Towards the final goal...

Nurse Practitioner

I did nothing wrong

This happened about 2 or 3 hours ago..
I was just about to finish my shift when I saw my friend attending a patient..
I want over to help.. The patient was ill..


As he was on hourly BP monitoring, I check his BP using a machine..
Manual BP couldn' be done as the korokoff sound cannot be heard..
It shows error at first, but then the staff nurse managed to get the result which was 45/38..


Then my friend discovered that the patient's fingers was a little cyanosed..
So I check his SpO2 level, it was 66% in O2-2L..
I informed the staff nurse and she ordered to increase the O2..
The SpO2 was fluactuating so I charted his results in the observation chart..
The SpO2 was still in abnormal range..
The nasal prongs was changed to face mask, then non-rebreather mask and O2 increasing..


As the staff nurses was managing the patient, I charted the progress of what is happening..
All of sudden, on of my senior asked why am I charting??
I was like, am I wrong doing it???


Not just that, the staff nurse said I shouldn't be doing the chartings!


I was so dissapointed in their response!


Am I doing wrong?
Is it my mistake?
Was that incorrect?


If so, I really don't know which is the right way..
I was thought that documentation is very important, and I stand by this principle!

I did nothing wrong..

Spoil my day...

As you all know,
Today is Saturday..
I'm on morning shift today..

Saturday mornings in the ward are usually the calmest..
The day went off being good, everyone did their duties well..

Quite busy at times but manageable..
I was in a good mood until suddenly someone did something which I cant tolerate at all!!

I was waiting for a patient to be back from the imaging department..
I was going to give her an insulin injection and a medicine..

Since her diet tray is on her table top, so I placed the UNOPENED sachet of medication in a MEDICATION CUP aside in the diet tray..

As I'm managing some admission at the other bed, one of the attendant came into the bay to collect diet trays as it had passed lunch time..
After managing the admission, I noticed that the tray of diet was gone, together with the medicine!!
I was shocked!! Totally!
I went to her, and indeed she threw all the food in the tray into a plastic bag together with the medication..
I query her why she threw it, she just acted calm and said I can get another one..

Later, the patient came back..
I gave her the insulin, but she refused the medication..
Later before I left, she asked me for her lunch..
I was shocked, second time! She haven't eaten yet???
That tray of diet was untouched??

I was so frustrated!!
I cant face that attendant so I asked my friend to request a diet from her..
In the end, she only ordered some bread and milo for her!

I cant tolerate this!
You might think that it's just a tray of diet, why make a fuss out of it?

You will know when you look at the patient's face..
She was starving! Asking where is her diet..
She was so lethargy..
When the bread was served, she was glad and was really enjoying the food..
This shows how hungry she actually was..
And she was just injected with insulin!

And I did complain this matter to my college..
I shall not let this pass..

A nurse's job include a lot of aspect..
From major, emergency procedures to minor, simple tasks..

A nurse's job is to care.
I am a nurse.
If I don't care, who else cares?

A Rememberance

Before I even step into the ward for practical, I was told by my tutors:

"There is a line between patient and nurses, dont cross it, be professional"

and I finally knew why..

We were told to talk to the patients in the ward by our clinical instructors, help them pass through time, cheer them up..
But there is always a borderline which we must not over stepped..

If you're lucky, it does no harm..
Unfortunately, mine was bad..

I still remember in Semester 1, when a group of us friends were posted to the same ward..
There we met an Indonesian lady, came in because of Ca Colon..
She had done an operation and was having a colostomy..
She was quite ill, she only lies on her bed even during mealtime..

We finally got close to her and her husband (which was good in joking), and her daughter..
Then one day, she collapsed and fortunately she was resuscitated and placed in CCU..
Even more fortunate was, she eventually was transferred out to the normal Cardiac Ward for heart monitoring..

This is when we met her son as her daughter went back to Indonesia..
Then we would be visiting them whenever we got the time..
And one day, I was so happy to see her finally sat up by herself to the bedside, taking her lunch!

Few days later, she was fit for discharge!
Before they left, we exchange our Facebook email with her son to stay in contact..
One of my friend asked
"is it ok to be so close to the patient?"
I replied that it was her son, not the patient..

Whenever she came back for a follow up, her husband would sure to contact one of us..
And we will always have a small gathering..
Their visit during my last semester was her final one..

