Now I Know Why They Said It's...- Episode 2

1.45pm
Selamat datang ke Rumah Sakit Ibu dan Anak Siti Fatimah!

2.00pm
Muka Chwi sungguh berseri-seri waktu menyampaikan penjelasan tugas-tugas yang bakal dipindahkan ke bahu kami berdua (Ainul dan aku) selama seminggu ini. Ohoho…

2.30pm
Perawat di sampingku menyapaku sambil tersenyum.
“Akak yang gantikan untuk minggu ni ye?”. Aku tersenyum mengangguk.
Dia menyambung, “Kakak itu (sambil menunjuk ke arah Chwi) tak pernah tidur tau...!”
Ohohoho…

3.00pm
Sambil mengintai-intai 11 baby-baby yang bermasalah kat kamar bayi, aku still blur2 ape nak buat. Nak kate kena follow-up, satu je yg kena follow-up. Mane sibuknya? Santai je...biar betul...

5.00pm
”Meh makan...adik koas, dah pernah try kapurung?” perawat mengajak kami yang terpinga-pinga.
”Kapurung? Ape tu?”
Ternyata kapurung ni besh jugak! Habis 3 pinggan! Waduh2...asyiknye kalo macam ni terus!

6.00pm
Ada tiga partus! What??? Tiga sekaligus?
Ape patut aku buat??! Ohohohoho....(sambil berlari-lari ke kamar bersalin)

6.15pm
Aduh...camne nak pegang baby ni...mati anak orang karang...
Okay, timbang, ukur-ukur-ukur, suntik, bungkus, bagi die menyusu ngan mama die, dan tulis status yang panjang gile...
hmmm....
Caput succadenum?
Refleks moro?
Expiratory grunting?
H/L?
APA ITU???

Hari itu berjalan begitu perlahan….mcm orang bercinta, sehari bagaikan setahun! semuanya kelihatan sangat kabur.

From that nite and on, kami belajar satu-persatu perkara yang tugas perlu kami buat kat sini which consist of:

1 - Setiap pagi bermula jam 2 am kami kena tulis status semua pasien untuk follow-up esok harinya...



2 – Starting 5am after performing Subuh prayer, kami kena telanjangkan baby dan timbang mereka sume!!! Hehe But there’s a catch! Sambil telanjangkan, baby2 ni boleh jadi baru buang air kecil atau besar...huhu So kamilah kena bersihkan...ohoho Apepun depa tetap cute!!!

3 – Follow up! TNPS are modified to HrPS which stands for Heart Rate-Pernafasan-Suhu. Every baby tau! Tanye jugak dah brape kali buang air besar, warna apa, kencing smoothy tak(hihi), tengok tali pusat die basah atau kering and ada tanda2 inflammation tak…okay?

4 – Pastu around 8am doktor akan dating utk visite (ward round). Turun naik pusing-pusing…tulis resep(for medications) dan pengantar lab…anything the patients need, we’re here to serve!



5 – Back to kamar bayi, doktor akan isi status dengan instructions. Sambil tu kite buat jadual susu for all the babies kat kamar bayi. Jangan lupe berat badan baby, because the nurses need that to suit them with their milk!

6 – Sometimes kena buat parenteral feeding utk baby yang kena puasa. Baby ni dipuasakan sbb die sesak, distress pernafasan, cannot drink thru mouth. So alternatively, thru infuse. Makanan die ni consist of certain ingredients which have been calculated by the doctor. So keje kami adalah membuat parenteral food ni…senang? Bukan mcm buat air sirap tau…need full concentration and patience! Satu kesilapan can cost u a fortune! Seriously! (ada sejarah sebenarnye…) Wanna try? ohoho

7 – Sepanjang hari, we need to check at the labour room every half-an-hour for any spontaneous partus(normal labour) or sectio saesarian (operation labour). Pada hari2 santai, partus boleh menghantar sehingga10 bayi2 ke kamar bayi! Terima kasih doktor2 obgyn! ;)

8 – Sambut bayi, suction2, timbang dan ukur, buat APGAR dan BALLARD die (which are complicated to be explain here…next time maybe k…), resepkan neo-K (vit. K penting utk baby baru lahir utk cegah perdarahan) dan suntik intra-muskular, bungkus, bagi mak die utk menyusu! (Fuuuh…! Selesai satu baby!)

So basically itula keje wajib kami kat Fatimah. List di atas tak termasuk keje2 tambahan tak berbayar yang sebenarnye bukan keje kami. They are:

1 – Bagi baby minum susu. For newborn babies, sgt tak digalakkan bagi minum susu pakai botol susu sbb ini boleh ganggu pertumbuhan rahang depa, so kena bagi either using small spoo n or spoit (picagari). Tak tersangka, kesabaran yg tingi diperlukan utk menyempurnakan kerja ni hanya utk seorg baby. Apatah lagi 10 babies!!! Thank God I’m not a nurse!



