Part 2 – Life As A Peri Medical House Officer In Hospital Umum Sarawak | Main Building, Side Building, Infectious Disease Ward
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The Peri Medical House Officer Team takes care of:
The Emergency Department- Green zone
- Yellow zone
- Yellow respiratory zone
- Green-Yellow zone
- Asthma Bay
- Red Zone I
- Red Zone II
- Decon
- CSSD
- EDOU
Main BuildingSide BuildingInfectious Disease WardSDC (Surgical Daycare)In this article, I will be sharing my experiences as a Perimedical House Officer covering main building, side building, SDC as well as the Infectious Disease (ID) ward.
As I previously mentioned in my previous article, the work begins from 7am till 6pm (short days), 7am till 10pm (long days) and 8am till 9am (night shifts).
Covering this part of the hospital meant taking care of “stranded patients” which are medical patients who are lodging in other department wards as there are no space or beds available in the main medical wards. Usually, patients like these are somewhat stable enough to be left on their own without constant supervision. Those that do require, are usually left in the Emergency Department or transferred straight to medical wards.
The Main Building
Taking care of the Main Building meant that one would have to cover:
On some days, there would not be any perimedical patients in certain wards. Thus, there are days that we do not have to go to these wards. On bad days, there are perimedical patients on every floor and the patient count will be extremely high.
During my time serving in the main building, I was blessed enough to have a partner. Thus, despite the high volume of patients, it felt manageable.
Upon my arrival, I usually begin from the highest floor and work my way down. Thus, I begin from the 7th floor by checking with the TL or Team Leader to identify new cases and update the list followed by tracing the blood investigations.
This is to ensure that the patients are not missed during rounds.
I proceed with doing this in the wards of every floor till I am done prior to beginning my morning reviews.
Usually by then, the Medical Officers have arrived and are proceeding with their morning reviews.
Sometimes, we join in and sometimes, we are asked to review the other patients and on our own until the specialist arrives.
Upon the specialist’s arrival, we would all meet up at one place to begin out rounds.
Rounds in perimedical is similar to that in the ward. The only difference is that rounds are once daily and the patients are all around the place.
In between, there would be new transfer ins, attending to acute issues of which the nurses from other wards would call or inform the House Officers from other departments.
After that, it is followed by preparation of the coming morning bloods. The wards and bed numbers are labelled on top of the forms and kept in the ETD for the night House Officers to take.
The Side Building
The Side Building is less hectic than main building and that meant we had to cover:
As usual, upon my arrival, I would begin at the topmost floor and check for any new patients as well as to trace the bloods.
After all of it is done, I begin my review in the ICU Extension 2 Ward. The ICU Extension 2 ward consists of unstable, intubated patients of various departments.
Usually by the time I begin my morning review, the specialist would have just arrived and we begin our rounds.
After the ICU Extension 2 is followed by Neurosurgical Ward since they are located at the same place, then Neurosurgical HDU.
Upon completion of morning rounds is followed by carrying out the active joblists, discharges and requesting for radiological scans.
Similar to Main Building, the coming morning bloods are prepped and kept at the Emergency Department for the night house officers to collect.
SDC – Surgical Day Care
SDC is the Surgical Day Care as per the name. Usually patients who are admitted here come in on the day of the procedure itself and is discharged in the evening.
However, when the wards are fully occupied and the Emergency Department is overflowing with stranded patients, the SDC converts temporarily to host the stranded patients.
At max, the patient load is only two cubicles full and the patients being admitted there are usually relatively stable.
Similar to main building and side building, I begin my day with tracing the bloods, x-rays or any relevant radiologist reports before beginning my review and rounds with the medical officer and specialists.
The Infectious Disease Ward
The Infectious Disease Ward or “ID Ward” is located in a building separate from the main or side building.
Previously, it used to be the House Officer’s Accommodation. However, it was subsequently converted into a ward.
The ward consists of two floors with each floor containing 6 isolation rooms for each floor. Upon entering the ward itself, one has to change into the hospital scrubs and prior entering the ward isolation rooms, one has to don apron, shower cap and gloves, the standard PPE.
The casenotes are not allowed to be brought in, thus all reviews are written outside.
What do I do if I were stationed to at the Infectious Disease Ward?
The house officer allocated to the ID ward are those from the Peri Pool, meaning our shift is from 7am till 6pm for short days.
Thus, upon my arrival, I would change into the hospital scrubs. Then, I would proceed to trace the bloods. The bloods sent from the ID ward are usually late. Thus. It would either be pending in the system or yet to be in the system.
Next, I will begin my reviews, first to the newly transferred in patients followed by the rest while awaiting the medical officer.
There is a whiteboard consisting of the names of the patients in the isolation rooms. Usually in the morning prior to entering the isolation rooms, we would have a short round and presentation with the ID consultant with the whiteboard.
Thus, during my time there, I would constantly update and personalise it according to my style which would be easier for me during my presentation with the ward consultant.
After that, we will all proceed to the isolation room. As House Officers, we are the scribe and assistants of the medical officers. Since, we are not allowed to bring the casenotes into the isolation room, thus we will type everything inside our phone and transfer it onto paper after our grand rounds with the patients.
Rounds at the Infectious Disease Ward is only once daily.
After the completion of rounds, just like any ward is the completion of active joblist.
Personally, I enjoyed my time in the Infectious Disease Ward a lot, mainly because I was given the autonomy to customise the board as I liked, present to the consultant myself and was asked multiple questions during rounds and having discussions which I find rather stimulating and enjoyable.
On top of that, I even had time to return home for a quick lunch every time I was stationed at this ward.
In the afternoon, some patients on high oxygen support may need arterial blood gases (ABGs) at certain time. If not, it is the preparation of coming morning bloods and transfer ins of any new patients.
Being in charge of the other places is considerably less hectic than being allocated in the Yellow Zone which can get rather crazy at times as there is massive movement of patients constantly. It actually feels like as if I am at KL Sentral during peak hours.
However, do not fear if you are allocated into the Peri Medical Pool. The workload can get extremely hectic and it can be rather messy. But, always try your best to learn as much as you can during your period serving there and to enjoy your journey.
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Eric
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