My First Night Shift In Surgery | Housemanship Diaries

Related Posts:

• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

My first “ON” or “On-night” or night shift in General Surgery was in the Female Surgical Ward with a friend whom I’ve known since around my first posting but have yet to be in the same posting together till our fourth posting in General Surgery.

We were blessed enough to have at least 2 people per ward for the night shift.

Our shift as “on-night” in Surgery began from 7pm and will usually last till all the discharges are done the following morning.

Upon my arrival to the ward, I was informed that one patient in particular had no urine in her CBD (urinary catheter) bag and that she felt like urinating but was unable to void. Considering that she had a urinary catheter in-situ, voiding should not have been an issue.

I attended STAT and assessed her. She had a mass over her abdomen which was hard, non-mobile but had smooth edges, around 15cm by 10cm, a rather large one which I assumed was a tumour, probably pressing onto her urinary bladder as well.

It did not occur to me to check if the patient was previously passing urine, it also did not occur to me to check her intake and output chart. All I could think of at that time was, she felt like voiding, she is in pain, there is no urine flowing into her urine bag.

Thus, I prepped the trolley to reinsert a new CBD. I donned my plastic apron and prepped my materials needed and proceeded to clean the patient’s vagina and reinsert a new urinary catheter in as probably as sterile as I could, bedside.

Upon insertion of the new urinary catheter, there was no urine outflow. Thinking that I may have blocked it or inserted not all the way in, totally abandoning my theoretical principles learnt, I proceeded to reinsert about 3 times and each time was met with no urinary outflow but there were bloodstains from the urethra.

I called my partner for help and he proceeded to help me in informing in the oncall group and referred to Urology medical officer oncall who was rather grumpy.

It was during his referral that I realised that the patient had been anuric (not passing any urine) for sometime now. Clearly, she would not have any urine output and although she felt the need to void, it would not have been an issue considering there is a urinary catheter in-situ.

I had unnecessarily caused trauma and I felt foolish for acting prior performing a thorough examination and understanding her case.

The Urology medical officer came and reinserted a CBD to which she asked us not to remove and to request for an ultrasound the following day for assessment as she suspected that the tumour over her abdomen had infiltrated into her urinary bladder or urinary system.

That was settled but definitely ate up a huge amount of our time because of my mistake.

Subsequently I was rather slow and there were a few post-operative patients and new patients admitted into the ward. Hence, I proceeded to do the needful. By the time I was done, my partner had completed taking the blood for the whole ward and at that time, it was around 3am. I could sense the back-to-back disappointment I have caused him and at that point, I have given up on apologising.

We then proceeded to complete our planned discharges of the patients and by 6am, started tracing the blood results of the patients before retiring into the house officer’s room for a break.

In the morning, as usual as in other postings, we would be “summoned” in the group to take any bloods or to start our discharges.

We returned home around 11am and our post-night shift was followed by an off day.

Personally, I felt that I could’ve done a lot better as I was rather slow that night. However, for a first night shift in Surgical, it was not as bad as it seems.

Related Posts:

• My First Day Back At Work After A 6-Week-Break | Housemanship Diaries
• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

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My First Day Back At Work After A 6-Week-Break | Housemanship Diaries

Related Posts:

• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Last Day In Paediatrics As A House Officer
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

I officially returned to work on the 2nd of October 2024.

Initially, I was stationed to work the morning shift at ward. However, a colleague of mine decided to take a sick leave on that day when she was initially stationed as the House Officer in the Emergency Department, ETD HO.

Being the Allocation Leader in this department, it is my duty to immediately look for a replacement and to update in the group with the medical officers. Not one person came to mind and I felt bad since it was a friend of mine who took a sick leave or did I feel comfortable dragging another person to cover this shift since it is a shift most people avoided.

Thus, I offered to be the ETD HO myself. It was during an anaemic House Officer period and there were only one House Officer stationed at the Emergency Department.

