Conversing with Life

The longest day

SIP is upon me!

All too soon, I find myself doing SIP when it seemed like yesterday when I started my year 5 posting with geriatrics.

Just before the posting, I told myself I must enjoy this posting and approach it with enthusiasm and an earnest willingness to learn.

At the moment I'm still good on that promise, although I'm feeling a bit less 'on' already.

How do you decide if a posting has been a good one?

I think a posting is good if:
(1) good cases were seen.
(2) good teaching from doctors
(3) good rapport with the team and nurses

But the most important criteria I feel is my personal performance, be it in the end-of-posting test, skills in procedures or just plain answering all questions thrown at me.

For this posting, I'm having extraordinary luck with the venepunctures and plug setting. It's been mostly 'one shot, one kills' so far with a few exceptions. Hopefully the luck stays. I'll always remember what my anaesthesia consultant (Dr Wong Loong Tat) said, "The key to a successful plug setting is preparation of the vein." Wonderful advice.

In terms of being able to hold an intelligent conversation with the doctors (ie. talk knowledgeably about patients), I need to buck up. Sometimes I feel pretty dumb when I don't know the answer. Or sometimes you know the answer but it doesn't quite come out the way it should be, concise and smooth. Sometimes I get so nervous and unsure, everything comes out wrong and I end up sounding really dumb.
That really gets me down, especially since I feel I should know a bit of everything by now. And being able to talk intelligently to doctors is very important to me, because if I can't talk on the same level, then something must be really wrong.

In my ward, we see a lot of onco cases. Oncology isn't something I see in the wards often, especially these terminal non-surgically resectable types. The history is a bit hard to digest and lots of foreign terms and concepts. Although the aim here is to function as junior HOs, it's difficult to digest these cases and present them. What are the important issues? What are the patient's immediate needs? I'm taking longer than usual to digest through the cases on the team, it was frustrating to be asked "Do you know this case?" and I fumble.

Rapport with the nurses have been positive so far and lots of impromptu teaching, which is great because I learn better from that. And lots more teaching is promised.

So it's been good so far, I hope to keep it that way. Will actively remind myself to stay positive and keep plugging.

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Saw my first "sign-out" case today. Was doing the evening round with the registrar when a patient "expired". I was planning to actually talk to him after his SJS subsided because he had some cardio findings but then...

Death can be assessed by 4 criteria: asystole, no spontaneous breathing, fixed and dilated pupils, Doll's negative.

I felt a tinge of sadness but I also knew he left for another journey. He suffered painful diseases in this lifetime, hopefully he'll have a better one next.

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Good things do happen too. Was pleasantly surprised to hear that my registrar is an avid runner too.
What do you get when you put 2 crazy runners together?
Hopefully lots of conversation on sports!

(i know it's not funny, i just came out with it spontaneously)

Wei Qiang converses @ 18:32