'16. I think I made a good decision in joining this. It taught me a lot about how to encounter God and equip yourself with God's words. (Skip the lessons I learnt in that camp okay? Maybe I'll write another post in details about it). After joining that camp, I want to experience God and let go of everything. Rest in him. He's the faithful God who we can trust.
Trust in lord with your heart and not your eyyez and eclverything will be prepared for you.
Rest in him. All those who are weary can come to me for my yolk is enough for you.
I want to claim the promise! I want to rest in you and let go of things! Even though I pray about my placement and all the stuffs, but I still clinging onto it. I still handle by myself with my own wisdom and strength. I do not rely on God completely 100%. I do not. So I want to change. I pray to God and say
You're the faithful God. You're the God that can make the blind to see, make the deaf can hear and make the water turns into wine. Since I'm in health care setting and need to help patient to find their source of problems, Lord I need you. I need your healing power to help me in seeing patient. I prayed everything before I see the patient, pray for the wisdom.
But it's just unexplainable.
I just do the same routine, conducting interview, reporting results, do objective assessment and come out with diagnosis followed by treatment plan. I did the stuffs like I normally do. But just somehow, I found favor in supervisors eyes. They gave me the feedback that you've improved tremendously since week 1. At the moment, I'm just grateful to God and really don't know what happen. I've really done my own parts, doing the same thing everyday.
Hallelujah, Glories belong to God, He shows me his faithfulness and his miracle on me. He helps me to go through the tough moment. I finally came to understand every challenge God gave you is according to your limit, he won't abandon you. (1Cor 10:13 No temptation has overtaken you except what is common to mankind. And God is faithful; he will not let you be tempted beyond what you can bear. But when you are tempted, he will also provide a way out so that you can endure it.)
Turn to God, not lean on your own understanding. A note for myself.
Monday, 2 January 2017
CE 3B: Thrilling Placement
Lord, you really know me. Know my needs. Know my weakness and want to work on me to shape me to be in your image. Amen.
All things happen according to your plan.
So here starts the second attachment. This time: SGH.
Happily going to Cardiopulmonary (CP) attachment. this is the field that I aimed to be during my year 2. Maybe I watch too many doctors drama especially ER. Imagine I myself is the staff at er and able to think and act calmly under stressful situation. So I was quite interested in joining that field as it's thrilling and seeing patient in critical condition. Yeah. CP! ICU!
First day, quite chill. Discussed about the contraindication, precautions and investigation stuffs. I noted down and didn't revise it. 😣😣 straight to the point.
I actually experience God's grace again in this attachment. Truly surely very grateful to God. I breached safety barriers multiple times. But thank God. I learned from every mistake and don't repeat it.
-On the first week, I took the BP for my patient. Initially it was 88/50 then I took the second and it still around the same range. Then I thought it's fine since I was just gonna do bed exercise. No big deal. But then with the intervention going on, my patient changed position and I never take any BP thereafter. I walked him to toilet and came back and sat him down on the chair as he expressed he wanted to. Then he sat down and lowered his head. Me and my partner thought that he's just resting. At that point of time, my sup came into the room. Saw that patient lowered his head, she knelt down and patted on him saying "uncle, uncle" but yet no response received. She saw his face turned pale and unrolling of eyes followed by some minimal jerky movement of his hands. She quickly called on the nurses and everyone rushed in. The next moment, HE SEIZURE. Then the staffs were trying hard to transfer him from the chair to the bed. Because it's very dangerous in the chair, what if he fell down on the floor? Me and my partner were just watching by side. STUNT. NO IDEA WHAT'S GOING ON. The doctors asked what's the BP before during and after. But I can't answer any of them cause I never take the BP again.
My sup asked me out and said "I'm very unsatisfied with your patient's safety today. " not checking BP again after knowing that BP is very low initially and he's on fit chart but yet you dint check it after every positional changes. I'm scared. I totally blank. I thought it won't happen in my therapy service. But it happened.
