Another Beginning

... and a happy new year of 2019 to us! Woohoo, another year to start off with. Alhamdulillah we are blessed to be alive and still kicking with some of us igniting new year resolution while some already resolved to get real and face the hard truth of not getting any resolution done LOL. Let's start the year (although I'm nine days late but, meh, it still counts) with a reaction gif from my favourite Doctor played by Matt Smith.

I must say, this year really started off well. Big part of it is because I had finally completed my housemanship and now working as a junior MO in Emergency department (ED). The sheer sense of relief that just washed me away feels so incredibly.. rejuvenating. It's like entering a dream-like state of mind. I still half-believed that I am no longer a houseman (I still work like one, more to that later).

Now, some of you might have caught something from my statement in the previous paragraph. A junior MO? Surely you meant floating MO, bro? Also, where will you go after this?

And the answer to all that, really, is made up of two following words: contract houseman. For those who are new to my blog (aceceh poyo gila) or need a sidenote, I am from the first batch of contract doctors (lantikan kontrak) that started housemanship in December 2016. Now, that alone didn't make any huge differences when we worked as a houseman. It's when we are done with it and moving on to being a medical officer (MO) that it becomes rather muddled up.

Why? Because contract doctors should mean there is a selection on deciding who gets to be a permanent MO and contract MO. That's the reason they made all this contract houseman in the first place. The idea is that those who performed less stellar or had many disciplinary issues and etc. will not get an offer to continue working with the KKM a.k.a the Government. That, in some sense, relieves the Government of some burden of too many doctors in the KKM (really?) and ideally, being able to control the quality of their workforce to some degree.

Initially I had already drafted in greater length about this nonsensical, whimsical, diabolical matter of the permanent vs contract MO shenanigan but I realised the tone of the topic contradicts the vigorous mood I wanted to started off with. Plus, it's all unverified in nature (they rarely not, really) so I summed it up about my status currently:

• Technically, I am a floating MO with a full MMC registration number who was told will float at this hospital for the next 6 months.
• In the period of this 6 months, the result of the placement will be announced. It can happen after 3 or 4 months, or some time much later. So, let's just agree 6 months is the period for all intents and purposes of this topic. That means, to clarify, I don't know where I will go next.
• Now, ED has graced us who float in the department by taking us into their cohorts. That means, my colleagues and I follow the same pathway new MOs that are transferred to this hospital ED take - two weeks of tagging before working in shifts like the rests of the MOs.
• In comparison, the previous floating MOs or new floating MOs under permanent housemanship already have their placement known and will float only for a month. They have lesser working hours and basically just waiting to report in at their new place.

Yo KKM, where my placement at?

Now, moving on, let's talk about being a (junior) MO!

The first two weeks of working as an MO in ED involves a period of tagging where I had to go to work from 8 am to 7 pm with both weekends and public holiday off. I must say, the feeling of having the measly ONE hour more before going to work is monumental (as a houseman we started work at 7am - that's the official one, anyway). It is liberating. It's like petrichor after a long, dry spell. It's daisy and buttercup. In other words, I like it. I like it very much. 

Not to mention the fact I had both weekends off. And public holiday, too, as well. Wait, didn't I mention this before? I did? Well, I have to tell you guys again, weekends off? Am I hallucinating or what? What is this, a trap? Oh, what about the 8am to 7pm thing? Isn't that still a lot of working hours?

Literally everything is better than being a houseman with their working hours.

And now that it's my third week of working, I now enter shift system. For the first 3 weeks, I will only be working either AM shift or the PM shift with one day off (eh, no longer weekends off?). AM shift is from 8am to 3pm (WHAAAT) and PM shift is from 3pm to 10pm. After they review my work and deemed that I am safe to work at night, I will then do night shift as well which is from 10pm till 8am and attending any postnight work. 

