A week in Recovery Area

Last week I was assigned to be in Recovery Area or previously known as Post Anaestatic Care Unit (PACU). For the first three days, I could only help the basic things while my mind were struggling to remember the flow and the job-to-do there. Yeah, by right, I need to catch up myself whatever happens in the area (huhuu, newly joined person kan =(..hukhuk). But, the next few days, I felt so grateful for people in OT started to accept and help me mastering the area (really hope that I am accepted..*optimist..optimist..). Know what, I only have 6 days to catch up all those thing, by the way, it should be enough right..You will know whether it is suffiicient or not after this yaa..Happy reading!!

What to do..

Here is the to-do-list for nurses incharge of recovery area at my place ya..It might be useful for you or it might not, so, take good things and do leave the bad ones ya..


Preparing Setting

 Since currently I am working according to office hour, my official time starts at 0830 and ends at 1700 (24hour style). For last week, I was placed in Recovery Room (RR), so basically, RR begins to have patient after the operations are done. Thus, there is no cases commonly early in the morning except emergency cases but still rare. Therefore, nurse's job for morning time is to prepare the RR, clean and clear the places, top up anything related (such as face mask, green gauze, yankuer sucker and etc.), change the collecting tube, and arrange nicely the setting. If we have some extra time, do help the general worker (we usually call them attendant in GOV hospital) preparing trolleys to receive patients.

Do lend your hand and a little energy for small works as I believe there might be hidden barakah among them that we conciously dont know, and it might help us back when we need people's assistance one day. Let us not be a selfish person ya. For a new beginner like me, all those thing help me lots, allowing me to slowly catch up the whole setting, knowing what do OT have in it and where are places of things (this would be helpful for us in the future when we seek for something ya), and most important thing, we can do lots of things by ourselves without depending so much on the other people when they are not around. This is so-called indirectly self-ward orientation as we cant expect people to tell and orientate us all the time, and it surely benefits you much.

Receiving the patient.

Once an operation is done, patient will be wheeled out by the circulating nurse assisted by general worker (GW) or runner of the operation. First thing to do is 10 seconds assesment on the patient by a glance. What to see is the condition of the patient by sight. Is patient concious, is patient put under general anaesthasia (GA) or local anaesthasia (LA) or regional block (RB). From that, we straightly can arrange in our mind what to do next and next.

Patient under GA

Initial thing to do is to maintain patient's airway because normally they are sent out before they gain  their fully consciousness, that the main job for RR (to keep eye on till patient conscious and send them back safely). Patient under GA commonly needs assistance to breath post-operatively as we know GA decreases respiratory function (we'll talk on this later ya). We will commonly see patient with Guedel airway to help them breath.

 

Guedel Airway

Compulsorily, giving oxygen is the first thing to be done for under GA patient. Next is the SpO2 monitoring, then blood pressure taking. Continuing drips is also a must if any.

Patient under Local Anaesthasia or Regional Block

Usually, they normally breath and what we need to do is to monitor the SpO2 and the blood pressure. Comforting the patient is always a must like covering up patient with blanket or switching on a warmer. We must be alert about LA areas or RB type (wether it is spinal or epidural) because sometimes it will affect patients' movement and might need some assistance from us.


Pain Management

Frequently, painkillers are administered in the OT while and after the procedure. However, anaesthetist will also order those drugs in the RR such as Dynastat 20mg or 40 mg intravenously and Morphine via Patient Controlled Analgesic (PCA).

To prepare the PCA, we just need real guide to show us because different types of PCA need different step to run them. So, alwas be prepare to learn ya..!!

Sending Patient Back

After close observation for almost 30 mins without any complications, severe pain, and good respiration, patient will be sent back to ward or day ward to be discharged or further intervened. We commonly call nurse in charge form ward right after 10 mins of observation, giving them time to come and also to help patient to reduce their bill by not staying longer in RR.

During pass over, patient will transfer from bed to bed with or without assistance, depend on the condition. This will benefits patient so much, as an early ambulatory is proven beneficial in healing period, physically and spiritually. We'll report to the nurse in charge, the type of surgery done, surgeon and anaesthetist, specimens if any, induction drugs used, dressing if any.

That is all for RR week.... To reach the competency, 1 week is never enough and as I always believe, skill can be gained by time and repetitions but not knowledge and rationales, as they need up-high passion and keen desire to get them. Not to say that we have to study all the times, but what I insist is DO ALWAYS USE YOUR BRAIN TO THINK, TO ANTICIPATE, TO ANALYZE, and  TO SET ACTONS. Later, you will find out that you can still manage to competently do steps of procedure, because the strong memory and tough thoughtful mind will guide you then.

fiey ahmad

so much thing to learn, 

that makes life so beautiful

Setting in Operation Theatre (OT)

In Ampang Puteri Specialist Hospital, the OT is so great and well-arranged. I am so amazed stepping into it for the first time, feeling like in the Grey's Anatomy scene (exxagerative neh=P), but seriously saying, I like the setting so much, so far..hihi..( OT Temerloh also best, but a bit big>>HAUNTED, ye ke?)

Sharing is an investment.

So, here I am. I am going to share a bit about OT setting and hope it might be useful to students who will be soon posted in OT and also beneficail to people who will enter the OT for surgery purposes.

