Excruciating Pleasure

Geez that test 3 was brain hemorrhaging...
others said it was test 5


Denial: shet! this cant be difficult!
Anger: arrgh! OR!
Bargain: Wahhh..
Depression- google search
Acceptance- HHwWatever!


We hit mcdo right after the last test and debated on all the possible answers. At least i know i can defend myself from the debilitating arguments for more than an hour. Although, Im still not sure about the diet issue of T and A. Nevertheless, there is the internet - my ever loyal source of information and updates. So i googled the answer to every question i can remember. A little satisfied with what i got yet i still wanted to get involve in an argument. Therese was silent... and Marti was irate. There wasnt anything to do but wait for the final answer.

The Waiting... the most dreaded part of my life. I hate waiting. Id rather come in late than wait. But now i have no choice. I have to wait. It doesnt make sense at all to me but im not in my right mind to make sense at all. Everyone had to wait for the result. And i found out that staying at home was a difficult task. But thanx to my comrades for the afternoon jogs, the sunset viewing, the badminton evenings and the night outs... it made my 2nd vacation colorful.

Back to school. I missed it unintentionally but now i am back deliberately. Like i said, staying at home to do all the waiting was more difficult than reading a pile of journals in the library. I can stay online all night and not feel drained the next day. But of course, thanx to Centrum. It backed me up all the way. There's just always something to do... school papers, seminars and of course.. the hangout scheds.

Did i make the right move?! I should have taken the entire test and not just A PART of it. So sometimes i am thinking whether i did the right thing. I had all the books i needed in the first place... even the latest community book which i had carried from cebu to my vacay destination. It was never even opened. So, had i not taken my vacay, i would have whole heartedly taken the entire test which was really my plan. But its over now- i have passed. I deviated from my own plans after successfully convincing my friends to take the entire test. There wasnt much time to review. I had 3 weeks utmost and my time was running fast. I felt i wasnt ready to be battered by another exam but there wasnt any choice. When i got back home, i wasnt even registered to take the board until it was almost deadline.. Finally, my decision became final. After selling the books that will make me take 1-5, i finally found my focus.

Library seemed to be the second home we got. I spend 4 hours utmost. The rest of my mates can hang in there for the entire day. Moreover, all the books were there; all the information we had were right before us. Except of course, we do not have reviewers who make nasty jokes and nonsensical remarks. All we got is peer... and PEER PRESSURE is a good thing... despite that we slip off to watch movies in the cinema at least once a week. But even the review questionares were brought in the cinema.. which is pathetic really. But it sure worked for us... at least we produced a 10th placer. Congratulations BSN-A LibTeam and to all my batchmates..

Drink Shot 6/14

I tell you it wasnt hung over. It was my allergies hitting back at me after having a taste of tequilla. Tnx to our maestra liquor expert. I spent the next six hours spreading antihistamine lotion all over my abdomen, thigh and back. Good thing i didnt have it on my face, or its no longer allergies- its murder!

It was red rash medically. But sounds more like deformity to me, like having had a leprosy or something with the same gravity. And the worst part is the awful itchiness. So bless the guy who discovered antihistamine!

hiccup

A thudding involuntary noise accompanied by the jerking movement of the chest- hiccup.

I cant remember the last time i experienced hiccup and tonight i am having one of the hiccup moments.

I tried to swallow but it doesnt make it stop. I tried to inhale deeply and try to stop breathing for a while and its still there. I tried to relax and listen to my own noise but it just gives me a funny feeling and still it doesnt stop.

I gave up. And it stopped. Now im wondering how to elicit the hiccup moment again.

neophyte's report

I am flattered that I have been a part of the Trauma team. I have always wanted to work in such area and no regrets at all. Assessment and monitoring of vital signs is the most essential task in all areas.

In the Internal Medicine Department, the most common medical problem I have encountered is hypertension, COPD and loose bowel movement.

It is important to keep in hand a respiratory mask because patients in this area do a lot of coughing and besides, microorganisms are too small to be seen. You do not know what your patients have till they undergo diagnostic procedures.

One patient came in ambulatory and said he just wanted to have his blood pressure checked. So I took his initial blood pressure and referred it to the resident on duty who was sitting adjacent to me and was also interviewing the patient. The moment I turned my back and already around 2 meters away, he collapsed and he had seizure. I was surprised how suddenly a patient who looks so good at first sight, who was conscious and coherent would suddenly loss consciousness. So we had him placed on a stretcher and the doctor started an IV line and gave him medications from our supply. What i am trying to say is that, some patients may look good at first sight but could be masked by a terrible condition. Well, all I can say is that the Emergency Room is full of surprises: from the patient’s condition, to the facilities, to the staff on duty and even to the utility workers.

I got to practice how to take ECG. I also got to appreciate adventitious breath sounds through auscultation. I did a lot of intramuscular pain medication injections (ofcourse with consent). Then I also did cardio-pulmonary resuscitation to a person with only a few seconds to spare. I even tried doing post-mortem care to a patient I never even got to handle. But I am thankful that I never had any patient who went into arrest during my care.

Most patients I met in the Surgery Department were either mauled, had a bad fall or had a vehicular accident. In this area, I got to have an appreciative look at contusions, abrasions, lacerations, broken bones in the xray film, traumatic amputation of fingers, gun shot wounds, dog bites, etc.

