Mastodawn

Tagline: “Hourly Toilet Break”

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If humans had taglines, what would yours be?

Those who have worked with me know that I have such thing called “The Hourly Toilet Break”.

Firstly, because I consume lots of fluids and secondly, that is how I ensure I do get the break once in a while on a busy day or maybe, the day is quite slow and I am just, bored.

Of course when the day is rather busy and hectic, time just flies and that I do not even realise the time passing by. By the time I actually do complete my task and take the opportunity to just rest for a while, 2-3 hours have gone by.

How Did The Hourly Toilet Break Started?

Photo by Hafidz Alifuddin on Pexels.com

I didn’t actually planned for such thing at work. Obviously.

At home, I do frequently go for my toilet breaks as I’m forever consuming green teas or black coffees or water. All of which contributes to the filling of my bladder, in addition to the fluids being diuretics.

It wasn’t until I started my tagging in my sixth rotation, the Emergency & Trauma Department that I reinforced this so-called “hourly toilet break”.

The tagging hours in the Emergency & Trauma Department is long, just as in other postings whereby we had to work from 7am til 10pm everyday with an off day each week for 10 days straight.

Thus, it helped me in ensuring that I either get to sit and recollect myself during hectic days or to make the hours pass during slow days.

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The Theoretical Doctor Aug 17

Overcoming My Fear To Refer A Case I DO NOT KNOW | Housemanship Diaries

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What fears have you overcome and how?

At the moment of writing this article, I am in my sixth and final rotation which is in the Department of Emergency Medicine, pushing into my third month.

One might think that as we become more senior in our current job, it gets easier or the fear fades.

Well, the anxiety certainly reduces but that does not mean that it disappears.

For me, the fear is still there as to who I would be working with or who I would be referring to and most of all, referring a case that I not know.

I’m sure we’ve all been there before. Especially upon arrival to work and to be absolutely clueless about the patient and their case and progress and to not have anyone handover the case to you.

Not that we won’t take the time to understand. It is just that, we will or at least I would take the time to digest the initial presentation, clinical examination and findings followed by the initial management of the patient and other teams as well as the current progress.

Once I have finally understood the issue of the patient from A to Z, then I can confidently refer the patient for a simple thing.

That’ll usually take me about 5-10 minutes, especially if there is just one too many writing. To others that may seem like an eternity.

The thing is they will somewhat give me a template of what to say in regards to the patient but I am still absolutely clueless and wishes to kindly absorb the pages and information about the patient before I walk into the battlefield.

This is because, one too many times, I will be asked about things totally irrelevant to the case of the patient which will take me some time and if I’m not so lucky, ended up being shouted at. I mean, that’s the worst that can happen right? Certainly reminds me of my early days of housemanship.

Maybe it’s a form of childhood trauma or maybe not, but I need to at least have a reason to defend myself and the patient.

It’s like a debate or a business deal which I find that I may need to fib or exaggerate myself in order to get a test approved or to refer, all for the sake of the patient or sometimes the superiors.

It’s alright but at times it can be rather annoying especially when they want it done in a minutes time.

The next that I have to actually open my mouth and communicate. Being an introvert, I can easily talk to people but I dislike being in groups, small talks or actually talking at times.

I find it exhausting and thus upon the end of my shift, I just need time to recuperate.

However, back to the question of this article, my fear, to refer to other departments, especially, if it is a case I do not know and to a tiger of a person who loves finding any fault just to reject the case is still present to this day and what have I done to overcome it? Nothing, really, just extreme patience.

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The Theoretical Doctor Aug 14

Reflection – After Almost 2 Years Of Practicing As A Junior Doctor

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“Would you want to return back to medical school?”

No.

I enjoyed my 5 years of medical school very much and I appreciate the memories formed throughout those years.

However, after working as a junior doctor for 2 years, I would not consider turning back time, just to go through medical school all over again. I enjoyed studying and it was equally tough and fun. Besides that, I had the best study group, “The Impostors”.

Going through the COVID-19 Pandemic season of social distancing and online classes made the journey easier. I remembered staying back in Kuala Lumpur and waking up in the morning prior to starting class just to set up my laptop and my connecting screen, sending the link earlier to the group, sharing the slides if needed and while the classes are on-going, I would go about cooking, cleaning or folding clothes.

My coffee and tea would be on standby and everything was prim and proper. Besides that, breakfast, lunch and dinner would always be prepped by me, for me or my friend who lives upstairs. After that, I would proceed to study during the wee hours.

I think the time I managed to complete reading various textbooks were during the COVID pandemic.

Then, I graduated and started my housemanship. It was extremely tough at first and it’s still difficult now at times but I’ve grown to accept the fact that there will be difficult days as well as good days.

Three months later after starting my housemanship journey, my first pay was banked in and subsequently, every month I received my monthly pay.

