THE HOUSEJOB CHRONICLES: CHAPTER 6B: MEDICINE

Hello, welcome here again.

I will continue my journey with you.

As always, if you are enjoying it, kindly share with others and leave a gracious like.

Let ride in…..

LITIGATION?

There were sour experiences in the past where court cases came up and these experiences made my seniors extra careful with the process of managing patients. They went extra miles to make sure everything was in place. There was always a crosscheck of every written word and supervision was followed strictly.

“Rose, make sure you write the name of the patient on the front and back of the sheet” my senior mentioned as I wrote her findings down on the sheet of paper (I was in a center that was yet to be computerized).

CLINICS

We had two clinics in a week and they were long.

It took a while to get used to them but after a while I did. The clinic was a unique part of my time in this unit. I had to do many things at the same time. I was designated with collection of data from patients, I also had to see new patients, old patients and still review with a senior.

After the clinics, we had ward rounds and those bit into chunks of the remaining day.

HISTORIC WARD ROUNDS

The ward rounds were excruciating.

We often spent long hours on a single patient and that meant standing for long hours and this was irrespective of the number of patients available. It was one of the moments I dreaded because there was no time frame for the among of time we were going to stand. However, it was not everyone that made us stand that long and we had a favourite who will looked forward to having lead the rounds especially as there was going to enough teaching and a lighter atmosphere.

I specially looked forward to having this very senior person come around

There is no way my story about this unit would be complete without mentioning about the ward rounds.

Interestingly, most of the patients we co-managed felt more loved as they knew we would come everyday and still spend a reasonable time explaining and taking them along with us in the management of their conditions.

CALLS

Now, I had about three calls I was to respond to and they were the unit call, departmental calls which could either be a ward call or medical team on call, then the general casualty call (which could either be once or twice in a month).

All these were preferably best not to be but on the same day, however, it also meant that the days of the week were scarcely free.

There were unit weekend calls that often interrupted the weekend plans. This call was not meant to be a tasking but for my unit, it remained a demanding call.

I already told you about meticulous.

There was a patient that came in during one of these calls that became a core painful memory for me. I’ll share my experience without sharing details about the condition or anything patient sensitive.

That would be shared in the next part.

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I hope to see you in next part.

Continue to stay safe and God bless.

#W.O.L.A.P

THE HOUSEJOB CHRONICLES: CHAPTER 4B: PAEDIATRICS

In the last part, I ended it with a hanging sentence.

I will continue it here.

Now, even though the emergency unit was the first point of contact for all the patients before dispersing them to appropriate units, it remained a place where some patients remained for a while under care even though they were no longer in an emergency state.

The emergency was a bubbling space and attention was needed frequently.

Gratefully, I worked with people I enjoyed and eased work sometimes.

But there is an aspect I am yet to talk about and it is part of the reasons the previous part was ended on a hanging sentence.

HERCULEAN CALLS

The calls in pediatrics were not a joke. They were the main reason that this unit was exerting.

Now, it was one thing to be in the emergency unit and another to continue a call there. It felt like a continuous journey with small spaces to breathe.

Being on a call in the children emergency unit also involved being in charge of the wards and hands were few.

Two house officers manning about 4 wards plus incoming emergency cases

Children being children could be demanding and their lines difficult to site. One had to be mindful and careful when attending to them and hence despite the bulk of patients to see, one could not rush processes with children.

It was hard to have a proper blink at night.

And this will not stop the fact that one had to be ready the next morning to continue work as usual excepted to be fresh and properly composed.

On some of the nights, the calls from the ward were excessive and sometimes uncalled for, however despite that one still needed to be available.

Sometimes, attention was needed in several places and the tension caused one to be on the edge.

Yet one had to maintain composure because everyone would be on edge at that point and as the doctor you had to be the least person on edge.

VAMPIRE?

On my calls, I did so many blood transfusions that I felt like a vampire.

There was a call that I did about three blood transfusions almost simultaneously and at the same time my attention was being called to attend to incoming patients. My colleague was attending to a critical in one of the wards and I had to attend to the different demands placed on me.

Transfusing blood products meant giving premedication and then monitoring to avoid reaction and also keeping vital signs in check.

With children, extra attention was needed and in times where I was attending to many children I still needed to pay attention to the ones I was transfusing making sure the transfusion went smoothly.

