Thursday, November 6, 2008

(October 2008)

Currently i;m in my 3rd month of work..i've started working officially on 8/7/'s amazing how you can still do lots of mistakes even though it's been that long.

I'm in my paediatrics posting,..general paediatric, to be exact. Before this i was posted for 2 months in NICU (neonatal intensive care unit). The two places are totally different, in terms of management, yet they're still in the same department.

Neonatal is defined the period since birth until 1 month of age. Above that age, babies would get admitted in the general paediatric ward.

NICU is quite an interesting place, to say the least. Throughout my student years , i've only been to NICU once , that is only less than an hour. Then all of a sudden, my FIRST POSTIng is there..i was quite shocked. I've never been really good at poking patients to get their blood, unfortunately..and now..i have to poke neonates..whereby you can hardly see the veins..HOw is it possible to actually poke them???
or so i thought.. time passes by, it's actually easier to poke neonates as compared to adults. Surprisingly the veins are quite visible, however, it's very you really have to focus when you'er maneuvering the needle.
(sorry that the fist matter i have to bring about is regarding taking bloods -- it's actually one of the most important job that we have to do as houseman..We have to be very efficient in taking bloods -- the quicker the better)

Most cases in NICU involves taking care of premature babies ( which are babies born before 37 completed weeks of gestation) normal gestation - for ladies out there and those who are already married --> we count as 40 weeks as the expected date of delivery. That means that usually we count the day that we expect the baby to come out after 40 weeks of pregnancy. that's how they get the date..there;s actually a formula how to get date, but better not to get to that detail.

anyway, at this hospital, they admit babies who are born less then 34 weeks of age and birth weight of less than 1.8 kg. The youngest baby that i've ever helped admit is a 23 weeks old baby. (about less than 6 months of pregnancy)..he's about 700 gram!!

He's actually surviving until now.actually, the doctors didn't think that he'd make it ..but Allah is Most Powerful..wahuwa a'la kulli shay ing qaadir..

My specialist -- or actually the consultant at NICU is only 36 years old! i couldn't believe he's that young..that means that he had studied all the way from --taking masters and then subspecialty-- non stop.

I work mostly with chinese doctors. Both my specialists at nicu are chinese.All my MO (medical officers -- the doctors who are seniors than houseman) - are chinese..yet all the HO (house officers a.k.a houseman) are fact the staff nurses too.
There are about 4 MO's at NICu - and 6 HO's..which is quite a luxury, actually.

not many department can have that many doctors working for them at one time,, actually.

Howevder, all the MOs are such darlings to work with! They are sooo nice and helpful..

but being in NICu is quite an experience..especially during oncalls..i remember my first oncall - i didn't get to sleep..coz there was a case we had to handle until almost 3 am..then i had to start getting the bloods for investigation. Usually the rule there is to settle blood taking by 6 am...that night, being my first oncall and about 5 patients i have to take blood from...i started about 4 am ..i also had to do otehr procedures -- so i tried to settle those early.. i think i finished at about 6 am..
unfortunately from thw investigations -- some of it i didn't tell the MO. i didnt; know the urgency at the i shrugged it off..

hm..woe is me when in the end, one of the babies, had disturbed electrolyte values in which he had to be corrected ealrier..but i was not able to realize the problem..and the baby had to be reintubated..i was so shocked that the next day i went home directly(after work) and the rest can be told by my parents..

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