Setahun sudah

Lebih dari setahun saya bergelar seorang doktor.
Siapa sangka saya sudah berada di tahap ini.
Saya sendiri pun masih tak percaya.

Setahun yang berlalu dengan berbagai pahit manis.
Kenangan yang tak mungkin saya dapat di tempat lain.

Posting Surgical yang benar-benar menguji kekuatan dalaman.
Jatuh bangun di sini.
Menangis setiap hari.
Bibir tak lepas berzikir nak quit.
Alhamdulillah berjaya habiskan empat bulan yang memeritkan.

Posting Medical yang sangat enjoy.
Tapi sangatlah physically challange.
Saya sangat suka adjust reflo dan insulin di Endocrine Department.
Saya pernah insert Femoral Catheter semasa di Nephrology Department.
Saya belajar ECG di Cardiology Department.
Saya sangat relax di Periphery.
Saya pernah pergi kerja seawal 4.30 pagi di Hematology Department.
Alhamdulillah saya lulus long case dan written assessment serta berjaya habiskan tempoh empat bulan di Medical.

Posting O&G yang sangat saya rindui.
Waktu tagging yang sangat perit.
Perasaan nak quit pernah hadir masa tagging di O&G.
Saya cipta sejarah sendiri tak balik rumah masa tagging hanya sebab nak completekan tagging sheet.
Saya sangat enjoy O&G bila dah offtag.
Team mate yang sangat best.
Beberapa MO dan specialist yang sangat mesra dengan houseman.
Saya ada azam dan impian nak jadi MO di O&G.
InsyaAllah.
Alhamdulillah empat bulan juga di O&G tanpa extension.

Sekarang saya di bulan kedua Ortho.
Di Periphery.
Posting yang sangay relax saya kira setakat ini.
InsyaAllah hujung tahun ini baru habis.

Next posting insyaAllah Paeds.

Lepas Paeds saya fikir nak buat Anaest.
InsyaAllah.

Bila Allah kata jadi, maka jadilah.
Bila Allah kata saya mampu, maka saya akan mampu walaupun susah.
Bila Allah dah aturkan ini jalan hidup saya, maka ini lah yang akan berlaku.

Terima kasih ya Allah.
Tak pernah saya rasa Allah tak bersama saya walaupun sedetik.

Random tips untuk HO

Tips-tips di bawah bukanlah dari saya.
Ianya saya dapat semasa aktiviti googling.
Maaf saya tak sertakan sumber-sumber nya sebab saya terus copy and paste bila saya baca.
So andai ini tips dari anda, saya minta izin letak di sini ya.

Btw, tips di bawah ini saaaangat banyak.
Tapi ianya sangat berguna untuk HO dan bakal HO!

1. If you don’t know, say it and admit it.

2. If you are not good at taking blood tell them so. Say “Weh, aku cuba dah nak ambil blood, tapi selalu tak dapat. Boleh tak hang tolong?”

3. Make your worries and ignorance known. Aku selalu mengadu yang aku tak tahu and they are so kind. They will say “Biasalah tu, first posting. Nanti hang akan terer punya.” They cannot be angry at me because I made it known I am not lazy, I am just stupid.

4. When the MO got irritated with the whole ward and hence your fellow colleagues kena marah because of YOUR mistakes, please apologize. It’s easy, I will give you a script, “Weh, sorrylah.. Sebab aku, hangpa semua kena marah. Actually macam mana nak buat morning review sebenarnya?What did I do wrong? Sorry…aku tak tau langsung!” Hah, and then they will tell you what to do. Next morning, you do exactly what you are told. So if you still got scolded, THEY will come to you and say, “Weh, sorry hang kena marah. Semalam aku terlupa nak habaq…hang kena off brannula yang tak dipakai sebelum MO mai round.”

5. Always offer to help. Go back at the same time as your colleagues. “Weh, hang ada apa-apa lagi tak yang tak siap? Jom kita siapkan cepat-cepat. Dah pukul lima. Nanti kita boleh balik skali.”

6.  Be friendly.

7.  Be nice and helpful.

8. Do make friends and during your first posting, be especially careful about being labeled lazy. Defend your honor and your reputation. Especially important in your first posting that people think you are NOT lazy. Always, always admit that you don’t know and always humbly ask for help. During my first posting, I cannot remember how many times I began my sentence with, “Weh, aku tak tau macam mana nak…..”

