HOUSEMANSHIP IN HKL (2022 until God-knows-when)

 Bismillahirrahmaanirrhim

Today is my 54th day of life in HO-ship and I decided to write something about it til I get through this challenging phase in my life.  

Our intake this time was 50 HOs in HKL. During our first orientation day in HKL, we already get the logbook for our first posting. The first week was our orientation session from 8am-5pm every day. That was the only time I can see sunshine before I started working in ward lol.

HKL is so huge. They got 20+ medical wards, 15+ surgical wards, 8+ paeds wards, ortho and o&g I'm not sure the exact number of the wards

orientation in Auditorium in main block

orientation in IPHKL

In HKL - 3 postings in HKL(orthopedics, medical, surgical) and 2 postings in Hospital Tunku Azizah(HTA)(pediatrics & o&g. So all postings in HKL are using manual system and 2 postings in HTA are using computerized system. Our rotation depends on what our first posting. We can't choose our first posting. For me : Pediatrics --> O&G --> Ortho --> medical --> surgical --> elective posting( Anaesth/KK/PSY/ED). So if you get ortho as your first posting, so it will be next medical-->surgical-->peadiatric-->O&G-->elective. So, I gotta enjoy 8 months in air cond condition before entering main block HKL for the remaining postings lol.

we are still using covid logbook

We were divided into 6 departments up to availability in each department. So far as I remembered, 14 out of 50 were sent to the Paediatrics department (my posting now) because of the vacancies there. Out of 14, we were further divided into 4 different wards in General Pediatrics. 6 of us were sent into the same ward (I won't mention it here lol). 

So, as soon as we entered our ward, all seniors and MO's were quite shocked because 6 persons were quite large in number. So we learned everything from scratch. We need to learn the system. Especially in HTA, all are computerised since 2019. Previously, pediatric was in Institut Pediatrik HKL(IPHKL). Now I only went to IPHKL when my boss asked me to trace some old notes from Genetic clinic etc.

IPHKL-we didn't work here anymore, all wards in this building are currently used by medical dept

the new hospital I'm working rn

HTA from afar. Seniors were right. HKL is so huge like there were 5 hospitals in it.

For paeds, we will do 6 weeks(gen paeds) + 2 months (SCN) + 2 weeks(gen paeds) = 4 months. For some seniors it will be like this --> 2months (SCN) + 2 months(gen paeds) = 4 months. So, most of the seniors who came from SCN were all phlebotomist because they've done multiple line insertion and blood taking in SCN(with small veins) before entering general wards. 

In paeds, you need to tag from 7am-10pm every day for 2 weeks(off day 1 day per week). Usually, I will wake up at 4.30am every day and make sure I'm in the hospital at 5.30am so that I won't be late to review my patients every morning before starting rounds with MO and specialists. I've lost 5 kg so far(good things for me lol). So, we're done with our tagging for 2 weeks and need to off tag. For the first poster like us, we need to off tag with a specialist after we finish our tagging period. If we passed, we can do on call shift. But our leader knew our potential and readiness, so he didn't assign us to do oncall straight away after we off tag. After we offtag, we can go home at 7pm every day instead of 10pm during tagging period. The feeling we had when we can go home at 7pm was the best feeling ever haha(nikmatnya balik awal gituh). Because in paeds, we only have BD shift, not TDS shift like other departments. AM shift - 7am-7pm, PM shift/oncall - 7pm-7am. So, we don't see sunshine at all except during our offday lmao.

There were 4 cubicles in our ward with atleast 30++ patients each time : Acute, subacute, isolation clean + isolation dirty(covid) + front cubicle.

I was so so so slow during the first month of life as a HO. I think 2 years of leaving medschool really took a toll on me. But I keep in my mind, everything happened for a reason right ? I really hope medical school teaching was different back then because the life and reality during HOship is totally different. No one taught me to review patients every day, to do referrals, to request imaging etc. So, when I went to Medicorp teaching session, it was helpful for me and beneficial for me (because I left my medschool for almost 2 years before I started my HOship so everything almost berkarat sudah).

For our ward, we need to cover in peripheral wards and observation bay in emergency department too. For other wards, they will cover clinic, HDU, etc. 

Because HKL is so huge, so the wards also specialized. My ward is a general ward. So I only saw general cases like pneumonia, AEBA, febrile fit, covid, ROTA virus AGE, TB(keeps rising now among kids), etc. For other wards, they might be covering cardio, nephro, etc. So, I only saw general cases but a few cardio cases and nephrotic syndrome cases. It's a con for me but it's okay, atleast something knew I learn every day. But, when I covered peri wards, there the time when I saw several complicated cases, especially neuro cases and surgical cases in paeds. 

Things that I found useful during pediatric are : Frankshann book of dosage, some toys, chocolate, calculator, measuring tape, etc. 

I don't know why I was thrown into a department that needs the most calculation and maths because I really hate maths since school but I guess this is the time that I need to embrace it lol. All the dosages need to be calculated correctly according to weight precisely, all the fluid maintenence/correction and so on.  ISTG so please bring calculator before entering this department. 

And I don't know why I started with a posting that had the most difficult IV line setting and blood taking. Like, the kids will struggling and crying each time, their veins were so small, the need to deal with parents, etc. I think I only succeeded only a few IV line settings. Hopefully, when I enter SCN, I will get more practice there.

I think a few things that keep me going were : the babies cuteness, the fulfillment that I've got when the parents channel out their worries to me(when I become a listener to them), the feelings when the child so much improved, when someone trusted me to do something on my own, the staff nurses who were kind to me, the good and reliable MO's, the-not-so-malignant specialists, the helpful seniors, my supportive parents and batchmate. All of these small things that I should appreciate every day so that I can keep going and do my job properly.

I've gone through all the adaptations period and I noticed that if I want to be good at it, I need to go for it and volunteer to do something beneficial for me(I should be more proactive). I also need some good rest(should sleep early), study everyday, using my offday to help out with my mum's garden, exercise, eat healthy and to stay connected with my beloved friends. All of these keep my mental sanity and stability during these tough times.

We're done our Neonatal Resuscitation Programme before entering SCN next week. We're done our theory and practical exam for NRP.

finish our NRP, please pray for my SCN next week !

I will continue writing on this page when I have free time soon. Pray for me so that Allah will give me the strength to go to work and to become a safe doctor ever day !

Thanks for reading my thoughts here lol

#HOHKL

#HousemanshipHKL