Sunday, October 19, 2008
* Glimpse at the Medical Ward *
Finally, the schedule of our comprehensive and final exams are out.- Communicable Health Disease - October 20, 2008
- Nursing Research - October 22, 2008
- NCM 101 & 101a (Comprehensive Exam) - October 22, 2008
- NCM 101 (Final Exam) - October 23, 2008
Last October 16-18, 2008:
we had our duty in the Medical Ward at Baguio General Hospital.
So far, of all the wards I've been to for this semester, I'd say this is where ones skills are really honed. I learned a lot especially in terms of medications (i-drug study mo ba naman ang 10-13 na gamot ng pasyente mo hehe) and I was able to do more than I did in the other wards.
October 16, 2008, the patient of my classmate died. It felt very heavy for us all. We were there for two weeks and my classmate handled her for 6 shifts. We witnessed her struggle as well as her family's efforts to hold on. Somehow I felt mad at her doctor. Where was she when her patient was suffering that much?
Really, it felt so heavy we went to the Nurses' Lounge and cry. After that, we prayed for her. Bilib naman ako sa mga doktor at staff nurse, they really stood their ground and didn't shed a tear. Maybe after handling a lot of situations like this, they became, I dunno - immune?
It was in this ward that I saw a glimpse of other people's desire to treat. Nurses who practice there for a short time are called nurse fellow. I don't know why others are just so -- pabaya. I'm going to state some instances (based on my shift and only in the patients I handled):
- 8 PM - Responsibilidad ng fellow nurses ang magbigay ng IV medications. Naibigay ko na lahat ng oral medications ng pasyente ko for 6PM at ang pwede ko na lang ibigay ng 8PM ay Lactulose (syrup). Pinaalala ko sa nurse fellow(in charge of my patient) na ibigay niya yung IV med ng pasyente ko, sinabi niyang "Ay meron ba ading? Tapos na kasi shift ko, i-eendorse ko na lang sa susunod". May miting ang mga staff at fellow nurse sa nurses' station at nagpiktur-piktur pa. Natapos yun ng 8:47 at hindi pa dumating mga fellow nurse ng susunod na shift. 9:03 na, saka lang dumating ang susunod na shift. Delayed ang pagbigay ng IV medication. Binigay ng fellow nurse on duty yung IV med ng 9:30. Para saan pa ang ginagawa ng student nurses na Incident Reports at pag-iingat kung mismong Registered Nurses(hindi lahat) ay hindi gumagawa ng tama?
- Blood transfusion (BT) -Before inserting the line for BT, they thawed the blood pack in a basin of tap water - it is not ideal to do so.
- IV line - Pasyente pa mismo ang naglakad palapit sa akin para sabihing paubos na ang 'dextrose' niya. Nagpanik ako't ini-'off' ko ang IV line niya sabay pumunta sa nurses' station. Sinabi ko sa nurse fellow in charge at sinagot niya ako ng "tignan mo nga sa chart niya kung may 'to follow' at tanungin mo sa kasama niya kung merong IV sa bedside niya..." Hindi ba't siya ang may responsibilidad niya yun? Pagkatapos kong gawin yun at sinabing walang stock yung patient, saka lang siya nagpareseta ng 'dextrose'. Hay. Paanong hindi made-delay ang mga IV fluids kung late inihoo-hook? Hindi pa yung tamang oras ng paghook ang isinusulat sa IV 'paper'.
- Doctor - I was doing my sample charting when my patient's doctor and a nurse fellow came to me. "Delayed na yang IV fluids ah. (Tumingin sa nurse fellow at sinabing..) ... Pakiregulate mo nga." . Bumilis ang pagpatak ng 'dextrose' sa rate na 21 gtts/min. Umepal ako. "Sir mali po yan kasi 500mL lang yang 'dextrose'.". Sumagot ang doktora "Diba dapat 20-21 drops yan? Kaya nade-delay ang IV fluids eh." (Kausap niya yung fellow nurse). Nagexcuse ako at umalis. Kinompyut namin ng groupmate ko ang rate ng IV. PNSS 500mL x 12 hours (macrodrip) = 10.21 = 10 gtts/min. Sinong mali ngayon? Bumalik ako. Wala na ang doktora. Sinabi ko habang hawak ang 'dextrose', "Sir, 500mL lang ito." Ini-regulate ng fellow nurse sa 10 gtts/min. Di kami nagpansinan pagkatapos.
- Chemotherapy - The watcher has bought the needed IV line and 'chemo-dextrose'. I called the fellow nurse on duty because we weren't allowed to hook it. She came and has hooked it together with the main line (like what the other fellow nurse did in the blood transfusion). And then she went back to the nurses' station. Nagtataka ako bakit nakatakip ang 'dextrose' ng carbon paper. Sinabi ko sa clinical instructor ko at sinabing takpan ko rin daw ang IV line dahil decreased ang epekto ng chemo-drug. The drug was photosensitive. Iniwan lang ng fellow nurse na ganun ang IV line kaya tinakpan namin ng carbon paper at coupon bond.
Hindi lahat ng fellow nurses na nakasama ko ay ganun. Meron akong dalawang nakasamang hindi pabaya. Every now and then, they'd come to the far end of the ward (Hema-onco; I was assigned here for the last two days) and check on the patients and even ask me how our patients were doing if I would pass by the nurses' station. I wished the other fellow nurses were like them. They even reminded me of the medications I shouldn't forget. ;]
Honga pala, wala akong sembreak talaga. Sa ika-27 ng Oktubre 2008 magsisimula ang enrollment ng Nursing. Hay... Tapos sa ika-30 ng Oktubre naman ay magsisimula ang advanced duty namin. Ay! Meron pala akong sembreak, sa ika-1 at 2 ng Nobyembre! Saya-saya, natapat pang Sabado at Lingo. T_____T