9. Do not dissapear from wards and go for long lunches.

10. Do not argue over whose patient is this or that. If the work isn’t complete the patient suffers.Whilst some HOs couldn’t care less you should be different and care. After all that’s why you chose MEDICINE in the first place. Help your colleagues with their work.

11. If some nurses do not do their jobs, there is no need to argue with them just a gentle reminder. Better yet, do it yourself. Nurses are not trained to understand the urgency of certain medical conditions and the complex pathophysiology and pharmacological interactions. You chose MEDICINE so be a doctor. If the patient needs to be wheeled down for an investigation and the MAs or nurses are delaying time, offer to wheel the patient down with them. Remember its not beneath you to do that. Lead by example.

12. When you are on call know the problematic patients or critically ill patients. Keep a tight watch and review the patient yourself periodically. DO NOT RELY on nurses’ reports which may be inconsistent and inaccurate. (One patient i treated was recorded as BP 120/80 by a certain nurse-he was having hematemesis-when i checked myself -BP was 85/40)

13.Don’t be a hero. Inform your MO/Reg/Consultant when a patient deteriorates or when you get referrals that need urgent attention. But obviously you will need a strong background of medical knowledge to convey information in a legible/intelligent manner. Institute emergent attention yourself whilst waiting for MO/Reg/Consultant.

14.STUDY STUDY STUDY. If you get depressed thinking all you do is scut duties you should be even more depressed knowing that you do not know enough. Get good materials for the MRCP/MRCOG/MRCPaed/FRCS. Learn how to read CTs/MRIs/X-rays. You can use the chance when you request for investigations from the Radiologists to teach you a thing or two. Study, memorize and examine patients. Think of differentials and dont just accept what the casualty officer’s diagnosis is. If your MO/Reg is not knowledgable use that to funnel your own efforts to be a better clinician so as to guide your future HOs.

15.Come on the weekends and do your rounds. Know your patients inside out.

16. Perlu sentiasa ada buku nota saiz poket. Apa jua term, istilah, perkara-perkara yang tidak kita fahami, terus tulis dalam buku nota. Saya akan tulis segenap perkara termasuklah perkara-perkara yang mudah dan simple, kemudian sebelum tidur, saya akan baca semula dan mana yang tidak difahami terus search dan baca dari internet.

17. Masa dan prioriti. Perkara ini amat penting. Kita tiada masa yang banyak, untuk kita duduk lama-lama belek-belek nota pesakit. Perlu ada prioriti dalam kerja kita, untuk kita tahu apa prioriti kita, perlu fahami dulu kerja kita macam mana.

18. Selalu praktiskan diri untuk 'present case' ketika ward round. Saya pada mulanya memang janggal teramat, kerana tidak pernah present case terutama di hadapan MO dan pakar-pakar. Tapi bila kita selalu beranikan diri, present case akan buat kita lebih mudah fahami tentang pesakit, dan melatih kita untuk lebih yakin dalam kerjaya kita sebagai doktor. Saya selalu present case sendirian dahulu sebelum bermula ward round.

19. Jangan mudah bagi alasan dan dalih jika kita tidak dapat buat sesuatu perkara. Misalnya, ambil darah atau set branula. Pastikan kita cuba dahulu sebaiknya, belajar teknik dan cara yang sebaiknya daripada senior terutama ketika masa tagging. Kerana  kalau dididik sifat beralasan dan berdalih ini, akan lama-kelamaan membawa kepada  sifat malas dan masalah attitude pada kita.

20. Betulkan niat. Try to think of it as your jihad and not so much ‘work’. On very bust days i will imagine that i am in the war zones of bosnia or palestine and be thankful that at least there are no bullets whizzing pass your face.

21. Have a good attitude. Don’t abscond, clerk case ala kadar or leave your work unfinished. It is very childish and unfair to your co workers. Learn to have good team work. When you have good rapport , you frens can ‘cover’ you if you have to rest for awhile and they may even be willing to help you with your duties.