2 days ago, I received an inbox message in my Facebook..
It was her son telling that her mom had passed away on the 11th of November..
I was shocked..
We never expected it..

Truly it was sad..
What we can do now is to hope she is in a better place..

..Nursing is a job not only of its skills and knowledge..
..But it also involves emotion and values..
..It is not an easy job, it was never an easy job..

Still, I did not regret crossing the line, because I know, we made a difference in their life..
We may not find another patient to be this close to again, but I really enjoy the time I can care for others..

Visit to Health Clinics

The next stop of our CHN visit is to rural health clinics..
The purpose is to understand the health settings and the services provided..





And the other group went to the BAKAS unit...
Enjoy the pics!

Very syok sbuject!!

Community Health Nursing (CHN) is a very good subject!
The whole oreintation week, we were all going for field trips!

Sadly, our group is too big, so we were divided into 2..
Therefore there are some places that I didnt go for..

Anyway, before the orientation week, we had a field trip we learnt about Environmental Health which is a sub-topic of Health Promotion, which is a sub for CHN..

We headed for 2 water purification centre..
First the Indah Water & second the PBA..

~Indah Water~

~PBA~

Stay tuned for CHN's orientation week!

Exams...

Hey yo people..
Been quite busy these few weeks.. (read here)

So, my class test 2 is over..
Did it so so, not too good or bad..

And OSCE is today!
Did not bad also..
The marks hasn't come out yet..

Anyway, nursing had been more interesting these few weeks!!
Gonna share them to you soon!!

An interesting subject

Hey guys..
It's been a while since my last post..
My laptop got a viral infection..
Read about it here & it's recovery here..

Anyway, this post is about an interesting nursig subject I'm learning now besides those medical ones I mentioned before.. *Read it here*

The subject is called Health Promotion..
It's a sub-topic for Community Health Nursing (CHN)

In this subject, I'm learning about health care for the community, health education and health promotion..

We're going to have visits on Malaysia's health care settings, for the rural and also to community health care centres (klinik desa)..

The thing that interests me is health education..
I'm going to be giving a health education talk to Standard 1 students!
What's more, I'm going to have a cooking demo as required when studying nutrition education!

That's fun!!
But the down part is, it's also about doing statistics about the community's health..

Anyway, looking forward to learn more!!

Green to Blue...

Moving on from Green to Blue!

Semester 3 lo...

Starting 1st July, I'm officially a sem3 student..
At least partially.. I still need to wait for my cross book to be updated..

Anyway, made it through for a year already!!
~OMG~ That was really fast!
As if manipulated by a time machine..

Sem3 is gonna be hard!
Learning the toughest subjects - Disorders of the Hemopoietic, Respiratory & Cardiovascular System..




But learning about CVS is what I've been waiting for!
Coz, I've been eager about learning to interprete ECGs..
It's a tough subject but I wish to conquer it!!
That will help a lot in emergency cases..

Another new thing is, I'd got a new mantee.........again!
I thought I'll be excluded from being in the mentor-mantee program this sem, but it seems I cant escape..
Anyway, my new mantee is 20years old from Perak..

Good la..
Senior d...
Must accept challanges..

Looking foward into the challanges!

Excitment turned Dull..

Finally, today, there's a patient who needed to have a CVL inserted and I'm so excited!
But, it was still KIV, depending on some test results.

At that time, the semester 4 seniors went back to college for some cross updating so there were only us, the semester 2 and the juniors, semester 1..

When I heard about it, I was so happy, I volunteered to assist the anaesthetist in inserting the line..
This is a rare procedure in the ward as insertion of the CVL is less commonly done in the ward..
Since I just learnt this and it's a rare opportunity, I got to grab this chance!

Then the semester 4 came back after finishing their business..

When the SN looked at me and say, "prepare the trolley for CVL", I was so excited and quickly start to prepare the trolley..
As I was starting to prepare the trolley, suddenly I was called to answer a call..
It was a call from my tutor asking me something about posters in the classroom..
It was totally an unnecessary call as I will be meeting her the coming Monday..

Patient with CVL

After the finishing the conversation, I went back to preparing the trolley just to see those Sem4 seniors taking over my trolley that I was preparing halfway...
Well when I was trying to join in, they seem to be 'taking over' the job pretty well...