2 – Menyambut bayi adalah keje seorg nurse kebidanan, not a co-ass. Tapi pernahlah satu hari, nurse2 ni tiba2 menghilang! So ape lagi, kamilah yg ditunjuk. Nasib baik dh pernah tgk byk kali sangat…so takdela kekok. Aku pakai apron, sarung tangan sterile, tadah sarung (kain batik), sambut baby, bersih dan keringkan, rawat tali pusat dan bungkus!

Some moments yang tak terlupakan:

1 – There’s one day, semua doktor residen anak ada exam nasional, so kami ditinggalkan tergantung tanpa tali! Kalau ada pape, all up to our heads and hands… Oh noooo!
Nak dijadikan cerita, hari tu lah yg paling hectic! That day lah ada banyak SC, time tulah ada patient gemelli (kembar) which is very prone to pathological condition due to their size and their mother’s strength to give birth to two babies… So there I am, waiting in full curiousity, what will happen to the babies? When the first baby is out, cepat2 kitorg bawa ke kamar bayi, suction, rangsang taktil…thank God after a few seconds die pun menangis…then baby kedua…after 15 minutes die still tanak kuar! Ibu…semangat bu! Kuat!!! Aku rase aku yg paling nervous dlm bilik tu sbb in my mind, kalau baby tu mati, I’ll be dead too! Huhu Alhamdulillah, again, after a long few minutes, the second baby keluar sendiri walaupun before that try pakai vacuum tak berjaya…at the end, both babies selamat dan sihat… :)

2 – Melihat ibu2 yang bakal bersalin. Gelagat mereka: unforgettable! When people are in pain, they tend to do unimaginable things such as crying like a baby, making funny faces, and even being in a position which seems like a horse or a cow. Seriously…even it’s not supposed to be laughed at, it’s too funny! I’m sorry to that particular person for laughing at her, I didn’t mean to, but in an absent mind with a very exhausting body, we kind a searching for entertainment in everything. Our bad! Really sorry…

3 – Opposite to d above, it’s very warming and heart-felt to see a mother’s reaction looking at her baby for the first time…there’s no word for it…what I know is that they are the happiest person at that time…I hope one day I will experience something like that, the moment of my life…insyaAllah…

3 – My moments with the babies! I love everything about them! Their faces, their cries, their smells, their skins, their chuckles…owh, aren’t they the cutest thing?!!



As conclusion, I can say this might be the most exhausting week in my life!
Stressful, painful(literally) until it leaves a mark at my foot! (after that kaki aku sakit selama seminggu di LB, time cek doktor, doktor ckp aku maybe kena gout arthritis…how serious is that??)
Kat sane kitorg betul2 emotionally challenged! Bile2 je boleh rase nak mengamuk, rase nak nangis (dh nangis dh pun…), rase nak buat muke…tp alhamdulillah, Allah beri kekuatan di sebalik setiap kekurangan.
We become more mature, more stabilized in emotional control, smarter in making our choises; lepas ni jgn pilih Fatimah lagi!! huhu

RSIA Fatimah dah memahatkan kenangan signifikan dlm minda dan hati ini…I’ll use what it taught, I’ll leave what’s painful, I’ll keep what it gave as a unique present…

And now I know why they said it's STRESSFUL at pediatric department!

IMAN NAILAH 2008
noradrenaline2001@yhaoo.com

Susahnyer Tag Kali ni...

I've been tagged by Muhammad Shafiq Mansor!

Here are the rules:

1.List these rules on your blog.

2.Share 7 facts about yourself on your blog.

3.Tell 7 unspectacular quirks on yours.

4.Tag 7 people at the end of your post by leaving their names as well as links to
their blogs.

5.Link the person who tagged you.

6.Leave a comment for each blogger.

Allrite...

7 facts about me:

1. My name is Nurul Iman binti Abdul Rahim. It's a common name in Malaysia, but seemed odd in the place I'm studying now. Everytime I pronounce my name, they'll repeat it as 'Imen' = 'E-men' and it ends up as 'Imeng'. They kept on saying it's a guy's name! So what? I like it!

2. I live in Shah Alam Selangor. I never live outside Selangor all my life except while I'm in Londang Matriculation and here in Makassar. So basically I'm a true Selangorian! Nyanyi sket..."Duli yang makan durian..selamat di atas pokok..." oops...that is THE OTHER version...sorry...my bad...

3. I'm a year younger than my academic level(at least for Msian level) just because I passed the PTS exam. So I got to 'lompat' from standard 3 straight to standard 5! No strings attached! hehe So people would say I seem more mature from my age...but what do u expect? I'm living a year older from my real age! But the great thing about it is I got to finish earlier than the people around me, and I'm still young when I marries! (what so great about that???)

4. I have a really nice family and I'm so thankful for it! It's just perfect as the way it is...I mean for us...for me at least...it's just beautiful how Allah had created everything so detailed and so harmony together...the goods and the faults, all created to be completed. :)

5. I love art...any kinds of art. I can judge what's nice, what's not, at least through my arty-eyes.(arty - is there such a word? whatever...)

6. I'm living with two beloved seniors. They're the best! Can't say more...it's just a great fate to end-up with them in this small home of ours.

7. I was born on January 25th, 1987 in Louisiana, USA, but lived there for only 1 year so i don't have the tiniest memory while I'm there.