22. Try to have a good relationship with the senior nurse, team leader, sister, matron ect. This people can greatly influence your work environment. Just have patience and remember that one day, you will be more superior that your ‘tormenters’. They know this and some of them do feel jealous of Drs. You earn more and they know that you will always be ahead of them even though you are younger and less experienced. On the plus side, they can also teach you alot of things that you didn’t learn in med school.

23.Try to talk to examine patients as much as possible even tho your MO or specialist have seen them. You will remember cases better and have an appreceiation of what is normal or abnormal.

24. Dress well and speak in a confident and manner. Be humble but let the nurses know who’s boss. Your superiors will also pick on you less. Trust me, when you don’t appear confident, it gives your superiors the aura that you don’t know what’s going on we’ll start to focus on you.

25. Ask questions. Before you realize it you will be an MO shipped off to some pendalaman and you have to survive.

26. When you are new, always ask other colleagues. Who is who so that you know who you are talking to and how to address them. Always be polite. Remember important people.

27. If you see the patient with another senior MO/specialist please write seen by Dr …. On the top of the page.

28. When you are with the team, always listen to the plan of action and write down in the notes so that you know what to do for this patient.

29. Attitude : Punctuality. Working as a group. Always ask if unsure. Make sure your not bullied. Have a good support system because it is depressing at first. Proffesionalism.

30. Discipline, attitude, common sense, sincererity.

31. Learn about your superiors (Specialists and MOs). Apa yg diorang suka dan tak suka.

32. Able to respond appropiately. Dahulukan mana yg penting.

33. Able to clerk and come to diagnosis especially common diseases/problem.

34. Able to do/send appropriate investigation.

35. Able to order/perform basic management (yg advance tu let the MO/Specialist think about it hehe.

36. Able to decide which patient need to inform first. Kalau 20 patient masuk, takkan nak inform semua at one shot.

37. "Makcik, saya nak cucuk ambil darah sikit ye, nak tengok kandungan garam. Darah yang kita ambil pagi tadi menunjukkan makcik kurang garam, jadi kita dah bagi air ikut jarum sepanjang hari, sekarang ni kita nak tengok garam tu meningkat atau tak."

38. Cari senior atau MO yang agak baik dan sanggup menunjukajar kita. Mengaku kelemahan kita. Tag dia ke mana saja dia pergi ketika bertugas. Anda akan banyak belajar benda-benda baru. Bila balik rumah, baca semula buku text. 

39.  Just advice during HO stay close with family. You really need their support. It's torturing esp in 1st 2-3 month. Pray a lot. Belajar manage time. Banyakkan berbuat baik dekat patient. Senyum. Talk.

40. It all comes back to ur own definition of successful HO laa. Cukup sekadar competent buat kerja or is it more than that? So paling penting sekali bagi kita is to set niat betul2 kite nk aim jadi HO yg macam mana. 

41. Disiplinkan diri masuk kerja on time, balik on time cos setiap minit kite berbayar dan kita nak gaji berkat kan? Jaga solat. Walau sesibuk mana pun kite insyaAllah possible je nak solat. Mintak tolong kawan cover sat. Jangan carried away sangat dengan keje. Selalu check masa so that kite boleh adjust accordingly bile nak lari sat pegi surau. Everyday time nk jalan masuk wad, muhasabah niat & doa semoga Allah permudahkan urusan kita. :)

42. Find your own destress mechanism. Cubela untuk husnuzhon dengan keadaan & orang sekeliling kita. Contohnya kalau kena marah kaw-kaw, just anggap orang tu mungkin tak cukup tido ke malam semalam sebab postcall or dia sangat penat sampai takleh control emotion. Things like that la, supaya awak tak terkesan sangat dengan keadaan tersebut.

43. Everyday is a learning process. Dont let yourself be trapped in just carrying out daily orders by MO/specialists without allowing yourself to learn something at the same time, be it minor things like how to insert nasogastric tube instead of just suruh nurse buatkan. Awal-awal memang ada depression phase sikit kalau asyik fail dengan brannula & ABG etc. But tell yourself, its okay cos you are learning. So usahakan juga sampai dapat & jangan senang sangat nak give up and pass keje tu kat orang lain. But make sure communicate with patient la, mintak maaf dulu baru cucuk depa. They'll understand insyaAllah. :)

44. Besides making friends with your colleagues, nurses are your friends also. They're the best people to help you adapt in the ward. So make it a point to get to know them & memorise their names instead of just calling them by staffnurse or misi. :)

45. Cubela cari cara paling berhikmah utk ingatkan diorang pasal aurat & solat. Takut-takut kite ni orang terakhir diorang jumpa kat dunia ni n yet kite tak pesan pun pasal kewajipan diorang.