I have already worked AM and PM shifts and I tell you, it felt damn gooooood. I don't even feel an ounce of fatigue. By the time I reviewed most of my patients and getting the hang of the situation I will be left with only a few hours taking care of them and start preparing for the passover to the next shift people. True, some stations are more hectic than the rest and the passover usually take almost an hour so I almost never went back on time but nevertheless, I can't believe how much better being an MO working in ED is!

But being an MO came with another level of Responsibility® that I have to shoulder on. As a junior MO I will always be paired with a senior MO covering major stations. For stations that I have to handle on my own, any cases that I wanted to discuss I will do so by finding the registrar or EP (Emergency Physician) in charge of my station. 

At first, it can be quite difficult. The transition from being an HO to an MO doesn't mean you automatically being upgraded in terms of knowledge and experience to handle all the cases. If you are not familiar with some cases during the end of your housemanship you will still, unfortunately, still be clueless as an MO upon encountering the similar case. 

At times, you are stuck between making your own decision as an MO and to ask or discuss cases with other MOs. Some MOs will ask you to think on your own because you are already an MO while some will tell you to not simply do things on your own without consulting others. Because of the responsibility and the vulnerability of actions taken down when something BAD happened to your patients, that cold feet feeling is pretty scary to deal with, especially for cases like dengue fever.

NS1 positive?? AAAAAAAAHHHHHHHHHHH!!!

It is not too precarious of a matter to begin with actually, in my opinion. I do stumbled here and there but for me over time it will be better. I have an okay relationship with all the MOs in ED (I think!) and while I do not hesitate to ask for opinion, I usually approach them with my own plan and rather than asking what to do, I ask whether is there something else that I have missed. So far, I have no difficulty in voicing out what I think I should do to my patients and when discussing cases with the EPs it gives me plentiful learning opportunities that I deeply appreciate. This is another reason why I enjoy working in my ED.

If work can be enjoyable it should be when I work here in ED 

Another thing that I need some delicate balance is when working with my colleagues who are doing their HO posting in ED. Like I said before, there is like no huge difference between them and I. No upgraded skills, no improved knowledge, no added experience. Some are even better (haven't I told you I am an average doctor at best?) than me, actually. A lot of them are.

So I tried my best, at times, in asking them to help me at work. I really, really, really, don't want to sound like an MO who orders people around while not doing enough work myself. I really don't. Haven't I preached and complained about those type of people incessantly before? A vigilant reminder for me to look in the mirror and do some serious reflection.

Sometimes, not always though, but sometimes, I have this inwardly mental grumble that I am still doing a houseman work. Astaghfirullah. But it's true, I do sometimes feel that way. Whether it's about the staff nurse still asking me to insert line or some other work, I felt that I deserved to work less? not doing menial jobs? and I don't know, being treated like other MO?  when working. (gosh I broke all those grammatical rule with the question marks but it's hard to be articulate here)

I'm not pouting. You are.

And each time these thoughts intruded my mind, I stopped myself. Am I that bighead to demand such things? Am I good enough or important enough to not being occupied with those chores? And I will be reminded with memories of when working as an HO in ED being helped by the MOs in doing houseman work - that alone stopped me in the track.

I remember my bosses helped me with difficult lines, or made calls themselves to refer cases to other teams, or tracing blood and calling patient's relatives to get further information. I remember the good things my bosses still do like thanking us when they or us finished the work shift of the day. I remember the task being delegated evenly to cover the patients that are pouring non-stop into ED during peak hours. I remember that I love how teamwork is strong in ED and these things helped me a lot.

And so I try to be like them. Even though there's already a complaint made regarding new MOs (from my batch who just became MOs in ED) about being rather useless and ordering people without doing any real work, I will try my best to simply do my best (or should I not tell you guys about this issue in the first place? It's rather hushed up and "anonymous" LOL). I have good support of people who can tell me directly if I am not pulling my weight enough so I am ever grateful for the live feedback.

But overall, I'm happy. Alhamdulillah for all the good things that are coming my way now. I hope it can continue to be so. That's it for now. Here to a new year with yet another beginning. Bismillah!