There was an incidence I had of transfusion reaction where the child began coughing when the transfusion started. I was transfusing platelets and was almost done with the first bag to commence the next one when the child began to to cough. I immediately stopped the transfusion. Commenced intravenous fluids, steroids and observed. a senior colleague was standing by to monitor then afterwards the coughing subsided and was relieved. we waited for about 20 minutes before commencing the second transfusion to which the patient did not react to.

This experience scared me because I had never experienced a reaction in all of the transfusions I had administered but once again it stressed the importance of paying close attention and observing patients during the first 10 minutes of commencing transfusion as that was a crucial time in notice transfusion reactions.

But this was not the unit I did more calls…

Talking about calls, the neonatal ward was a different ball game but that would be a story for another part…..

On one of those days….

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I missed last week and I hope to cover up with a post this week.

If you are enjoying this series, kindly let me know and until next part, continue to stay safe and God bless.

#W.O.L.A.P

THE HOUSEJOB CHRONICLES: CHAPTER 4A: PAEDIATRICS

My break was over and I was to resume my new posting.

I was ready (according to myself) to have another unique experience and I was open to what it came with.

With this department, there were different units and we were to spend weeks in each of them with two units have more prominence (per compulsory).

G.I?

I was posted to the Gastroenterology unit and it was said to be the calmest unit with few to sometimes almost no patients.

There was a clause I was not aware of

I did not realize that I had to work with a sister unit that was more demanding than mine and I did not know that I would have to work with difficult persons.

And this was supposed to be a soft beginning for me

The unit that I ended up participating in more was the Infectious unit and it demanded more from me than my primary unit.

Now, I found myself in a department that handled children of all sizes and ages and this meant that they needed to be handled with extra care. Not only were we managing the children but the parents as well. The more concern were the parents more than the children.

Children are easily forgiving, parents are not

Being in infectious unit meant doing more. It meant being involved in more responsibilities and meant staying longer in the hospital.

It also meant filling research papers

On my first day, I was given a topic to present in about 3 days from my starting the unit.

But that was not the main cause of stress.

The main cause of stress in this unit was the people I was working with. The combination of people I worked with nerve wrecked me. I though I had gained experience from Surgery due to the different kinds of people I had worked with but it did not prepare me for the rattling I was going to go through.

Now, I came to this unit with the desire to get the work done but I did not know that it was going to come with issues I had to handle.

I was working with unique individuals, and my immediate colleague at some point felt I was excessively proactive and that caused a friction between us to the point I felt threatened. We had to involve senior parties to bridge in the gap and mediate. That experience helped me to be aware of workplace jealousy.

I eagerly looked forward to rotating to another unit and change my environment.

EMERGENCY?

God answered my prayers and after 2 weeks I moved to the emergency unit. There I met colleagues I enjoyed and though the unit was demanding, it was bearable.

I will share one of the unique experiences I had in the unit. Two children were brought in with burns. The older one was scarcely burnt on the forehead while the second had burns on both arms and legs.

The culprit?

The older one had dropped a lighted match into the small generator that still had fuel in it and the younger one in curiosity bent over the flames that caused the burn.

Interestingly, the older one was hurt less and received a good amount of scolding. When asked why the act was done, a good response could not be gotten.

The experience was an eye-opener that children should not be left unmonitored and especially when they are hyperactive, there should be a limited contact to harmful appliances.

Being in this unit required that you were always available even when there were no patients to attend to. There were days that the station was so filled, that it was hard to sit down with the need to pay consistent attention on the patients being admitted.

There were days we had to spend overtime because of the influx of patients. From acute diarrhea to severe malaria to febrile convulsions to asthmatic attacks to neoplastic conditions. The emergency unit was the first point of contact for the patients before dispersing them to other units.

However…..

My first day feeling pumped but would that feeling last?

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I have dragged this part for more than a week. I will stop here and continue in the next part.

If you are enjoying this series, kindly let me know and until next part, continue to stay safe and God bless.

#W.O.L.A.P

THE HOUSEJOB CHRONICLES: CHAPTER 2A: SURGERY

I had days to complete my registration in the hospital.

Tests to run and medical examination to undergo.

I found new people whom I connected with and worked with to get the process done faster.

In between, we made time to laugh at the experience we were having.

Finally the registration was done, we had orientation and waited to be posted.

I watched as others got their posting letter given to them. in my heart, I wondered what posting I wanted to start with first.

