Category Archives: Hospital

Sarangani readying operationalization of P250M hospital

GENERAL SANTOS CITY (MindaNews / 22 Feb) – The provincial government of Sarangani is pushing for the operationalization by the third quarter of the year of its P250-million provincial hospital in Alabel town. Dr. Arvin Alejandro, Sarangani provincial health officer, said the facility is now about 70 percent finished and they are targeting the full […]

The ICC Essentials

Assalamu Alaykum! (Peace be upon you all!)
Heya! Here we go again with the usual “I am sorry it took me so long to post here again” scenario which I believe I should already get rid of (-_-) Starting today! I never even have a “Date published” tags on my posts…so no one would really know how late I am. haha! But kidding aside, I think the dates really doesn’t matter anymore… If I am writing these experiences and maybe some tips for the next ICCs*, the order of each rotation would not matter: for every block (all 8 of them) have different schedules, and perhaps different experiences as well. So I will just write what I have in my journals, keep them short and concise as possible (which I am really poor at by the way), and hopefully pray that someone would stumble on this blog and read it. haha. 
Anyway, continuing our sharing of stories and learning experiences (?) as an ICC student… I see my calendar here that we are now in our 8th week as an ICC student. Cool! It’s December already and we have 2 more weeks to go for the first semester! Yeay!
Which reminds me, I still have a lot of “weeks”, I mean rotations to cover uuggggh! <(-_-)> oh well.
Back to our main topic for today: The ICC essentials. What is different with being an ICC Student or Junior Clerk is that you will now be more exposed to the patients. Most of your days will be spent not in the classrooms, but in the wards monitoring patients’ vital signs; in the Out-patient Department (OPD) interviewing new and follow-up patients; and if lucky or unlucky, you will also be left ALONE to do your directed physical examinations. (I emphasized the word “alone” because the past 2 years we have been used to doing things by group.) And with that big realizations comes the great need to have your own medical equipment and stuffs.
Here are the important MUST HAVES as an ICC Student:
My ICC stuffs (sorry for the quality, just used my phone here)
MUST HAVE:

1) Your own Stethoscope — No need to explain why. You just don’t become a third year medical student without your own stethoscope

2) Aneroid Sphygmomanometer — (we call it “BP App”) Others prefer the digital one. Either way, it is important to have one anytime you go o duty. Just be sure you really know how to use them 🙂 If you are still not sure, better train with your classmates first. Or here’s a tip: ask your patient what’s their last BP before, with that you know where you are supposed to here the Korotkoffs 😉

3) Calculator — You will be asked to do a lot of computations: BMI, Expected Fetal weight, etc. If you are not a math whiz, better bring a calculator where ever you go. Keep it handy (not too big, you are not an accountant! And not too small that you have to use some ultra thin fiber to press on a single number!) These guys are also very helpful during exams.

4) Medical Tapes! (Micropore) — You can’t live in the wards without these! There are expensive ones (P130) and some fake cheap ones (P35) in Bambang. Buy as much as you can. You will eventually see how handy these things are: from taping IV Canulas to labeling your stuffs to even repairing ripped off papers, Micropores will sooner be your favorite thing in the world! (at least in medschool)

5) Measuring Tapes — Ever wonder when is the time that you will use those freebies that your seniors gave you during your freshie days? Well, this is it! Those handy, pull-and-tuck tape measures will surely be put to use in most rotations as OB, Pedia, Orthopedics, even in Ophthalmology!

6) Clipboard! — Same as above, you know you need them.

7) Paper and Pens — Oh come on! don’t tell me I have to explain this one?

OTHERS (you can borrow them from your friends, but it’s better to have one if you can)

1) Thermometer — for the constant monitoring duties. We have digital thermometers now (P50-P75) in Bambang.

2) Penlight — After your Neuro and Ophtha rotation, you are supposed to have your own penlight. But you can always borrow if you forgot to bring them 🙂

3) Neuro Hammer — Don’t forget to bring this one during ROR (Rhemua-Ortho-Rehab), Neuro and even in IM rotations.

4) Tourniquet — You will be asked to extract some blood for laboratories, or insert an IV Canula, or “line” the patient, and a tourniquet is an essential item for that. Yes, you can use your latex gloves if there are really none of these around. But I say it’s better to have one, it’s pretty cheap anyway (P15-20), and makes you look like an IV-lining expert.

