Hospital Posting 3: Emergency Department

I actually don’t know how to start this post. Super excited to pen down my experience! Even right now, I and my friends are sharing our hospital posting stories, talking and listening and me, writing! It’s really funny how it lead us to talk about marriage, and how I think I’d probably get married at 30 or older. haha. Because right now, all I dream of is to work in a hospital!

So..

My first week of posting was so-so until I met some nice doctors at the cardio ward. The second week was a bit boring as there were few new admissions and I don’t have a friend to talk to or plan things (Mas was spending time at the cardio clinic while I chose to stay at the ward).

So, on Wednesday, I went to Amy and Humairah who were posted to the A&E department. I’ve been in love with A&E for a long time but I simply didn’t choose it for my electives as I was told that you can’t learn much there. That’s not entirely true though, but it’s not a false statement either.

The only person I know from the whole department was Dr. Kewal whom I met  when he was a locum at my uncle’s clinic and I was ‘attaching’ at that clinic then (this  was in March I think). One good thing about this doctor is that he always appear so calm even when the case is really troubling. I mean, he never look anxious. Perhaps that’s one of the quality required to be an ER doc? Obviously you can’t be panicking around when a person is on the verge of death and the decision you make might save him!

My friends were telling me how doctors are a little hard to approach as they sit amongst themselves and are hardly alone. So it’ll be a bit awkward to suddenly go up to them & talk. Especially for me! ‘Cause I don’t have much courage to talk to strangers, what else to a group of strangers! I’m talkative, yes, but only around those I’m comfortable with (doesn’t matter if they’re comfortable, or not! hihi).

So, they introduced me to a MA who had been nice to them for the past 1 week, En Mahfuzah or more friendly known as Che Mat or Dr. Mat . Why call him doctor, you may ask. Well, that’s the mysterious part of Che Mat and I’d like it to remain as such. I don’t know other stuff about Che Mat except for the fact that he’s still new in HPP* and that he always wears a mask and put his gloves on. Che Mat is one nice guy ’cause he always ask us if we wanna do this or that (procedures). You see, medical students like me and my friends, we always try to wait for the ‘right time’ to ask and most of the time, we end up not asking. But lucky me, I realized early that the most important thing when you’re doing your elective is to ASK and it doesn’t matter if you think you’re not ready. Just be confident and do it. There’s always a first time for everything and it’s gotta be now. And Che Mat being Che Mat – let me do like a whole lot of procedures! Even injecting a person’s butt is fun & thrilling – if it’s your first time!

To me, doing wound dressing was one of the most traumatizing experience. There was a guy who came in with abrasion wounds all over him. In his palms, elbows, knee and even his chin! I volunteered to do it without even thinking (I’ve done it before on patients with minor abrasions). You see,  I seek to help out in A&E more eagerly than to find cases/opportunities to learn from. I usually do my history taking(Hx) and physical examination (PE) in the morning when I’m at the wards ( of the Internal Medicine department – where I’m posted to). Here in A&E, I try all I can to help out the MAs and nurses & patients( so they can go home faster!). There’re a lot of doctors and quite a number of MAs but at the same time, A LOT of patients. Doctors see patients and the ones that’re responsible to manage the patient afterwards are the MAs/nurses. So just imagine their workload! I’m not saying doctors are not doing much but rather pointing out the fact that both parties play equally important roles. So back to my abrasion-guy. You know how wound dressing is, you must SCRUB on his wound to remove the dirt and clean the area. And the wound is big and bleeding (but not deep enough to require sutures) and he groans every time I put my gauze on him and we both scream when I scrub. Yup, it’s THAT terrifying. Well, I’ll just have to numb my feelings, no? But when I think of it again, I’m not sure if I ever wanna be feeling-less in such situations.

I love being there, so the last week of my posting, I decided to stay till night – everyday. It was indeed tiring but I don’t mind! I think I wouldn’t even mind sleeping there either LOL. Anyway, I then started to get to know the doctors there while hiding behind the curtains each time I caught the sight of the HOD (head of department).  Dr. Wong was the one who gave me the courage to approach the doctors and I’m not even sure if her name is Dr. Wong! She is a really sweet, pregnant doctor and she said, after seeing me behind the curtains for a few days “You can learn procedures later. At this stage, it’s better to follow doctors and see them clerk patients.”. It may sound like nothing to you, but she coming to me and telling me to do so out of concern – meant a lot to me. So, I pulled myself together and talked. I feel the need to thank Dr Wong from the deepest core of my heart and pray so she gets a beautiful charming baby like herself.

From the last page of my report.
From the last page of my report.

