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Thursday, September 25, 2014

Surgery Internship 101

Internship 101

I began my day anxiously wondering how will i cope in the department. I  had met the HOD previous day to report me joining into the surgery department. I was late 1 week from schedule due to self declared holiday. That week i thought i should spend my days with my baby sisters whom were in high school. Well, more of slept more-quality timeless-holiday. All because, i spent ALL my money during RAYA. By the end of first of raya, i am pennyless and helpless against my family needs and desires. No more shopping spree or going for a short break holiday at any beach or hotel etc... This time, i went only to my grandparents house in Puchong,Selangor and Pontian,Johor. If not because of our tradition of going convoys to relatives houses, i didn't even get a chance to spend my holiday going away from Segamat. 

Today, i got the money and yes, i have the mood to update the blog after so long." I need to plan my money properly." A resolution i made every time i received the money. 

Surgery Internship 101

My first day in surgery wasn't that bad. Just like a sponge, i had to absorb everything at once. It was splendid because we get to go home early after finishing our work. WORK!!! Finally, i'm a worker in society. I am no longer a full time student of exam but rather full time student of medicine, i hope. Everything was blurry at first but things began to take shape and form once you do it repeatedly. 

Today was my second day. I ran almost all the time. Yesterday, sir taught me about dressing and doing wound debridement of diabetic foot ulcer using different method step by step:
  1.  Prepare all items needed,making sure everything is kept sterile. 
  2. Use unsterilised glove and take savlon and pour it over the wound. Immerse cotton swab into savlon in cup and scrub the wound and surrounding area like washing with soap.
  3.  Add savlon with hydrogen peroxide in 3;2 ratio.Clean the wound properly. Finish with saline.
  4. Use sterilised gloves.Curette the wound. Remove all slough untill the wound surface became concave and all granulation tissue appearing like cauliflower growth is removed.The wound be filled with oozing blood and blood clots upon curretage. ( Do keep a change of clothes for this matter!Its blood splattering all over!!! Remember remove your pretty watch too! o_0)
  5. . Immerse cotton swab into betadine with hydrogen peroxide and apply generously to wound.The wound should appear pink or red with healthy granulation tissue on its  concave surface.
  6. Next, immerse cotton swab into betadine ,squeeze it thoroughly so that it wont stain the dressing in the outer layer.Keep the swab properly into the wound and add another white cotton swab over it to prevent soaking. 
  7. Take a roll gauze and big cotton pad to cover the wound properly.
  8. Tape the ends of bandage with micronized  pore cellotape. 

On the next patient, we learn to install a cost effective VAC unit to large foot ulcer in a diabetic patiet. The vacuum unit is kept for 3 days and by using this method and appliances, the total cost is reduced from staggering Rs5000 to only rs400 for ensuring the wound healing.This VAC unit helps to remove the dead tissues and pus from the wound for three days without a change of dressing. I wished we had some kind of hydraulic machine to hold the patient foot so both of us, the patient wont get leg cramp from lifting his leg far too long and the doctors in charge wont get back pain from supporting the leg and bending over the bed. Fuhh! 


Yesterday we went back by 1.30pm. Today, 3pm. If everyday like this, i should think of another hobby to fill up my empty day in the evening. Or, shall i driving lessons? Maybe i will. 

Pray for me. Wish me to be better in life and hereafter. 

Lesson of the day:
  • Arrange your priorities
  • Check your work.
  • Consult and ask if in doubt.
  • Smile even if tired.
  • Focus to seniors/staffs instructions
  • Know when to say no .
  • Do discharge previous day, so you can give it to staff for corrections.
  • Again, always check your work with co intern and staffs.

Future me, be strong! Don't loose faith and hope!!! 


 
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