- Second incident: I was reading case note in ICA (Intermediate care area) and it's about 1-month long and I fall asleep... then my sup asked me have you checked her blood test. I checked immediately and reported HB 5.5 previously 7.2. She asked me whether can see the patients or not. That time I was half-asleep and I said: YES. CAN STILL SEE. I literally can see her eyes rolling into white and she asked what's the cut off point for hb level? I can't answer. She said we discussed it on the first day already! I checked my little book and found 8.0! (Exclamation there to signify the importance but yet I dint revise it.)
She asked will you go and see the patient if I dint tell you about the cut-off point. I said yes. 😢😢😢
She totally has the very bad image on me regarding my safety performance.
- Third, which happened in the fourth week. You know how serious it is? Lecturer told me that every mistake u made before week 3 is uncounted but the actual evaluation will start from week 4 and 5. But, I saw the wrong patient! It's actually room 10 bed 1, but I saw the patient in room 9 bed 1! Both surnames are tan! I read the cade note saying admitted due to hypertension, premorbid independent ADL without aids. So I see my patient with my partner, my supervisor wasn't with us cause it's already week 4. (It took quite long cause she wad changung diapers) First thing when we saw my patient, we were like OMG SUCH A BIG SIZE WOMAN. It's okay, just continue with asking questions. When I ask the patient, she say she has been wheelchair bound for 8 years! Never walk before! I was like argh? Case note write independent ADL and able to walk ah! I thought of it and assumed maybe case note is worn info, so I chose to believe patient. Then I proceed to conduct objective assessment. I did all the bed assessment but before I moving on to my walking assessment which she already sit out of bed, she said she got the feeling of wanting to pass motion. Fine, I let her sit and do her business first. Then my partner went and ask for more informations from her daughter which sit inside the room as well. Then the patient just lie back down on bed first to do her business. While I was checking in her, her family by side talking to her, one physio came and asked us whether have we seen 10/1, my partner say NO, WE SEEING THIS.
Physio: oh good, so u see 9/, then I go and see 10/1. I was like WHAT? WAIT. THIS IS 10/1, WE ARE SEEING HER. but he just say thanks I will go and see 10/1.
I paused. Took a step back. I took out my phone and checked. Correct ah! My patient is 10/1! Then I walked out the room and see room number.
HOLY GOSH! IT'S ROOM 9!
Bead-sized sweats kept dropping on my forehead. I went in and told my partner, 完蛋了 完蛋了 wrong patient! Faster leave! I don't know what's her condition! Since she's in the bed just leave now!
My partner was like Jennis! Calm down! You need to at least took the BP of the patient before leaving and talked to the family! I cannot process, one thing in my mind is: LEAVE NOW. I just don't care and went outside. Then the physio knew and was laughing bitterly. He told my sup and I proceed to see my actual patient.
Even when you read/heard this, you may find it ridiculous and unforgivable. You may fail me for my safety. BUT MY GOD HELP ME, GAVE ME MIRACLE. you may say this kind of help is not good cause may harm the patients, but I ponder, God may want me to learn things from all the incidents. He want me to be alert and rmb all the mistakes and not to repeat it in future. Thank you Lord for your greatness and wonderful arrangement.
All things happen according to your plan.
So here starts the second attachment. This time: SGH.
Happily going to Cardiopulmonary (CP) attachment. this is the field that I aimed to be during my year 2. Maybe I watch too many doctors drama especially ER. Imagine I myself is the staff at er and able to think and act calmly under stressful situation. So I was quite interested in joining that field as it's thrilling and seeing patient in critical condition. Yeah. CP! ICU!
First day, quite chill. Discussed about the contraindication, precautions and investigation stuffs. I noted down and didn't revise it. 😣😣 straight to the point.
I actually experience God's grace again in this attachment. Truly surely very grateful to God. I breached safety barriers multiple times. But thank God. I learned from every mistake and don't repeat it.
