Life As a Houseman Part 5- Anaesth posting

    

Hi everyone, I am going to move to a new website.

Some post will follow and this blog will be deleted.

 Do join me for more info about doctors and life. 

Thank you

 https://www.drcodedeciphered.com/ 

  Hello everyone, long time no see. How are you all? so far so good? 

Anyone ever regret in choosing HSIJB as a house officer training ground? Hmm...I do not know as nobody inform me yet. 

Hopefully everyone who ever read my blog are doing well in your current posting. I believe everyone are always lethargic looking, with poor GCS and urinary retention during working period. 

IV caffeine and CBD stat !

Life is fantastic. Errr...not as a medical doctor. Hahahaha.... 

      Flashing back my anesth posting (which was about 1year++ ago) . This posting was relatively chills and relaxing compared to other department. Once you in anesth, say bye bye to hunger. Say hello to fatty abdomen

You eat 5meal per day @@ (breakfast, lunch, tea break, dinner, and supper) WTH!!!!!

You had to undergo 3 different rotations which were : 

1. Acute pain service (APS)

2. Operation theater (OT)

3. Intensive care unit (ICU)

     Different rotations will teach you different things. Let me brief you all. 

Which posting come 1st? - nobody know as specialist decided for your rotation. You will fulfill all the 3 rotations at the end of the posting. 

Everyone will be posted in OT 1st for 2week tagging, subsequently u will be rotate to APS/ICU or remained in OT. You will returned to OT in last 2week. Basically each rotation took about 1 month plus. 

I started my rotation in ICU 1st. 

      For your information, ICU is the best place to provide critical care to those critical ill patients. Best continuous vital signs monitoring with well equipped with more advanced items or ventilator.

In ICU, you learnt how to insert arterial line, USG guided CVL insertion, USG guided fluid resuscitation status, ventilator settling, how to manage critical ill patients etc.

My favorite intensivist Dr Axxx is there to give guidance. 

From there, you will know to set up a ventilator and understood the principles of respiration mechanic. It is amazing!

In here, you had little responsibility in ICU because MO and specialist were the one who in charge of the patients. Your jobs were to assist them. SN in ICU will inform to specialist/MO directly if anythings went wrong. 

2nd rotation was OT.

       In OT, you learnt how to intubate patient, difficult ventilation, fluid resuscitation, types of ETT, OT ventilator machines, RSI , spinal analgesia and etc

You had to grab your chance to fight with new MO for intubation. If you just kept quite, nobody will give you the chance to intubate patients. I really fight with MOs to gain enough experience for intubation. We also can stand a chance to give spinal analgesia, i think i had done >10times during anesth posting. 

Doing night shift in OT was like....visiting the North pole. Please wear thick clothes or else you will get cold easily. 

3rd rotation was APS

       In APS , you learnt how to reduce patients' pain score by giving multiple modalities, treating chronic pain, giving morphine protocols, oralized the iv medication, diluting medications and etc. You will work with APS nurses in HSIJB. Those nurses were very experience in APS stuff, and they were the pioneer in establish APS with Dr Exxxx. 

Plenty of stuff you need to seek their advice and opinion. You behave like a 1st poster again. They were your boss! Please treated them nicely. Obeyed their commands and helped each others. Respected them. Or else, they can give you hard times or even extend you. 

I mixed with them well, and some one them wanted to introduce other nurses to me as girlfriend. Hahaha...

The tips was be hardworking, humble and willing to learn. 

Overall I do like them as a team, but I do know like this rotation. It was because all you deal was pain!!!! Pain here pain there. Some patients who were super Manja will keep complaining of pain. I do not like the nature of the work. But after this rotation, I did feel more comfortable in giving morphine, tramadol, or fentanyl. 

Each rotation, you need to present a CME. 

At the end of posting, you need to have viva with 2 specialists and 1pain specialist. The questions were tough but I believed if you worked well with them, they will pass you easily. 

A lot of anesth MOs persuade me to choose anesth as my future job. But i refused, because i cannot sit there and watch people doing operation. 

I wanted to be involved in operation too..

Coming up next--peadiatric posting (when I became a 100m runner!!)