Dr Sara, Dr Fahmi, Dr Sheikh, Dr Roshan, Dr Allan, Dr Amreet and Dr Pala are the first few doctors I talked to and followed around like a penguin. They’re really nice people and I regret not approaching them earlier on. Dr Sheikh taught me how to appreciate figures in an ultrasound, Dr Pala shared a good discussion with me, while the others let me help them and explained stuffs while attending to patients. Doing simple things like taking blood, filling the lab forms, clipping it all together and sending them to the machine in yellow zone (the machine will transport those samples to the lab and i tell you, the concept is really cool!), are meaningful to me. Because I feel like I’m being part of the team. The concept of not considering your position or specific job description, simply everyone rallying together for the same aim of serving the people – intrigues me. That’s why I love the ER i guess.

Oh, but I messed up a little while trying to help. Remember I was telling about how I lost Dr Sara’s patient in my previous post and put him in trouble when the specialist found out? He didn’t tell the specialist it was my fault, perhaps he thought he shouldn’t have asked a medical student at the first place. Well, the problem is, he didn’t even ask! I offered and messed it up. In the end, I found the patient (he went to the toilet, ate and even went to smoke!) but brought him to Dr Sara at the wrong time – when the specialist was there! I still feel bad now.

One thing I hope I would do differently when I’m a doctor though is – to care for the needs of the patients inside out and not care only about solving the case and sending them home. I don’t know if it’s the A&E so they have to do it fast and all. What I love about being a doctor is the patient-doctor interaction and I would never want to lose that even if I decide to choose A&E. I find some doctors not explaining to patients about what’s wrong with them (especially in the green zone) and leave them clueless and worried. I don’t know if I would do the same had I been in their position. But since I’m not, I stand aside, call it a mistake and vowed to never do that. As I told you before, I learnt some tricks from ER (the tv series) and applied some where relevant. I took the time to explain the patients’ condition to them after listening to the doctors discussion or directly asking the provisional diagnosis. I hold the hands of the elderly ones as they shiver when the MAs were about to insert branula or draw blood and talked to those who were scared while their heads were sutured. I did that because I want someone to do that if the patient were my parents or relatives. And I did that because that was why I chose medicine. I believe everyone who chose this path would say the same but sometimes, as you’re in that position, you forget the real reason you’re there at the first place. And that’s scary. Sometimes, we forget that patients are human too and showing that little kindness brings about a hell lot of a difference. Instead of shouting to the patients, talking softly means something. As you remind yourself of the reason you chose to be a healthcare professional (doctor/MA/nurses), you’ll realize how close you are to Allah’s blessings.

I’m grateful to have known some really good MAs & nurses whom now, I’m proud to call; my friends. I really love this group of people. They’re soo cool and fun to hang out with. I mean we joke around & share stories like we’d known each other for a really long time. Plus, they’re humble.  They allow me to assist them while doing procedures and later let me do it myself – this is mainly why I love them [special mention of Jannah (a student nurse) and Che Mat]! haha. I did countless of ECGs, wound dressing, injections and assisted them in lots of other procedures. Most importantly, they taught me a lot especially in terms of interaction with patients.

I observed Kak Ida & other MAs do T&S (Toilet & Suturing) a few times and practiced T&S myself for a few times on a cotton gauze.  En Zamzury (one of the MAs) even let me try suturing! You know how cool it was? –  REALLY COOL! (medical students are allowed to do suturing UNDER supervision). I learnt a lot while chipping in & listening to Kak Wusni (a senior MA) questioning her juniors. Assisted Fariha in doing a urinary catheterization. The fun part was when i  was  at the secondary triage (with Adira & later on Munir as her shift ends) as I get to clerk patients. It was SOOO fun ’cause I felt like a real doctor. I didn’t even went for dinner or toilet breaks! I should’ve tried staying there on days that weren’t my last! I met 5 psychiatric (psy) patients and learnt a lot from my MA friend on how to deal/clerk psy patients. It was exciting and sad of course seeing these people. They look completely normal on the outside but you know they’re not normal once they start talking  with you or with “someone beside them” (whom you can’t see).  Oh! I even met an angry (difficult) patient! It was like being in an OSCE (Objective structured clinical examination – our clinical skill exam)!  This was really cool & scary. My BP would have shoot up real high at that moment.

It’s really regretful that I have no photos taken with any of them(the doctors/MAs/nurses). But I guess our memories together and my gratitude shall seal the relationship we share, no? We shall meet again, in 5 years maybe? I hope facebook would do its part in keeping us in touch!

To those who will be getting married soon, congratulations & invite me please! :D I’ll try to make it if it’s next year. Or if it’s after 3 years. hehe.

Till next time.

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*HPP – Hospital Pulau Pinang/Penang General Hospital

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