Hence, I went to work and stocked up my necessary supplies before meeting the post night House Officer in the Emergency Department to receive my handover.

Of all days, it had to be one whereby no coming mornings (bloods) were taken for the patients and there were a lot of active job-lists not being carried out. Not to mention scans to be requested the following morning.

Basically, there were a ton of “shits” being thrown to me and if I do not settle it myself or to push my post night colleague to help me, I would be in a mess for the day.

Imagine having just returned to work to this. Without thinking much, I started identifying the patients who had bloods to be taken and proceeded to take all of them and sent it off. After sending them off, I started preparing for scans and called the radiology medical officer oncall to present my case.

Finally, after I thought I was done, I decided to review the stranded patients.

Normally, the stranded patients should be reviewed around 7am as we would begin our morning rounds around 7:30am till 8am. Thankfully, it was the weekend and rounds began much later.

I went through my list of stranded patients and there were almost 20. 20 stranded patients at various locations.

Would I have the time to review all of them? What about the active joblists or scans? Can I rely on my post night colleague? What if there is a new case?

I remembered it being a rainy day and the referrals were initially from wards and not from the Emergency Department (ETD).

Perhaps it would be a slow day. I thought to myself.

But, I thought too soon.

Soon, referrals started piling up. My medical officer’s phone (MO) was blowing up with calls. Other sub-specialities kept reaching out for me to help them out and at one point, me and my medical officer had to split to ensure we got everything done to the best that we could.

I wished that I could literally divide myself but I couldn’t. On top of that, my right foot started to ache. I just came back from a 6-week-break. I can’t afford to go on anther few weeks. If I do, just when am I going to end this posting?

I recalled it being a terribly hectic day and I felt bad as I was mostly away, having been dragged away by other sub-specialities, escorting patients or carrying out the active job-lists. I could not really be by my medical officer’s (MO) side to see the cases.

Finally, the end of my shift approached. 7pm and my night colleague came for handover.

Despite it being the evening already, the fire was still burning strong, referrals did not stop coming in and I still had tasks to complete or I would be handing over “shits” to my night colleague.

Finally, it was around 8-9pm, I can’t really remember as I was following night rounds with the OT call medical officer and registrar. My medical officer told me to return home since the following day, I would be morning shift.

I remembered returning home that day, somewhat unsatisfied with myself. No doubt that it was a tough day, but I could definitely do better. If only my leg did not slow me. The pain seems to increase with every step I took and with every exertion I made.

However, as I remembered, I was blessed to have an angel as my medical officer oncall for that day. Instead of shaming me or being sarcastic or mentioning that I could do better, she simply thanked me for putting my best effort on the first day back and welcomed me back.

It’s angels like this who makes me want to try to be better the following day.

Related Posts:

• The House Officer’s Dilemma | Housemanship Diaries
• Reflection of the Paediatrics Posting
• Surviving A Month Of Tagging In My Fourth Posting – Surgery | Housemanship Diaries
• Appreciation Towards The Medical Officers (MOs) – Housemanship Diaries
• My Last Day In Paediatrics As A House Officer
• My Downfall In Surgery Which Led To My Extension – Housemanship Diaries
• 1 Year Of Housemanship Update – Housemanship Diaries
• Another Good Advice I Will Remember For The Longest Time – Housemanship Diaries
• The Time I Turned A Baby’s Hand Blue – Housemanship Diaries
• Enjoying The Journey – Housemanship Diaries

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Writing After A Long Time

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Day 496 of my housemanship journey, a the time of writing this article.

A few months ago, I took a sweet 6-week-long break after having just completed my first year of practicing as a junior doctor.

It was unplanned and definitely a blessing in disguise.

However, that rendered me to overshoot my allocated amount of leaves within a posting . Thus, I was extended in my fourth posting, Surgery.