-On the first week, I took the BP for my patient. Initially it was 88/50 then I took the second and it still around the same range. Then I thought it's fine since I was just gonna do bed exercise. No big deal. But then with the intervention going on, my patient changed position and I never take any BP thereafter. I walked him to toilet and came back and sat him down on the chair as he expressed he wanted to. Then he sat down and lowered his head. Me and my partner thought that he's just resting. At that point of time, my sup came into the room. Saw that patient lowered his head, she knelt down and patted on him saying "uncle, uncle" but yet no response received. She saw his face turned pale and unrolling of eyes followed by some minimal jerky movement of his hands. She quickly called on the nurses and everyone rushed in. The next moment, HE SEIZURE. Then the staffs were trying hard to transfer him from the chair to the bed. Because it's very dangerous in the chair, what if he fell down on the floor? Me and my partner were just watching by side. STUNT. NO IDEA WHAT'S GOING ON. The doctors asked what's the BP before during and after. But I can't answer any of them cause I never take the BP again.
My sup asked me out and said "I'm very unsatisfied with your patient's safety today. " not checking BP again after knowing that BP is very low initially and he's on fit chart but yet you dint check it after every positional changes. I'm scared. I totally blank. I thought it won't happen in my therapy service. But it happened.
- Second incident: I was reading case note in ICA (Intermediate care area) and it's about 1-month long and I fall asleep... then my sup asked me have you checked her blood test. I checked immediately and reported HB 5.5 previously 7.2. She asked me whether can see the patients or not. That time I was half-asleep and I said: YES. CAN STILL SEE. I literally can see her eyes rolling into white and she asked what's the cut off point for hb level? I can't answer. She said we discussed it on the first day already! I checked my little book and found 8.0! (Exclamation there to signify the importance but yet I dint revise it.)
She asked will you go and see the patient if I dint tell you about the cut-off point. I said yes. 😢😢😢
She totally has the very bad image on me regarding my safety performance.
- Third, which happened in the fourth week. You know how serious it is? Lecturer told me that every mistake u made before week 3 is uncounted but the actual evaluation will start from week 4 and 5. But, I saw the wrong patient! It's actually room 10 bed 1, but I saw the patient in room 9 bed 1! Both surnames are tan! I read the cade note saying admitted due to hypertension, premorbid independent ADL without aids. So I see my patient with my partner, my supervisor wasn't with us cause it's already week 4. (It took quite long cause she wad changung diapers) First thing when we saw my patient, we were like OMG SUCH A BIG SIZE WOMAN. It's okay, just continue with asking questions. When I ask the patient, she say she has been wheelchair bound for 8 years! Never walk before! I was like argh? Case note write independent ADL and able to walk ah! I thought of it and assumed maybe case note is worn info, so I chose to believe patient. Then I proceed to conduct objective assessment. I did all the bed assessment but before I moving on to my walking assessment which she already sit out of bed, she said she got the feeling of wanting to pass motion. Fine, I let her sit and do her business first. Then my partner went and ask for more informations from her daughter which sit inside the room as well. Then the patient just lie back down on bed first to do her business. While I was checking in her, her family by side talking to her, one physio came and asked us whether have we seen 10/1, my partner say NO, WE SEEING THIS.
Physio: oh good, so u see 9/, then I go and see 10/1. I was like WHAT? WAIT. THIS IS 10/1, WE ARE SEEING HER. but he just say thanks I will go and see 10/1.
I paused. Took a step back. I took out my phone and checked. Correct ah! My patient is 10/1! Then I walked out the room and see room number.
HOLY GOSH! IT'S ROOM 9!
Bead-sized sweats kept dropping on my forehead. I went in and told my partner, 完蛋了 完蛋了 wrong patient! Faster leave! I don't know what's her condition! Since she's in the bed just leave now!
My partner was like Jennis! Calm down! You need to at least took the BP of the patient before leaving and talked to the family! I cannot process, one thing in my mind is: LEAVE NOW. I just don't care and went outside. Then the physio knew and was laughing bitterly. He told my sup and I proceed to see my actual patient.
Even when you read/heard this, you may find it ridiculous and unforgivable. You may fail me for my safety. BUT MY GOD HELP ME, GAVE ME MIRACLE. you may say this kind of help is not good cause may harm the patients, but I ponder, God may want me to learn things from all the incidents. He want me to be alert and rmb all the mistakes and not to repeat it in future. Thank you Lord for your greatness and wonderful arrangement.
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