Eventually as I become more and more senior, things became more and more familiar and easier and some things or procedures became a reflex, even the management plans.

Thus, considering, the things that I’m doing now which I think is much easier as compared to my medical school days, would I want to turn back time?

Nope. Medical school is important and equally tough. On top of that, I’m not getting paid. Instead, my parents had to pay for my medical school fees.

So, no. I cherished those days as I said. But I certainly do not want to relieve them again.

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The Theoretical Doctor Aug 13

Preparing For My Exit From The Medical Posting As A House Officer | Housemanship Diaries

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Medical. My Fifth rotation.

While I was in Medical School, my favourite rotation was the Medical Posting and I’ve always imagined myself being a Medical Officer in Medical.

Thus, upon entering my Housemanship Journey, I did not choose to rotate in Medical as my first posting. Many people said that the Medical Posting is the most difficult posting of all the postings due to the patient load as well as the workload.

Thus, I began in Orthopaedics and placed Medical as my Fifth Posting. Mainly, because I wanted to “enjoy” it. Enjoy it in the sense that I already knew the basics and knew how to function as a House Officer and would be able to learn how to manage the patients.

However, albeit being a senior poster, some old habits retain. In the Medical posting, we were required to hand in our logbooks 2 weeks prior our End of Posting Date.

However, I approached my mentor 5 weeks prior my exit. Unfortunately, my assigned mentor at that time was not available and asked me to approach my Specialist-in-charge of House Officers at that time to request for a new Mentor.

I approached the Specialist-in-charge and was assigned a new mentor which happened to be someone I worked with multiple times while I was in Medical 3.

The following week was a rather tensed week for me as I tried my best to cram as much as I could.

I finally had my assessment with my first mentor who is a Medical Officer that Sunday. Thankfully, I passed.

2 days later, I went for my assessment with my second mentor, my reassigned specialist, who passed me as well.

The issue next was the completion of my 12 CMEs. CME stands for Continuous Medical Education which occurs once a week on Tuesdays. In other postings, only 5 CMEs were required in order to pass. Sadly, it is not the same for the Medical Posting.

Unfortunately, CMEs done online were not acceptable even if there are certificate of attendance.

Luckily, I had attended a Hospital CME some time ago and I was only looking for ONE more CME prior to my exit of this posting.

Thus, I used that to my advantage and finally, I was able to hand in my logbook and officially exit the posting.

Sadly, a few days prior to my exit, something occurred that led to the demise of a patient. But, that is a story for another article. Thankfully, that did not affect my exit from this posting and I exited, on time.

If you are due to finish the Medical Posting or any posting in general, take it as a lesson from me and approach your assessors much earlier.

Otherwise, all the very best!

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The Theoretical Doctor Aug 2

Surviving The Night Shift As A House Officer In Medical 3 | Housemanship Diaries

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The Medical 3 Ward of Hospital Umum Sarawak or “Sarawak General Hospital” is located on the 9th floor of the main building.

Thankfully, being allocated as the Night House Officer, we only had to take care of one ward, unlike being allocated in Medical 4 / Medical 5 / Infectious Disease Ward or being in the Perimedical Team whereby we were always on the go.

The Medical 3 Ward consists of three teams, which are General Medicine, Respiratory and Neuromedical.

During the daytime, we have allocated House Officers for each team. However, during the night shift, we are in charge of the whole ward.

The jobscope of the night shift House Officer in this ward is the same as in other wards and postings which are transferring in of new patients, attending to acute issues and most importantly, coming mornings.

If you have read my previous article on Surviving The Night Shift In The Medical Posting In General, I mentioned that in this posting, upon my arrival to the ward for my night shift, I would begin taking my coming mornings.

The same goes for Medical 3. However, unlike the night shift in Perimedical, I do not take my arterial blood gases with my coming mornings.

I begin from the Respiratory cubicles which is located at the back of the ward and then move to the front cubicles before finally continuing at subacute and acute cubicles which are the beds located in the middle of the ward, in front of the nursing counter.

If I were late for my coming mornings, then I would proceed with taking the arterial blood gases together. But if I finished early, I would take the blood gases much later.

By 5:30am – 6am, I would start running my blood gases and paste them in the casenotes of the patients. Around 6am – 7am is when the morning team starts arriving to trace the bloods as well as begin their morning reviews.

Thus, I wait to be summoned for my bloodtaking or certests.

Finally, at 9am, I return home from my shift.

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The Theoretical Doctor Jul 29

Surviving The Night Shift In The Medical Posting In General | Housemanship Diaries

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The shift that I have always dreaded but enjoyed the most were the night shifts. I dreaded it because I knew that I would be alone most of the time and afraid that I would not be able to cope with the adrenaline rush or anxiety or the craziness that might ensue. However, I enjoyed it because that meant that I will be able to sleep in prior to going for my shift and the following day at 7am, the morning team will start arriving and I am not alone anymore.

