O&G Posting In HKL (Week 1) - Labour Room
Assalamualaikum warahmatullahi wabarakatuh.
Finally, it’s weekend! Last Monday was my first day in Hospital Kuala Lumpur (HKL), doing a 3-week posting on the O&G department (sakit Puan). As early as 6.45am we were already out of Vista and walked to the Sri Petaling LRT Station with my sleepy and not-enough-sleep eyes. We had to report at 8.00am, so we rushed to the manager's office and the experience I had on the first day wasn't as I expected; attach to a doctor, shadow her and follow her anywhere she goes. My expectations, just slipped through our fingers as we arrived at the specialist's clinic, where she was so busy, but we managed to sneak into her room before she checked another patient and she talked non-stop about the do's and Don'ts (mostly the Don'ts); don't take photos of anything, don't touch our patients, don't this don't that and don't mess up. Then she asked us where's our letter. When we told her the letters were in our bags, she scolded us telling us to get them.
It. Was. The. Scariest. 15 mins. Of. My. Life.
But I guess she had her own reasons for acting like that. Or maybe that's how she makes sure medical students under her supervision (though she isn't with us all the times) won't do anything stupid that might cause her to be responsible for. A person is different from another person, one person's style might not be the same as another person's style and who are we to judge her based on her attitude towards us, right? Ada lah rasa a bit unsatisfied, yelah pagi pagi dah kena warning and marah haha takuttt.
On the first week we had been placed in the labour ward, second week in the clinics, and for the third week we'd be in the wards. One week passed and 'twas a great experience! I was a bit grumpy on the first day as we were left hanging in the labour room and there was a slight regret in me by not choosing to do elective posting in Melaka and in a field or department, which is related to what we have learned this semester. I tried to convince and tell myself, 'It's okay to learn something new. Maybe it will be useful later.' First day was kinda exhausted with not-sure-where-to-go and what-should-I-do, but as time went by, everything became much more interesting and we were not afraid to simply get into any of the rooms as most of the MOs, HOs and nurses there were very kind and helpful.
Throughout this one whole week, we learned a lot of things and got amazing opportunities, observing the Spontaneous Vaginal Delivery (SVD) aka beranak normal and entering the operation theatre (OT) to have a better view on how c-section is done. To skim through the board every morning and find out who just came in, who had delivered baby became a routine. Went into the rooms, one by one, looked at the front door, searching for the gravida & para (how many times they have pregnant and how many children they have) and patients' bed-head tickets (BHT) aka case files to know if there's any complication and how they started coming into the hospital. Learned a lot of theoretical short-forms which were sometimes related to other systems such as CVS; DRNM, which stands for Dual Rhythm No Murmur, and also hospital short forms such as:
s/b; Seen By
IOL; Induction of Labour
PROM; Premature Rupture of Membrane
ANC; Antenatal Care
etc.
Every procedure I'd seen, I wrote in a small notebook given by Tiara and most of them have never been taught yet, included the type of painkiller, how an epidural is set up, how to read the CTG scan, which consists of Foetal Heart Rate (FHR) and contractions mothers feel, about babies, and what should we look for in placenta (2 veins 1 artery, rugae, lobes, etc), how they measure the opening and a lot more. It's gonna be a really long post if I mention everything here.
The first 2 days made us felt like we were some parasites, creeping anywhere we wanted, following anyone we preferred, like we were gonna mess up with something. Alhamdulillah, days after that were smooth and fine. Some of the nurses and even the doctors asked us some help and I got the opportunity in assisting the nurse during the suturing part.
My first time of witnessing the normal delivery was like ticking off a bucket list, a doubtlessly one of the unforgettable experiences I'd cherish in my life. It touched my heart gently, made my eyes watery, thinking how strong was my mother to face this when she gave birth to me and at the same time feeling really grateful when the newborn started moving his tiny hands and legs, crying at the top of his voice, telling the world he is here. The happy tears from the mother, the relief reaction of the husband who stayed up all night to accompany his wife and the sound of Azan from the father marked a perfect end of the 9-month pregnancy. Alhamdulillah!
But. Sometimes.
Entering a labour room will not always have a happy ending. Not all people come out with a smile on their faces. I just aware of the existence of a not-so-famous-but-kinda-familiar trisomy 18, which is the Edward Syndrome and usually occurs to a foetus of a woman who has advanced maternal age and obesity. Sometimes the foetus dies inside the uterus itself (Intrauterine Death) or sometimes he would still alive, but could only survive for an hour or two. The mother would still feel the contractions and have to give birth normally, but the foetal heart rate won't be monitored and basically they would only focus on the mother's life.