Surgery? O&G? Medicine? Paediatrics?

After some pause, I got my letter.

I was posted to Surgery.

I felt satisfied and open to the experience.

I got my unit posting and it was Pediatric Surgery.

I would come to find out it was known to be one of the most dreaded unit in Surgery.

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“You are to start your posting immediately. Call your senior registrar so he can inform you of what to do next” The Chief registrar informed me as I left his office.

I was completely unprepared. I had my ward coat but it was not in the best shape, my feet were not prepared as well. I was not wearing the most appropriate footwear but I had ben asked to resume and I was going to do that.

That day began my journey into a sea of experiences.

Am I taking your time?

24 HRS LONGER

The reason Pediatrics Surgery was dreaded was because of its tendency to demand isolation from the rest of the hospital, the frequency of surgeries, the urgencies of surgeries and the hours the surgeries took.

I met an older house officer who stayed with me for 4 days and who put me through what I needed to know and do in the unit. I was supposed to stay for 14 days and after 4 days with company, I was left alone.

Being alone meant I was going to be on a 24 hours call until another person joined me. My partner who just left had spent about 10 days alone before I came and he looked like a zombie.

Being on a continuous 24 hours call meant living in the call room as it meant I had to be available at any given time.

Being the only house officer meant that I was supposed to be available at any time of the day and that meant that some days I should not go beyond the walls of the ward and the call room.

My heart was open and ready to learn and experience and it helped my approach as well.

My aim was to keep a light hearted approach to situations and as the reality of the demands of the unit dawned on me, I need space to air out some stress, however I adjusted quickly and found every bit of the moment enjoyable. I did not fond myself dreading the unit instead I enjoyed every aspect of it. The surgeries were delicate but I was intrigued by the precious details and meticulousness of the procedures carried out.

The parents I met in this unit were among some of the most patient people I have ever met so far throughout this experience. Despite the delicate nature of their children’s condition, most of them maintained a very polite attitude and listened whenever I counselled them.

I also found myself getting attached to some of the children. There was a particular healthy child who came in for a hypospadias repair. He was such a social and warm child who got my attention and who also fancied me. He made a quick recovery and seeing him all through the period he was in the ward was very comforting.

One of the things that stod out was: The nature of the innoence of children made them so forgiving, however earning that trust did not come easy.

I was unable to set lines or collect samples because it was my first posting and it was difficult to do that easily with children.

My consultant was like “It would have been better if you had staretd with adults before comimg here”.

However I still made some efforts which were not successful and instead called the Registrars above me to help. I did not feel pressured because it was already deemed a difficult task to do these procedures on children and I felt I still had Pediatrics to practice more.

There were protocols and I also needed to handle certain “properties” of the unit, This is where the Saka bag came into play. This bag held surgical items that we could need if there happened to be an emergency at any time and I had to carry that bag all the time.

SAKA BAG

The weight of this bag was no joke.

I observed surgeries and asked questions. There were times I was asked, sometimes I recalled and other times I failed. However in all I learnt at thee end of the day and most of what I was taught stuck to my head most probably the way it was taught made it easier to remember.

After spending 5 days alone, I got a partner and this meant I could share the work with someone else. It was relieving for me to expereince some space of fresh air and to do personal things that I had halted.

Now, because this is a summary of my experience and because I am careful of breaching privacies of the patients I had interacted with I will basically share major lessons from this posting with you.

On the last day of my posting, I prepared to present with my unit during the clinical meeting. I stayed up all night to read on the topic and modified the slides with my seniors but….. I was unable to present.

Do you want to know why?

I’ll share with you in the next part of this series.

Until then stay safe and God bless.

#W.O.L.A.P

INTRO TO THE HOUSE JOB CHRONICLES

Hello!

I am back again with another series and as you can read from the title, I will be sharing the current stage of my life with you.

Mind you, this not as fresh as it should be but I will pick very important and interesting aspects of my journey and share with you.

I have learnt so much in recent months and from my experience, I believe you will be blessed by what God has been teaching me.

I wanted to start this series when I began this journey but I am starting months after.

This series is for everyone (I have to say that), so share with your people✌

With that being said, there is a possibility that it may be shared as alternate posts. However, it will be made in a format you can access easier with time.

Kindly, check out my shop, podcast, vlog and other posts shared on this space.

Until then, stay safe and God bless.

#daughterofabba