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.