5) Pulse Oxymeter — Not really required and it’s kinda expensive. But if you are pretty rich and you feel lazy counting those pulses by the clock, then perhaps this item is for you.

6) Handy Dsinfectants — Be it a 70% solution of Isopropyl Alcohol or a lemon-scented Alcogel, it’s up to you. If not, you can still find a lot of alcohols scattered around the hospital wards (you see them on their alcohol holders attached to the walls). And I am sure there is at least one of your classmates who have one hehe.



NOT REALLY REQUIRED (You can borrow from your friends in other year levels)
  • Ophthalmoscope –during Ophtha rotation, you will be expected to have at least 2 students sharing one Ophthalmoscope. It’s a good investment if you are really planning to proceed to Ophtha.
  • Otoscope — usually comes with the Ophthalmoscope. For ORL duties.
Tadaa! I think those are the essentials that every ICC must have (or at least have an idea of). Being an ICC Student they say is pretty “benign” compared to the Clerks, but I believe this is the year that we should never put to waste. We have to learn as much as we can in preparation for the hellish year we are about to endure next year 🙂 So, get as many patient as you can! Ask as much questions as you can! Learn how to do things in the wards, how things work, which paper to fill in, etc. 

Hmmm Hope this post will serve its purpose 🙂
Salaam! Logging out!
-AIMD
*In case you were wondering what those “ICCs” are… ICC stands for “Integrated Clinical Clerkship” which refers to the group of students in Learning Unit 5 (LU5 or 3rd year proper) of UP College of Medicine. It is the equivalent of “Junior Clerkship” in other Medical schools. 

His last whisper (translated)

(Translated from the original piece written in Bahasa Sug: Hinapusan hagas, published Sept. 8, 2013)
Bismillah.
It was one of those days when we had our bedside preceptorials in PGH (Philippine general Hospital) as part of our class activity when this happened. My group was assigned in the Pedia wards and was given a patient with a lung disease to check and try to learn how to properly identify and diagnose a probable disease. We also have a preceptor, a doctor who will guide us along the course of the preceptorials.
Upon entering the wards, you cannot help but feel saddened by the states of our patients in PGH, especially if they are kids. You will see different patients with different ailments: some have inflamed parts of their head, some had bandages on their tiny arms, some had tubes in their throats, and some are even too young to be there (just some weeks or months old! Poor thing -_-).
We arrived at our patient’s bed and the preceptor started discussing things. Some of us started talking with the mother who was there to get pertinent important history of the patient’s disease. Some of my group-mates were already playing with the 1-year old child to get the child’s attention and liking. But I was actually observing another patient then.
Of all the patients in that ward, I can’t help but notice this patient lying on a bed not far from us. A boy of about 12 years of age. Just looking at him you can fairly conclude that he is really sick and already toxic 🙁 His skin are all yellow (jaundice). A number of IV fluids were hanging beside his bed and he had an NST (Nasotracheal tube) placed on his throat connected to the oxygen tank nearby. He appear weak and lethargic, he can even barely open his eyes very well. But he is awake then, as he was being fed by an older male companion, giving him some spoonful of porridge (I think). Another woman was sitting by his bedside, caressing his arms keeping him warm. Then I observed him trying to talk to that woman, as if wanting to say something to her. And the woman, getting that cue, stood up and came nearer. I saw hear leaned and placed her ears close to the kid’s lips. He was whispering something. Maybe he was thirsty, or he needs to go to the toilet, I assumed.