Ever since I came back to work on the 2nd of October, it has been a tough 1 and a half month. My body was shocked back to work and it was a tough season as there were many people leaving the department.

Working the morning shift was even more tiring than working the night shift. Hence, in order to survive without collapsing out of exhaustion, I chose to work during the night shift consecutively for days.

Looking back, only a month and a half flew by but it felt like months have gone by instead.

However, today, I am able to write after what feels like a really long time. I feel that I can slow down at least for the next month at least and enjoy my work instead as we transition into a good season in this department.

A huge batch of house officers has been allocated into this department and this morning, there are 17 junior doctors in charge of a single ward as compared to previously when there were only 3 – 4 junior doctors.

Is that a good thing?

For those who have been in the department for some time like me, we definitely appreciate this break. However, a part of me also question if they will be able to learn as much as we did?

If you are currently struggling with bad days at work, just remember that it is these days that teaches us and makes us grow and that good days are definitely coming.

For when it does arrive, it allows us to appreciate the moment.

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What are you most worried about for the future?

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Can you share a positive example of where you’ve felt loved?

And

Then

You promised

You started loosing control

Crazy nights

Broken beds

Internet Sex

Desire

Fantasy to life

Always and forever

And then ?

You ran away

And ran away again

Do you remember me when you f..k him

Does he knows you suppose to love till end of days ?

Till the day almost …

Kill me ..

And now ?

Leaving you from behind ?

That’s where your eyes are looking back while you are moving forward seeing nothing but back loook

Let’s touch the mint and smell our hands

Let’s mint our planet ..page 25/Budapest light

From 100 boring story ( Garden of mint )

Ok readers relax it’s just a song i was hearing , I doubt I captured the phrases all but that’s what I heard and shared with you manually (typing it )

yeah !

The prompt

I’ll give one example

YOU WILL ASK WHOEVER YOU BELIEVE ON TO GIVE YOU MORE DAYS TO BE WITH HIM OR HER

Find them !

TRUTHOPPOSITEREALITY .COM

Info@hichammneimne.com

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Can you share a positive example of where you’ve felt loved?

And

Then

You promised

You started loosing control

Crazy nights

Broken beds

Internet Sex

Desire

Fantasy to life

Always and forever

And then ?

You ran away

And ran away again

Do you remember me when you f..k him

Does he knows you suppose to love till end of days ?

Till the day almost …

Kill me ..

And now ?

Leaving you from behind ?

That’s where your eyes are looking back while you are moving forward seeing nothing but back loook

Let’s touch the mint and smell our hands

Let’s mint our planet ..page 25/Budapest light

From 100 boring story ( Garden of mint )

Ok readers relax it’s just a song i was hearing , I doubt I captured the phrases all but that’s what I heard and shared with you manually (typing it )

yeah !

The prompt

I’ll give one example

YOU WILL ASK WHOEVER YOU BELIEVE ON TO GIVE YOU MORE DAYS TO BE WITH HIM OR HER

Find them !

TRUTHOPPOSITEREALITY .COM

Info@hichammneimne.com

Abstract@hichammneimne.com

https://hichammartstudio.art.blog/2024/01/17/first-you-loved-%f0%9f%93%8c/

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What snack would you eat right now?

Yes it’s called monkey balls and it’s sold in Fiji islands 3 balls for a 1$

Since the prompt is short answer let me give you a story from my mind . ( fiction )

From the heaven of my heart and from the munchies land munchington

Once upon a time in the whimsical town of Munchington, there lived a mischievous little creature named Snackington. Snackington was known for his insatiable appetite for snacks, especially the enchanted candies that sparkled in every color imaginable.

One sunny afternoon, Snackington discovered a hidden treasure trove of snacks deep within the Enchanted Forest. Unable to resist the temptation, he indulged in one delightful treat after another until he had consumed more snacks than his tiny belly could handle.

