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Surviving Tagging And Finally Celebrating Christmas In The Medical Posting – Housemanship Diaries

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In the Medical Posting, seniors were required to tag for a minimum of 10 days prior to off-tag while juniors had to tag for a full 14 days.

I was due to have my off-tag assessment and in the Medical Posting, we were required to off-tag with Physicians, meaning the specialists.

Tagging everyday in the Medical Posting was rather annoying for me since we had to stay until 10pm and being a regular early riser, I would start feeling sleepy around 8pm as that is the time I start to unwind and go to bed.

However, I can’t because I am still tagging. On top of that, since I am tagging, I would be too exhausted by the time I reach home to even consider studying. I had to prioritise my sleep more or I would crash.

Thus, I tagged for a total of 12 days which consisted of two off days. Thus, in reality, I only actually tagged for 10 full days.

In order to officially off-tag, I had to have my logbook signed by the physician who assessed me as well as to have each procedure filled and countersigned by the medical officers.

Long story short, I finally off-tagged on Christmas Eve and did not realised that I have been allocated an off day on the 25th of December.

This was perfect as my parents flew in on the 24th night. Thus, upon having officially off-tagged, I left and started getting ready to travel to the airport to meet my parents.

The following day of course was Christmas which was well spent with my parents.

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Reflection Of The Surgical Posting | Housemanship Diaries

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

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As you can see based on the prompt that I would be answering, Surgical Posting is definitely the place where the environment among the superiors felt more like a family to me and I’ve always felt the love and care towards one another and the patients in the whole team.

Prior to entering this department, I’ve always had my doubts and fear considering that I’ve heard numerous negative comments in regard to the department. Mostly, the department was deemed “toxic”.

However, upon entering there during my first day, I was guided and encouraged to follow rounds even when I seemed rather lost. I was not reprimanded or shouted at but instead I was guided and taught.

No doubt it is a tiring posting and after having completed my tagging period in all of the 5 major postings (Orthopaedics, Paediatrics, Obstetrics & Gynaecology, Surgical and Medical), the tagging period in the Surgical Posting is the most tiring for me.

This posting sort of reminds me of Orthopaedics except the amount of patients are full-blown, never ending with random or common surgical-related issues and the patients are even more unstable.

The thing about being in this posting is that usually when an order is given by our superiors, it is expected to be carried out STAT, meaning immediately and they will usually keep checking in to know the progress and status of the patient which is both good and also annoying. Good because it keeps you on our toes and ensure things are being carried out. Bad as the day could be burning with multiple issues and joblists and there is lack of manpower and you barely had time to sit or even had a drink and next, you’re being summoned again.

However, looking back, I definitely enjoyed every bit of my journey over there. Eventually, I was given the responsibility of being one of the leaders in this department, the daily allocator to be exact, by my friend.

This unknowingly deepens my relationship among my superiors as we would constantly reach out to each other.

Along the way, I made friends with the nurses at Male Surgical Ward and I will always be grateful for their help.

The Surgical Posting also made me realise how much I enjoy Surgical-based and that I am one. Despite my initial interest in Medical upon entering my housemanship journey, I realised that I love hands-on more and I need to “see” the issue. For example, if a patient complaints of abdominal pain, assess the patient, send some blood workups which might help and in your direction of care as well as scans.

Most of the time, the issue is identified through the scan with the blood workup being highly suggestive. Thus we move on from there.

I can’t quite explain. Somehow it just make sense to me just like when I was previously in the Orthopaedics Department.

This posting is also where I spent the longest time. I entered the posting on the 4th of July 2024, which is around 5 months as I took a break in between due to my injury.

The Surgical Posting definitely holds a dear place in my heart. Upon bumping into my old superiors, I still greet them with joy and a smile, reminiscing my good times within the department.

If you are due to join the Surgical Posting, please prepare yourself both mentally and physically.

In my opinion, the Surgical Posting is a physically tiring and not as bad as it seems despite the multiple negative remarks. Perhaps, it was a different experience for others but in my humble opinion, it is NOT a toxic department. At least at the place that I am practicing in.

Have faith, hang in there and try your ultimate best everyday in both your work as well as in trying to learn the most you can out of this posting and journey.

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My First Night Shift In Surgery | Housemanship Diaries

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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.

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A short blog regarding my reflection on the details of my life that I should pay extra attention on.

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http://theoreticaldoctor.com/2024/09/26/controlling-my-food-choices-and-portion/

A Journey of Dedication and Passion.
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50 Tage täglich bloggen 🎉 oder: ALTER! Was postest Du denn alles?
Na, hier landet alles, was meinen B2B-Filter passiert (Brain2Blog). Ganz früher - also 1998-2006 - wäre das in unserem Forum und IRC-Channel gelandet.

2007-2009 in meinem Blog „Das Leben ist (m)ein
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New blogpost. Day 310. "Hectic moving day." https://tettig.com/day-310 #DailyBlogging #blogging #mastodon

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