46. Confident & positive okayh!

In the early morning.
1. Looking for a new faces. Go throgh their case note, ask additional questions where appropriate, quickly look at the clinical examinations findings documented, repeated myself for confirmation and add some other additional examinations.

2. Finish your rounds before your consultant.

3. Practice correct examination technique and REALLY examine the patient not just copy the previous BHT update.

4. If the nurses chart monitor seems suspicious/made up-check the vitals yourself. Carry a handbook e.g Oxford handbook of clinical medicine to check dosages/terms/clinical conditions etc you are unsure. Trace all the results and more importantly INTERPRATE them and act on them accordingly.

5. If dressings are not done by the nurses check it and do it yourself. Do it for your patient. You will learn how to do dressings effectively and watch wounds heal before your eyes.

Before going home.
1. For patients already in the ward. Go through all the case notes of every patients to find out the lates progress.

Kehidupan Baru

Esok, 26 Ogos 2013 merupakan permulaan kepada kehidupan yang baru.
Persekitaran yang baru.
Kawan-kawan yang baru.
Semuanya baru-baru belaka.

Alhamdulillah.
Allah tempatkan saya di hospital pilihan pertama.
Berkat doa Ibu dan Abah mungkin.
Sebab hakikatnya jauh di sudut hati saya nak ke hospital pilihan kedua.
Apapun Allah tahu apa yang terbaik untuk diri saya.
Terima kasih Allah!

Ya Allah.
Kuatkan aku dalam menempuh kehidupan baru ini.
Tabahkan aku dalam mengharungi onak duri yang bakal mendatang.
Tinggikan sifat sabar dalam diriku.
Bantu aku setiap masa ya Allah.
Jadikanlah aku seorang doktor yang menjadikan dakwah sebagai agenda utama.
Permudahkan urusanku untuk menjadi seorang doktor yang kompeten.
Ya Allah, jangan tinggalkan aku walau untuk sedetik masa yang kurang dari sesaat.
Amin ya Rabbal a'lamin.

Masanya sudah tiba.

9 Februari 2013 - Habis final exam MBBCh.
7 Mac 2013 - Hari Graduasi
13 Mac 2013 - Pulang ke Malaysia
2 April 2013 - Isi borang SPA
8 April 2013 - Daftar dengan MMC
9 April 2013 - Call SPA book tarikh interview
18 Mei 2013 - Interview SPA
25 Jun 2013 - Terima surat pelantikan SPA
13 Ogos 2013 - Terima surat tawaran PTM
19 - 23 Ogos 2013 - Program Transformasi Minda
26 Ogos 2012 - Mula berkhidmat di hospital insyaAllah.

Saya pergi MMC lambat dari orang lain.
Sebab?
Saya tunggu kawan, dia nak pergi dengan saya.
Tangguh punya tangguh sebab sijil dia tak sampai lagi.
Maka lambatlah kami ke MMC.

Interview lagi lambat dari kawan yang lain.
Sebab?
Pilihanraya.

Kerja pun lambat jugak.
Sebab?
PTM masa puasa hanya untuk local graduates.
Overseas graduates lepas raya.
Macam tak adil kan?

Register MMC lambat.
Interview lambat.
Maka kerja pun lambat.
Kawan-kawan yang register MMC seminggu awal dah PTM 1 Julai haritu.
Tengok beza dia banyak tak.
So siapa nak kerja awal terus register MMC cepat-cepat dan book tarikh interview lepas tu.

Walau apapun alasan yang saya tulis atas ni.
Yang perlu saya letak dan yakin dalam hati.
Ini semua adalah perancangan terbaik yang Allah dah aturkan saya.
Allah knows best.

Ya Allah.
Dengan keberkatan RasulMu. 

Permudahkanlah urusanku serta sahabat-sahabatku.
Amin.