Stabilizing the patient in this area is very important from the vital signs down to blood loss. Splinting, wound dressing, bandaging, applying pressure and assisting the patient to move in the ER, preparing the patients during the pre-operation like shaving, changing to OR gowns, checking of pre-op meds, catheterization, NGT insertion etc. are routines done in this area

Most cases I have assisted in this area are suturing. I remember, one time, we had a patient who had a vehicular accident and a had laceration on the foot around 6-7cm that divides the sole of the foot halfway horizontally. Bleeding was controlled by putting pressure and bandaging the wound with a roller bandage. At first sight it did look like a minor surgery, until the xray film revealed that there were fragments of broken bones. And when the resident checked the wound, he discovered that the wound was too deep and that the sole of the foot was flapping open revealing fragment of broken bones. So we referred the patient to an orthopedic doctor and was scheduled for a major operation in the Operating Room.

The worst case I have handled is a referred patient from the province with blast injury that left the patient with ruptured eyes, traumatic amputation of both left and right fingers and with multiple lacerations, abrasions and splinters on the face, upper and lower extremities and on the abdomen. There was a double line IV and the blood pressure of the patient was still difficult to assess. I had to monitor the IV line, the vital signs and the urinary output. When vital signs were stabilized, we had her transported to the ward for continuity of care. She undergo different surgery from eye surgery to amputation to exploration laparotomy. The last time i heard about that patient is that she still died of sepsis.

The challenging part in the OB department is the smell of lochia. But this department is also one of the most flattering areas I have been to. I have assisted in deliveries. And just the sight of the baby makes me feel happy.

On the other hand, it sickens me to see patients who attempted to commit abortion. They are in total denial and I couldn’t determine if they are in shame or they are just apathetic.

Vital signs and weight and height taking are routinely done in the OB unit. Patients were asked to lay on the lithotomy bed and spread their legs for the physician to do an internal examination. I have tried doing internal examination and many times I have felt the head of the baby. We do perineal preparation and we teach the patients to do deep breathing exercises. And many times, I have pushed stretchers with the patient on it to the delivery room.

I have seen the lifeless body of fetuses but I have also seen wonderful beings come to life

The Pediatrics Department is the most challenging part of the Emergency department (even the taking of vital signs is challenging), but I love it! Patience is a virtue in the pediatrics unit. It is the most challenging unit in the Emergency room but the most rewarding.

It is difficult to manage kids especially when you are strangers to them. I can attest how difficult it is to be therapeutic at all times by most health professionals (especially after seeing kids in ill state...grr )

Weight taking aside from temperature, heart rate and respiratory is important in pediatric patients. The dosage of the medication depends on the weight of the patient. So it is routine that we take the weight of the patient as soon as they get to the pediatrics department.

I remember one patient who came to us severely dehydrated and in respiratory distress. I secured the consent for intubation and have assisted in intubation. The doctor had to teach the patient’s relative to do ambubagging. I did continuous ambubagging (very tiring but rewarding task) until the patient was transported to the NICU. I have been with that patient to the xray room and back to the ER. And until the oxygen saturation level shoot up and stabilized to 98%, we had the patient transported to NICU (with me tagging along).

The Emergency Room in my hospital is a complex network. No wonder most patients look disoriented the moment they set foot in the Emergency room. They do not know which area to go to, whether surgery department, IM department, pediatrics department or OB department. First they have to fall in line at the Admitting section for an interview for an Emergency Record. Then they have to go to the Cashier and pay up. Then they can get their record where the physician could fill up his or her assessment. And with the number of patients that gets in the Emergency Room, there is limited space, equipments and manpower to give optimum care. So we prioritize care to the patients in need of immediate medical care or to someone with immediate life threatening condition.

Team work is very important. Two minds are better than one. That is why, we have a lot of referrals to different department for collaborative management.

Moreover, I think it is important for health professionals to learn how to speak different dialects. I had a hard time dealing with people who can’t speak tagalog and English. It was difficult to explain to them the procedures and what is happening.

I met a lot of good working and malfunctioning facilities. We have a stethoscope without its ear piece, an ECG that without strips, a BP apparatus that doesn’t work well and an alcohol breath test using the sense of smell.

Still, above all, I am grateful to be assigned in the Emergency Department though I’ve experienced a lot of stress and weight loss. My assessment skills were sharpened. I have learned to move more quickly and use time management. I have done a lot of stuff, some which I have ignored during my student days and some which I have never encountered before. I can say to my self that I have acquired a lot of knowledge, skills and work values in my area of assignment.

wash it

i just remembered my research study on handwashing way back in college. And just as i thought, the compliance of medical pratitioners is poor. Is it because they lack enough knowledge on the basics of asespsis or is it because they have no time to do handwashing?

I understand that frequent handwashing causes dryness and sometimes irritation. But handwashing soaps doesnt necessarily have to be antibacterial soaps. Even soaps with moisturizers can be used. This will protect the skin from dryness and irritation.

What is handwashing?! In school they will teach you that handwashing is the technique that will decrease the microorganisms on your hand thus decreasing the risk of acquiring infections. In the hospital setting, there is poor compliance on handwashing. And they formed a new definition to this term too. The term Handwashing is a neologism by those who wishes to get away with something wrongly done by covering up for their mistake.

Anyway, there are too many unreported medical malpractice and negligence happening inside the hospital, be it inside the operating room, the emergency room or the intensive care units. Public hospitals are prone to this one because: 1. lawsuit is poor, 2. clients are indigent, 3. lack of staff, 4. poor policies,5. minimal pay 6. unconducive working environment.

Now complain if your nurse or your doctor doesnt practice handwashing....

medmission1/18

medical, surgical and dental mission
01.18.07

to the indigent badjaos of zc....



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briefing with the crew....

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testing the gadgets...













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the admitting team for medical...










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consultations...















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tired but smiling Gelo...









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the crew:


doctors and nurses
behind the mission...



















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lunch at the beach

then swimming at the rest house...