Throughout this one whole week, we learned a lot of things and got amazing opportunities, observing the Spontaneous Vaginal Delivery (SVD) aka beranak normal and entering the operation theatre (OT) to have a better view on how c-section is done. To skim through the board every morning and find out who just came in, who had delivered baby became a routine. Went into the rooms, one by one, looked at the front door, searching for the gravida & para (how many times they have pregnant and how many children they have) and patients' bed-head tickets (BHT) aka case files to know if there's any complication and how they started coming into the hospital. Learned a lot of theoretical short-forms which were sometimes related to other systems such as CVS; DRNM, which stands for Dual Rhythm No Murmur, and also hospital short forms such as:
s/b; Seen By
IOL; Induction of Labour
PROM; Premature Rupture of Membrane
ANC; Antenatal Care
etc.
Every procedure I'd seen, I wrote in a small notebook given by Tiara and most of them have never been taught yet, included the type of painkiller, how an epidural is set up, how to read the CTG scan, which consists of Foetal Heart Rate (FHR) and contractions mothers feel, about babies, and what should we look for in placenta (2 veins 1 artery, rugae, lobes, etc), how they measure the opening and a lot more. It's gonna be a really long post if I mention everything here.
The first 2 days made us felt like we were some parasites, creeping anywhere we wanted, following anyone we preferred, like we were gonna mess up with something. Alhamdulillah, days after that were smooth and fine. Some of the nurses and even the doctors asked us some help and I got the opportunity in assisting the nurse during the suturing part.
My first time of witnessing the normal delivery was like ticking off a bucket list, a doubtlessly one of the unforgettable experiences I'd cherish in my life. It touched my heart gently, made my eyes watery, thinking how strong was my mother to face this when she gave birth to me and at the same time feeling really grateful when the newborn started moving his tiny hands and legs, crying at the top of his voice, telling the world he is here. The happy tears from the mother, the relief reaction of the husband who stayed up all night to accompany his wife and the sound of Azan from the father marked a perfect end of the 9-month pregnancy. Alhamdulillah!
But. Sometimes.
Entering a labour room will not always have a happy ending. Not all people come out with a smile on their faces. I just aware of the existence of a not-so-famous-but-kinda-familiar trisomy 18, which is the Edward Syndrome and usually occurs to a foetus of a woman who has advanced maternal age and obesity. Sometimes the foetus dies inside the uterus itself (Intrauterine Death) or sometimes he would still alive, but could only survive for an hour or two. The mother would still feel the contractions and have to give birth normally, but the foetal heart rate won't be monitored and basically they would only focus on the mother's life.
It's a sad truth that ones have to accept.
This posting also changed my mindset; only doctors can deliver babies. But, actually no. Every room is under supervision of a bidan and I just knew that bidan lah yang selalu deliver babies! Except if the mother has complication, then the doctors will take an action. We met Kak Izi, a 4th year medical student from Perdana University who is really really helpful! When all the medical teams were busy, she was the one who explained everything to us and I'm really glad of meeting someone nice like her. One doctor is the boss to another doctor and yes, they call boss to the doctors who have higher status than them. Medical Officers (MOs) are bosses to House Officers (HOs) and specialists are bosses to Medical Officers (MOs).
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| The only photo I captured haha |
Good night everyone!
More stories;
Oh baru akak tahu ada supervision from mak bidan. Ni yang kita panggil midwife tu kan,..
ReplyDeletehaaa betul tu Kak Farrah! Midwife baru saya ingat hehe thank you ingatkan! Tapi seriously ada tu sambut baby lagi power dari doktor biasa!
DeleteHi. Somehow I stumbled upon your blog ;) I think I remember your face from the labor room.
ReplyDeleteI was one of the HO there during your attachment.
O&G is very interesting but tiring as well! I'm glad I finished that posting in time.
The scenario would be a bit different in district hospitals where the doctors are busier than the midwives.
My only advice is to be proactive during your clinical training，as we're super busy most of the time and have no time even for ourselves. Split up, introduce yourself, don't br afraid to ask questions. That way you will be much more prepared to be a doctor. Good luck ;)
I think I remember you as well! I was a bit afraid to approach the MOs because they seemed really busy so I thought maybe I should just keep quiet and observe what they did. Alright then, for the real posting I'll be more proactive. Thank you Kak Farhana! :)
DeleteWAAAAA.... da DR la.. you're going to have lots lots of patients soon
ReplyDelete