As the sun dipped below the horizon, Snackington felt an odd sensation. To his astonishment, his teeth started to tingle and then, one by one, they began to wiggle and fall out. Panic set in as he realized the consequences of his snack-filled escapade.

Distraught and toothless, Snackington sought the advice of the wise old wizard, Molarus, who lived atop Candy Mountain. Molarus revealed that the enchanted snacks had a magical side effect when consumed in excess—they made teeth as light as air, causing them to float away.

Determined to remedy his predicament, Snackington embarked on a quest to retrieve his wandering teeth. With a toothbrush sword in hand and a floss rope at his side, he journeyed through the Marshmallow Marsh, crossed the Licorice Bridge, and ventured into the Gummy Bear Cave.

Along the way, Snackington encountered friendly creatures who offered guidance and shared tales of their own snack-related adventures. Together, they formed a merry band of snack enthusiasts, determined to find a way to reverse the enchantment.

As the group approached the elusive Candy Mountain, they faced a final challenge—a maze made of chewing gum. With clever teamwork and a few strategically placed snacks, they navigated the sticky labyrinth and reached the summit where Molarus awaited.

Molarus, impressed by Snackington’s determination, performed a magical ceremony to restore his teeth to their rightful places. Snackington learned a valuable lesson about moderation and the importance of caring for one’s pearly whites.

With his teeth once again intact, Snackington returned to Munchington, promising to savor his snacks in moderation and share the tale of his toothy adventure with others in the town. And so, the legend of Snackington’s toothy escapade became a cautionary tale for snack enthusiasts far and wide in the enchanted land of Munchington..

Do you still want to try monkey balls ?

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What is your mission?

It’s about one nation one god one believe one order equality .

Planet 1one

But

In life, abstract expressionist artists dedicate themselves to a profound mission – a relentless pursuit of the intangible,

a quest to distill the intricate symphony of emotions that course through the human spirit.

And as for me my canvases become portals to the depths of existence, each stroke a deliberate dance between chaos and order. Truth vs reality

Through the unpredictable language of color and form, I seek not only to create but to commune, inviting viewers to embark on a visceral journey into the enigmatic landscapes of own inner worlds that resonates with truth and emotions In this boundless exploration,

The mission often involves conveying emotions, exploring inner thoughts, and emphasizing the spontaneity and authenticity of the creative process through non-representational forms and gestures in in every art work and every letter.

I forge a connection between the tangible and the transcendent, leaving an enduring legacy that echoes the vibrant tapestry of the human experience.

The world without art is just meh 🫤

I’ll make sure it’s epic

https://hichammartstudio.art.blog/2024/01/09/to-save-the-planet%f0%9f%93%8c/

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Share what you know about the year you were born.

I mean it’s 1980 !

Wa had no internet

when the grass was greener

life was beautiful with no end

3 million six hundred and twelve human were born

Globally

In 1980, several notable events occurred globally. Some highlights include the eruption of Mount St. Helens in the United States, the beginning of the Iran-Iraq War, the establishment of Solidarity in Poland, and the Summer Olympics held in Moscow, which faced a boycott by several countries.

Holy Innocents Day, observed annually on December 28th. The day commemorates the execution of the innocent, male children in Bethlehem as told in Matthew 2:16.

It was a dynamic year with significant developments across various domains.

No matter what I know about 1980 can not be rewind or relived but am sure of 1 of these humans born that year will change the face of the plant and make it greener again .

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What skills or lessons have you learned recently?

It’s all about experience

It’s how much we are willing to change our eye glasses and how we see things

It’s all about to protect our hearts

Lessons:

Great Skill:

Mindfulness:

Mastering mindfulness is a powerful skill. It involves being fully present, aware of my thoughts and feelings without being overwhelmed by them. This skill enhances focus, reduces stress, (tbc ) and allows us to make more conscious choices.

By practicing mindfulness, we cultivate a deeper connection with ourselves and the world around us, fostering a more balanced and meaningful life.

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