COMPLETED MY HOUSEMANSHIP IN HKL . Recommended or Not ? (honest review lol)
Bismillahirrrahmaanirrahiim
Alhamdulillah for the past 2 years, I finally reached this point. It's hard but I did learn a lot in HKL. Where the place where everyone was afraid of doing HO here including my batchmate, but ALhamdulillah it was manageable.
What I can say thinking about housemanship in HKL is, that you must prepare mentally and physically for the tremendous amount of patients and workload as this hospital won't reject any patient from the other hospital.
And I can be proud of saying this, in the will of God, I never took an MC or EL or covid leave along this journey of housemanship. Whenever it is hard/tiring/depressing/ sick moments, I still show up every single day til the end. Everyone called me a workaholic tho haha no no I just tried my best to finish my tasks every single day.
I want to comment on every posting that I passed before. Although it might differ cuz other people experienced it differently, but I just want to share it from my POV.
It was a really hard and tiring posting, especially when it is my 1st posting where I want to adapt to almost everything and I lost 5kg here in 9D ward in general paeds. However, not gonna lie it was an enjoyable moment in SCN when I attended the newborns. I was questioned a lot at the beginning, about where I graduated from cuz I know I did really bad in my first 6 weeks in gen peads. Huhu so glad that no one ever questioned where I graduated in the next postings.
We have 3 general wards that were covered by HO which are 9D, 10A and KK7. 9D and 10A were equally busy as all the general cases will be admitted to this ward, while KK7 is busy discharging patients cuz all the stabilized patients will be transferred here. While 10C is a specialised ward where cardio, gastro will be admitted here in the ward and were covered by MO, while general cases will be covered by HO. There is an Observation Bay in ED that must be covered by HO 9D/KK7. While HO in 10A will cover Daycare. 9D HO also needs to cover peripheral gen paeds/medical patients in specialised wards.
HTA is so large and has so many wards just for paediatrics only. So it has a few specialised wards like oncology, surgical, respiratory, cardio, nephro.
For SCN we have 9A SCN ward,9B premature SCN ward. HO also need to cover resuscitation of the newborns for maternal OT and Delivery Suite in level 4. NICU has about 60 incubators which are covered by MO's and photoroom was cover by HO.
When I first entered NICU I was in awe because the NICU was so huge and it looks like a huge hall. You can see different sizes of the baby , some were small like a kitten, and some had unique congenital facial and body features.
My friend said that I was quite a 'Jonah' one when I/m in paeds. Well, it's hard not to admit that as a 1st poster haha. Most of the time it was quite eventful for me, sometimes I just want to cry cuz it was so overwhelming. There are certain occasions when I'm the only one who has a few babies born on arrival in PAC at the same time, most of the babies in MOT/LDS are intubated while in my shift, photoroom is full during my shift, also there is 1 special occasion where I can assist in doing a procedure called Exchange Transfusion for NNJ baby while in the middle of the night in my shift. But, somehow I think that's the way I can learn. The cons in SCN are we can't intubate a baby and we don't manage NICU babies. But in resuscitating a baby, we are allowed to attend to the baby without MO.
Well, there is a reason why I said it was not recommended in a certain way because, for gen paeds, we only covered general cases like AGE, asthma, bronchiolitis, pneumonia, covid, etc. I think that I've learnt more in HTAA while in medical school cuz all the different cases are packed in 1 ward. In NICU also we are restricted from reviewing the NICU cases because there is 1 case that happened before us resulting in HO is banned from managing and reviewing the NICU babies. While resuscitating the babies, we are not allowed to intubate the babies, only MO are allowed to do so.
Otherwise, this is my 2nd most enjoyed posting and after I've been through all postings as a houseman, I think this is the most chill and easy posting for me compared to other departments.
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Obstetric and gynaecology (50% recommended, 50% not recommended)- computerised systems
The shift is 7am-7pm, 7pm-7am. I wake up at 4.30am every day and make sure to be in the ward at 5.45am except for PAC/EPAU/OT.
Well, I don't know how I survived this posting as a 2nd poster cuz it was quite a tense posting as it involved 2 souls- the mother and the baby inside the womb.
We have to cover 5 antenatal+postnatal wards, 2 gynae wards, a labour room, maternal OT, gynae OT, PAC, and EPAU. Also, we got a special rotation MFM clinic. Also if compared to HTAA kuantan, this is much larger ! So we will rotate in 4 groups every month : labour room + 1st class ward, gynae ward, antenatal+postnatal ward+PAC+OHR(obs high-risk ward).
I started this posting in gynae rotation, where my 1st patient LO(passed away) during my 1st night shift :") a gynaeonco patient. Gynae was like a new world to me cuz it is so different from other rotations, my senior said it was like a medical female ward. There are a lot of referrals to other departments. Also further divided into general gynae and gynaeonco patients. 1 or 2 housemen will cover 1 gynae ward on AM shift. The gynaeonco patients will be taken care by 2 gynaeonco housemen (their shift is different : 7am-6pm, no night shift, 1 off-day on weekend). If there is any emergency case to enter OT (ruptured ectopic pregnancy/miscarriage, the houseman from the respective ward will enter) In gynae OT, we need to assist MO for laparoscopic procedures, so far I already assisted 6 laparoscopic procedures, some with cool MO, some with a 'Lion' MO lol. My friend also cannot understand why I got to assist that many lap OT in my shift (I don't admit I was jonah that time) cuz usually my friends got to assist max 2 cases of lap OT in their gynae rotation hurmm.
The next rotation is the labour room+1st class ward. I admit that my LDS rotation was one of the most tiring rotations but it was bearable cuz at least 3 HO in LDS to be a runner. So if there is any emergency cser from LDS, the HO from LDS will enter the MOT. When I was 1st time in LDS, I was in awe cuz it was a huge labour room with 11 delivery suites(I can't remember the exact number) with a baby warmer/resus trolley in each suite. I felt that women in KL are so lucky to deliver here cuz it offers 1st class facilities with privacy for the mother. So, the cons are that there are too many patients at 1 time with rooms are almost full on the day, and we barely have time to conduct delivery by ourselves or to do any procedure like episiotomy, or suture because most of the time we will be a runner as the LDS is so huge. We can only perform those procedures at night shift because there are not many patients at night compared to the daytime. So, most of the time it was done by the midwives. 1st class ward was the most relaxed ward, where only 1 HO to cover during AM and night shifts. I don't really like to cover this ward cuz there are a lot of high-class/government servant patients here so it requires a lot of patience to deal with them I guess.
We have 2 months to cover PAC/antenatal and postnatal ward/OHR. Because I'm in 2nd poster, I was rarely put in the OHR, I remember I only got to take care of OHR during 1st raya night when all my seniors went to take leave for raya lol, but it was quite a chill night for me Alhamdulillah. We have 4 antenatal+postnatal wards (7A/7B/7C/7D). 1/2 HO is allocated to each ward during AM and sometimes 1 HO need to cover 2 wards during the night shift. Also if there is any emergency cser, the HO from the ward need to enter the OT. I got to practice my VE skills in PAC and wards until I was quite confident enough to monitor the progress of labour and when to decide to send the patient to the labour room. All the induction of labour was done by MO every early morning. In PAC, most of the clerking was done by us and scanned by MO, some of the seniors were able to perform the scans also.
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I will tell you about ortho/medical/surgical posting later. thanks for reading !
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