7 unspectacular quirks on me:

1. I hate Medic! Is it too obvious? Hehe maybe I did hate it, but now after entering clinical life, it's a turning point in my life...i come to attach to it! I'm loving it!

2. I'm a very very forgetful person. So forgive me for forgetting ur birthday, or where u'r studying rite now, or even ur name! So sorry...didn't mean it...I'm trying my best to remember every detail...huhuhu

3. I'm a hopeless romantic. I hate to be one, but admit it...I am. huhu

4. I eat everything! (except for the harams of course!) U name it, I can insert it into my body, but of course I have some kind of appetite. I do choose, I do reject, but I can b DBKL(as my father name me) when I wanna be. (DBKL with all this bones? Are u kidding me???)

5. Some survey said I'm a judgemental person. Am I? Mybe I am. My best friend agrees with this. huhu

6. I've a lot of traumatic events in my life. I've my eyebrow stitched, I knock my forehead until it form a concave on my frontal bone, my face once swollen until I can hardly open my eyes, I let my feets get poked by hundreds of sea-porcupines spikes, and many more unfortunate events...

7. Ape lagi ek? Hmmmmmm....well, actually I'm a heart-breaker. I don't wanna be, but it's just written in my fate. I hope I don't have to do it again...

7 people I'm tagging:
Kak Najwa, Maimanah, Muh. Idris, Kak Halaa, Nurul Izzah, Addin, Maisarah.

:)

Now I Know Why They Said It's... - Episode 1

The tension starts to rise around me...

Fourth week of pediatrics, my first perception was so wrong.

It was MIX subdivision, consist of Nephrology(kidney), Neurology(nerves) and Nutrition. This week there are 11 co-ass(med students) submitted in this subdivision, and that number is more than enough to handle the only two patients of Nephrotic Syndrome.

So I took it for granted.

I came later than usual, about 20 minutes later that we're supposed to be.

I spent most of the times in the co-ass room, the discussion room, the canteen, the policlinic and other places rather than the second floor's 'meja batu'(co-ass’ station).

I read for a glance about Nephrotic Syndrome and Acute Nephritic Syndrome, but didn't make the time to read the patient's status.

At that point, I started to hate MIX subdivision for being so boring and giving less motivation for me to study. I need something adventurous, something much more demanding, and much more interesting to pump my excitement to learn.

Then on Thursday afternoon while hanging around at the 'meja batu', suddenly Dr. Hery came and asked us about our patient. He asked us, but his eyes are focusing on me. I felt cold. My mouth made some move, but there's no sound coming out. Other people kept on answering the questions for me. It was not obvious, but it's so embarrassing for me. It's too disappointing.

He left after giving some advice to study and learn the patients' status. That was like an alarm waking me up. I NEED TO STUDY!!!

With the new spirit burning inside me, I went home and planned to study. I made a simple slide for the next day's presentation, and that night I brought my laptop to my night-shift on-call, with the intention to study.

Again, I was asked to be in PICU (Pediatric Intensive Care Unit) for the 5th time, this week only. FYI, being in PICU means there's no sleep while you're in there. Rest is possible if there's no patient to be follow-up every 15 minutes which is very uncommon. So taking care for PICU patients at night-shift is actually a nightmare for most of us. But as a co-ass, what else can you ask for?

While in there, I managed to study a few slides and learned a lot from a nice discussion with Dr. Hery. At 2.30am, I left PICU to exchange shift and move to follow-up in Lontara 4(the 3rd class pediatric ward). I planned to study the nephrology patients but I don't seem to have the time with all the follow-up and the decreasing of the waking mind.

At 6.30am, I left to clean and change for office hour.

Now I'm starting to feel the pressure. This morning it was planned that I need to present the presentation about Macronutrient which I have the slightest idea of it. Moreover, I heard the doctor that will be the moderator likes to point to anybody to answer any question. Having the thought of it only made me feel nauseous. I keep on reading the nutrition book my friend brought, trying to memorize every important detail.
There’s:
essential amino acids,
non-essential amino acids and
conditionally-essential amino acids.
So essential amino acids needed to be taken because they’re not produced in the body, while the non-essentials are.
But what does conditionally mean???
And there’s phenylalanine, arginine, glycine, glutamine, lycine…
But which is which???

At the same time, I realized that the residents will ask about the mix patients. So I tried to read the status but my mind felt too saturated. NS and ANS become too confusing.
NS have proteinuria.
ANS can too.
But NS's is massive.
How would I know if it's massive or just more???

The more I read, the more confused I became. : (

Then suddenly we had ward round for mix patients. This time, I was the focus of arrows. The questions were all aimed to me, and I hesitated. I managed to answer some, but failed at most.

Oooh...this is bad.

Tomorrow I'll be going to Rumah Sakit Bersalin Fatimah, and I know too less to be near ready.

Now I'm too tired, but I really need to study.
Oooh...only Allah knows how sleepy I am rite now.
I know what I need. I need sleep.

IMAN NAILAH 2008

noradrenaline2001@yahoo.com

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