Then my classmate came to me and asked what was I doing not listening to our preceptor. My group-mates were already taking turns listening to our patient’s chest and observe any abnormal findings. Our preceptor started asking questions on the theoretical matters of our past lectures. I tried listening to her now lest she might call me and I can’t say anything.
And then suddenly the ward was in commotion.
We heard a woman shouting. Somewhere not far from us, crying: “Kaya mo yan! Wag kang susuko! Kayanin mo!” (“You can do it! Don’t give up! Fight!”). A nurse came running from her station and went to check on that bed, the woman still crying was now being restrained by an adult man, maybe her companion. Our preceptor stopped from her discussions, our patient’s mother held her son and checked what was happening. We, to, were already looking at the place where the commotion started. At first, the nurse who just came in—now busy maneuvering things on the bed–was covering the face of the patient she was trying to help, so I can’t recognize it yet. It took me some minutes before I realized what was happening. The woman I saw earlier trying to listen to that child whisper was the same woman now wailing and crying at the floor, shouting: “Kaya mo yan! Wag mo kami iwan!” (“You can still fight! Don’t leave us!”). And the patient being saved by the nurse is the same patient I saw earlier…
A few seconds more and a doctor came rushing in from nowhere. He checked the patient’s status and without even a shade of hesitation, he shouted:
“CODE!”
I felt Goosebumps crawling all over my skin. Everything was set in slow-motion like you see in movies. Everything but them, the doctors come running, some checking the patient’s pulse, some adjusting the bed, the nurses getting equipments, running with all the syringes and fluids I can’t even recognize. A young female doctor climbed up the bed and started the chest compression (resuscitation). One! Two! Three! I was unconsciously counting her presses on the patient’s chest. One doctor was already shouting “Ambo-bag please! We need Ambo-bag here!” Some personnel came running with the ambo-bag, then another bringing some kind of curtains to cover the bed and prevent other people from seeing what’s happening, especially in that place where the patients are all children below 19. But the curtain only covered half of the scene, only those towards the other patients, the other side was towards us, and we were seeing all of it happening right before our eyes.
One! Two! Three! Four! Five! The doctors keep doing the chest compressions; they have already taken turns doing this, for three times already. Nothing’s happening. Compress. Breathe. Compress. Breathe. A classmate came to comfort the crying woman, while the doctors try to do whatever that should be done to save the child.
Most of the students like me who were there were all stunned. We were all piled in a corner, observing all these things happened; speechless, helpless. I remember what was taught to us on our Basic Life Support lecture, we have to resuscitate the patient within less than 5 minutes or something more drastic will happen. About 2minutes already passed us, and still, nothing. I was able to glance at that child and for a moment I saw his right hand moved. Some trickle of blood was already flowing from the sides of his mouth as the resuscitation was still going on.
One! Two! Three! Four! They keep on pressing, still not losing hope. I kept on counting each press.
One! Two! Three! Four! Five! –Thirty! Air! One more try! One! Two! Three! Four!
It took us some more minutes before the doctors stopped and declared the time of death at 9:51am. Slowly, they all returned to their stations, some with their heads bowed, exhausted and defeated. The nurses and the remaining personnel started packing up things in silence as the woman who cried earlier wept more, clinging to the last remains of that child who shared his last moments, his last whisper to her.
Inna lillahi wa inna ilayhi raaji’uwn. (Verily from Allah we came from and to Him shall we all return).
This is the first time that I was able to experience a real “Code” in a hospital setting; an emergency case wherein you have to race with time to save someone’s life. It was scary. It sends shiver all over my spine. You will certainly feel the heavy burden of this job I am now trying to attain. To save a life is never a joke, and to lose one is a big burden you will carry all your life.
I glanced at my companions and I saw them, just like me, in shock. It was our first encounter. A real-life, eye-opening experience… and we are supposed to expect that we will meet more such cases in our future career here in this hospital. We were all having that same dream of “saving a life” and somehow in helping other people. But that single incident woke us all to the reality of this profession. That we cannot always win over death. That even the brightest, the smartest, and most skillful of all doctors would come together and save a life that was bound to end, we can still do nothing about it. That we, doctors and future doctors, are still humans after all. We are not God. We have no power over this thing we call “Life” and “Death”. It is all in the hands of the Creator, He who gives life, and He who takes them away from us. And each one of us, doctors or not, will certainly meet that same inevitable destiny of dying.
“Kullu nafsin Zaaikatul mawt”… “Every single being will certainly experience death” Allah said in the Qur’an (Surah AL-anbiya: 35). There’s no arguing with that.
We went home that day in silence, with that heavy feeling of unexplained sadness. But we came out from that hospital with greater determination too, to become better doctors, learn more and get the best we can that we may become more useful for our patients in the future, in shaa Allah!
Wa billahil tawfik wal hidaya,
Salam Kasilasa

Anak iluh (sung pa magduktur)