So I got out, frustrated..
I couldn't believe it!!!
I know you might have not done this procedure yet, but you could at tell me to pass it over to you rather than just 'take over'!

Night Shifts

Finally went on my night duties and it was fun although sleepy, but it was not bad..
For me and I think I may speak for others, night shift is like a party shift!
Picnic shift ~.~
Why??
Due to the late night hours, we're allowed to bring own food for the break time..
And I did brought a lot of food and snacks on the second night..

Anyway I gain some experience and knowledge on the routine and how to manage night shift.
The shift begins at 9pm and ends at 7am the next day...
Total of 10 hours spent in the ward..
There were not much to do actually, but it seemed busy..
It's like the times where you felt busy but you don't know what are you busy about..

Anyway the staff nurses were nice and friendly, willing to teach and guide.
Not just that, the nurse aid too is very friendly! We were like friends now! LOL
Only 4 students per ward during night shift, I was with Ling Min..
She was given a nickname by the nurse aid.. Haha, pity her..

We had a DIL patient in the ward.. A post ICU patient..
He had a PGU and was warded in ICU post-operatively..
Weak looking, GCS 5-6, only his right arm could move in response..

On my second night, the SN asked me to keep an eye on him, so I did..
After break (it was quite a long one), I felt a little guilty, so I decided to make a ward round to make it back up, as I was approaching the above mentioned patient, I felt something wrong..
I did not hear any breathing sound that he usually made (he breaths heavily)..
So, I check for his pulse, pulseless...
I quickly went towards the SN and the move the patient to the treatment room..
ECG monitored, asystole, then the SN in charge announce that it was a DNR case..

LO was done for the patient, and it was a coincidence that the opposite ward had a code blue..
Wow, what a night..

It was a worth it experience. I hope I can remember the routine and management in the wards in the next night duty..

How I ended up nursing... -2-

I've been doing a lot of findings on what is nursing and the job nature, but my mom wasn't happy..
She wants me to go through University cause she thinks only graduates from uni have bright future..

I was like . . . . . . . .
It so happened that opposite to my house lives a university lecturer and my mom seems to be getting advice from him..
And so I was forced into going for Form6..
I did fight for my right but parents are parents, whatever they said are right..
That is how I ended up studying for 2 years and left behind...

Then when I graduated from Form6 I decided to go for Nursing..
I went to get information from colleges and internet..
My mom once again isn't happy..
She again lecture me on how she wanted me to enroll myself in a university..

I was like, "I've no interest course in uni!. You want me to take up singing or what?"
I was into classical at that time and still am..
My mom was like "I don't care what course you take, just go into uni!"

But I was very happy when one of my uncle called up and help to advice my dad on what is right.
"He is old enough to make decision.. Don't force him"
After some rational talking, my dad finally agrees in my choice..
My mom on the other hand, still stubborn, was even more unhappy..

Anyways, my dad supported me by accompanying me to one of the college for interview, becoming my guarantor and advice my mom..

After successfully enrolled into a nursing college, my mom was speechless..
As if all her dreams were shattered..
I told her, "Please let me make my choice, I'll try my best and be the best"..
When things happened, she had no choice but to accept it....

Well, my mom's happy now..
She'd accepted me with my choice..

So to those of you who wanted this or not, try your best as there's no turning back!

How I ended up nursing...

Ever wonder why a guy wanted to be a nurse?
Well, wonder no more..

Why I choose nursing as my future?
My parents were against it..
My relatives were against it...

Well, I told them it's my interest..
I love to care & look after for others..

When I was small, I had no solid ambition..

Businessman
Inventor
Chef
Radio DJ
Singer

All those under influence of medias & peers..



But I saw the light when I was in Form 3 when I joined the St. John Ambulance..
When I was first exposed to first aid, I was really impressed..
I work my way up in the organisation and ended up to become the First Aid In-Charge of my division..


When I was Form5, I started to think......
What next??
My interest now is in the medical field, so why not continue this path...
But...
Where to go??
...Doctor *wasn't good in studies*
....Paramedic *low job prospect*
.....Nurse. . . . . ??

Then I started looking for information about Nursing and other medical field career . . . . . . . . . .

*stay tuned for part 2*