The Medical posting in general is a “heavy” posting because of the patient load. Almost all of the patients are so-called “Medical” patients once Surgical, Orthopaedic, Psychiatric or other causes have been ruled out, and it could stem from something as simple as electrolyte imbalance to myocardial infarction or stroke.

Thus, imagine the amount of coming mornings.

Prior to entering this posting, I’ve always enquired and listened to my fellow colleagues’ input and experiences. Most of them would say that “In the Medical posting, the rule of thumb for surviving the night shift is to start taking the bloods as soon as you arrive for the night shift”.

True enough. That is something I have practiced since and even in other postings as you do not know just when something may happen and next thing you know, the sun is rising and your coming mornings are late and the morning team have arrived and the bloods are still pending or not in the system or yet to be taken and the medical officers and specialists have arrived.

Sadly, when there is a delay in the blood investigations, there is a delay in management.

Thus, it is a tachycardic moment for me. Prior to entering my shift, I would screen through the coming morning list and upon arriving, I would usually prep my trolley, ensure my coming mornings are divided and arranged according to their cubicles, ensure enough syringes and needles are set aside as well as the alcohol swabs and cotton swabs.

Then, I will begin taking my coming mornings, usually working my way from the back of the ward then towards the front cubicle, subacute cubicle and finally, ending with the acute cubicle.

Usually in between, something will occur, maybe a patient newly admitted into ward or a patient will suddenly be hypotensive or hypertensive or hypoglycaemic or starts throwing up or wants to have a small talk.

Normally, I would not mind entertaining them. However, if I’m still due to complete my coming mornings, I would proceed to complete it and I usually will not rest until I do. At least I’ll be rest assured that should anything occur in between, I would not have to worry about the completion of my coming mornings.

The night shifts can be rather unpredictable as one minute it can seem rather quiet and calm at first and hectic the next. At times, it can get overwhelming as well.

However, have faith and know that help is always nearby and start taking your bloods as early as possible.

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joost van egmond Jun 9

#Ontgooglen doe je zo – introductie

Gebruikerservaringen bij het afstappen van google, stap voor stap. Introductie

https://jveg.org/notes/ontgooglen-doe-je-zo/

El Mundo de Óscar Jun 9

Reflexiones de Oscar «Lucidez en tiempos decadentes»

Que estos tiempos son decadentes, es algo desgraciadamente evidente en nuestra sociedad, mantener la calma y la claridad en tiempos de crisis moral como la actual es algo incluso heroico, es triste ver con los zascas están por encima de los argumentos razonados y sólidos, como suben al poder gente con dudosa categoría moral e intelectual, que banaliza lo que es serio y grave, que ve que gritar mas fuerte en vez de dar argumentos razonables cala en mucha gente.

Si, amigos y amigas, mantener una cierta lucidez en estos tiempos, es muy complicado, y yo personalmente no puedo considerarme alguien no haya sucumbido a impulsos, pero yo admito a mi debilidad, nunca he creído tener la razón absoluta y seguro me equivocaré, de hecho me he equivocado en más de una vez.

Yo nunca he creído que por ejemplo los de mi ideología lo hacen todo bien y perfecto, en absoluto, no me gusta y me parece peligroso la idolatría a un o una lider político, la gente de tendencia digamos autoritaria suele surgir de gente que le idolatra, liderazgos polarizadores, que no insta a debate sosegado y razonable, gente que lanza la soflama de «O conmigo o contra mi», y si, pienso en «lideres» como Trump, Milei, Abascal, Ayuso..etc

Resistencia y lucha, es lo que toca, abrazos y feliz Lunes, amigos y amigas.

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novaTopFlex Jun 2

Taglines on WordPress

Daily writing prompt If humans had taglines, what would yours be? View all responses

Actually, there is a feature on select themes on WordPress, including the “Curriculum” theme on my subdomain, that supports the creation of “human taglines.” And for my tagline, that would simply be “Expressing the ‘novaTop Identity.”

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Inside the Red Head's Head Jun 9, 2024

Daily writing prompt If humans had taglines, what would yours be? View all responses

I would not have a tagline or a catch phrase or anything like that. Nope, not me.

The best I could do would be to steal something from a movie, a book, or a song. I’m not interesting or important enough for anything more than that.

“There can be only one” from Highlander
“Lookin’ real good” from Better off Dead
“I have a bad feeling about this” from Star Wars
“No kitty, that’s a bad kitty!” from South Park
Literally every line from Spaceballs
Literally every line from Hitchhiker’s Guide to the Galaxy
“Spinning, whirling, still descending
Like a spiral sea, unending!
Sound and fury drowns my heart
Every nerve is torn apart!” from a little ditty by Rush

You know, something like that. Something subtle, right?

https://robertjames1971.blog/2024/06/09/taglines-nope/

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