Sep 3, 2018

A Step Back


To give credit when it's due is what I should do and that is exactly what I am doing right now. Entering ED has given me ample time to think of my current situation and an idea of the path I should take next. While working in ED eliminates that nagging worry I sometimes had when working in wards regarding the progress of the patients under my care, it also gives off a false sense of security.


Work in ED screams hectic and urgency and all that, but it's basically just touch-and-go practice. Assess the situation, stabilize the patient, do basic investigations and initial referrals, then proceed with either observation before discharging or admitting to relevant wards. The clerking is brief with only relevant important positive and negative findings are asked. We expect the worse thus the nets are always cast wider to avoid missing catastrophic emergencies before narrowing it down to a number of workable diagnoses.


Because of the nature of working in ED is like this, it gives you a lulled sense of urgency of what you should be prepared about in the first place. ED is an elective rotation usually given at the fifth or final posting of housemanship. It's the last pit stop before you are burdened with real responsibilities working as a medical officer (MO). If I'm to caught up in the easy flow of coming to work mindlessly day in and day out, I will miss a lot of things.


The deadline for my annual meta life-reflection post is approaching. I tried not to think about it because if I do, I will just get upset and depressed. If I don't think about it, I can see a bit of a glimmer for the future. I would feel that I can do it. The periodic zaps of reminder for me to buckle up may be infrequent, but at least I am aware of it and what I should do. There are still lots of things I want to know thoroughly before I ended my housemanship.


It's time for me to get serious, like serious serious. I have to do this last rotation really properly. I may not get the chance to learn how to perform some of the clinical procedures other housemen did before this but I really want to know how to do it before I leave. This is the number one major concern of mine - I lack clinical skills. I want to know the management of all the cases that come under the sun, or at least the basic principles of them. I want to know how to read ECGs (my worst enemy), x-rays and CT scans better. I want to learn how to present and refer case properly and efficiently. I want to know how to prepare basic medication and memorize their doses (I'm still bad at this). I want to learn to do basic ultrasound scans and more importantly to make sense with what I'm seeing in those scans. I want to be prepared. I want to be ready.


And so I have a lot to thank my ED in this. The bosses are friendly and supportive. There's a lot of opportunities to learn here. So many cases coming through the door that beg me to learn them all. I have to stop procrastinating and kerja goyang kaki like I usually am. I don't mind being scolded (so far I don't meet any of the screaming bosses yet) as long as I get to learn. I hope I can do this. I hope my enthusiasm lasts. In sha Allah all will be well. Ameen.

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