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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My First Night Shift Covering Medical 4 / Medical 5 / Infectious Disease Ward In Sarawak General Hospital – Housemanship Diaries

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Around my third month in the Department of Medical at Sarawak General Hospital, I was reallocated to Medical 4 which is the “Nephrology Ward” meaning patients who are admitted with newly diagnosed chronic kidney disease or have underlying kidney pathology requiring biopsy or haemodialysis (HD support) but clinically stable as in not requiring oxygen support, not in sepsis or not requiring medications for blood pressure support are admitted here.

I will explain more about that ward in another article.

Anyway, back to the reason for this article, being allocated in this ward meant that I had to cover not just this ward, Medical 4 but also Medical 5 as well as the Infectious Disease Ward during my night shift.

In the Department of Medical, the night shift is from 8pm till 10am the following day.

While I was allocated here, I was blessed enough to have a few taggers in the ward and tagging is from 7am till 10pm.

Thus, upon heading down at 8pm, there are usually a few people in Medical 4 till 10pm. Thus, upon entering my shift, I would first head over to Level 9 to place my bags, pop into Medical 4, for a while and then head over to Medical 5 to take the coming morning bloods.

Upon completion, I would then head over to Medical 4 and begin my coming mornings there. Usually while I’m taking my coming mornings, new patients will come in and thus I would transfer in at the same time.

Upon completion of my coming mornings in Medical 4, I would usually send my bloods at around 2am and then head over to the Infectious Disease Ward to take the coming mornings.

In between I would be free but sometimes I would receive call for new transfer ins at Medical 4 and Medical 5.

At 5-6am, I start running the blood gases. Usually when I take the coming mornings bloods, I would take the blood gases as well and keep it in a separate syringe in the cooler.

Surviving the night shift initially was intimidating as I have yet to experience it and Medical 4 and Medical 5 were located far apart from each other.

My main concern was if something were to occur at both wards at the same time.

Thankfully, my experiences were mostly good and I enjoyed every night shift I’ve experienced thus far in this ward.

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Favorite Moments

One of my favorite moments was when I had finally covered North Carolina on my geospatial project coming soon!

Daily writing prompt Describe one of your favorite moments. View all responses

There is one favorite moment that stands above all other favorite moments. Obviously there are a lot of favorites over the course of over 50 years, but there is one that is the clear favorite of favorites.

May 30, 2009. I stood at the alter and waited patiently, with the biggest smile ever, as my bride to be walked down the aisle toward me. We then stood together in front of family and friends and expressed our love for each other and vowed to share the rest of our days together.

As favorite moments go, that is the tipity top of the mountain, let me tell you.

https://robertjames1971.blog/2024/06/14/easy-answer/

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