Basically, OT consists of 5 main areas which are, Patient Hold (PH), OT Rooms, Recovery room, Dayward and its own Central Sterile Supply Service (CSSS). Name of the areas depends on the institutions but normally they will carry out almost the same job. Other than that, OT has small but important areas as well such as, male/female changing room (main entrance for the staffs) tea room (so-called pantry), wash room, sterile store, rooms for doctors, anaest, perfusionist and sister, and not forgotten the most important place should be is the Bilik Sembahyang (so close inside, so clean and loveable).

According to the patient route entering the OT, it will start at the patient entrance where  OT staff nurse receives patient from ward staffnurse. Then patient will be put or hold for a while at Patient Hold. Some institutions will practice vital signs taking here, some are not. Again, it depends. Next, after everything needed is ready (OT room ready), patient will be wheeled into the OT. Right after the surgery, Recovery Area is the observation area post-surgically. Some places still use Post-Anaesthetic Care Unit (PACU) for the monitoring bay. Eventually, patient will be discharged to their initial ward to have further interventions (usually surgical ward).

Nevertheless, there are special cases that not need to undergo the above route, such as day surgery-patient case. They will be admitted to the Day Ward for a day, more to simple procedure that not need close pre and post surgical observation. Discharge also be made from the Day Ward. Other than that, there are cases like ICU cases, they will be sent back to ICU right after the surgery done as their staff nurse will look more closely for them, thus no need to drop by at Recovery Area.


CSSS is a unit which also plays important roles in running the OT. Everything needed in OT procedure mostly is from CSSS. The hardworking and outstanding staffs there contribute much even most people dont realize it. Same goes to everyone who works behind the scene, lets HE the only one knows our works and intention.


Another hot place in the Ot is the OT counter, where assemble most of the staff there to look, stare, wonder, mumble at a white board. The white board tells almost everything about the flow of the operations-of-the-day. From there, people can arrange and manage what they are going to do, what are people are doing in the current time, what time people can relax and rest and so on.  Sometimes, people will smile and laugh and sometimes the board can also burn anger and stress to people seeing the workload of the day. Depends. Life got so many colors. That's what life for.


All right..That's all for now.. Later we continue ya...

p/s: wanna enjoy every moments here even knowing disasters will come soon..=)...tomorrow got long list  of orthopaedic cases. So, lets study a bit, fiey. (even I am at Recovery Area for this week)

fiey ahmad

Thanks Allah for all of these and the future.

A new chapter of Life

Alhamdulillah again and again..

After almost 4 months having post-graduating syndrome, I finally be here in Ampang Puteri Specialist Hospital. 15th October 2010 was my first day after trip to Singapore was cancelled (due to our passports were nowhere, hahha).

Alhamdulillah again and again...

I am posted as Staff Nurse in General Operation Theathre (GOT). I just dont know whether it is good or not, what i know is it is in my list of favorite areas as I dont mind working in any areas, for me nursing has lots to learn, in any areas for sure. Not to say that I am the 'NURSE TEGAR', but to always remind myself, I love the knowledge in Nursing and Medical so much, driving me so much eager to explore them more within this unknown limited time. Lets enjoy it..

1st Day

It was not much different from the 1st day clinical posting in any setting. After finishing things with Human Resource, we were brought to meet and hear wonderful inspiring words from the Chief Nursing Officer (like Matron nih), Mdm. Jamilah then seperated away to our own Department.

Haaa, unsurprisingly, we (my new wardmate Zulaikha) were welcomed with a HOT FEW MINUTES..hihi, smiled and monologued, "this is only a small thing..You got to face more than this soon, so just relax, fiey" (successfully hiding the tremendously pounding heart beat).

We took the chance to look around the OT. Nice and well-arranged..Next time, I'll share more about that. Other than that, we get to know the staffs even it was like weirdy uncomfort feeling at first (normal la kan), to be optimistic,> it'll get better and better soon.

2nd day:

Saturday I'll work only for half day. So, 830-1230pm but still got operation running on that day and luckily, I can put myself in the OT room to witness a part of the Relaparatomy op for the post-surgery adhesion at intestinal area. That was so cool, and I did learn lots that day. K.Kam (one of the staff) taught us lots and did remind me to always have the gut and passion to learn. I need to get into deeper knowledge in anatomy in order to catch up the flow of the operation, then I'll know to move accordingly.

Thanks to my families for the outstanding supports and cooperation.Thanks to fellow friends for the advices.Thanks to teachers and everybody who bring me up with those good and bad things..And a very special thanks and Alhamdulillah to Allah the Most Merciful for these days

fiey ahmad

tomorrow at recovery room

p/s: to all fellow frens, try, come and join me here..May Allah bless us all

Perniagaan yang menguntungkan

Masa suatu perkara yang sulit dan rumit untuk dibincangkan bukan.. Nyatanya, masa itu hanyalah relatif kepada suatu perubahan waktu, dan setiap waktu yang berlalu itu takkan pernah dapat ditemui kembali walau sejauh manapun ciptaan manusia bermodalkan tingginya teknologi manusia. Ahh, tipu saja cerita-cerita khayalan manusia seperti Back to Future, dan bermacam cerita merentas masa yang lain, sama dongengnya dengan cerita Doraemon dan Nobita bersama mesin masanya. Mana mungkin kan manusia itu merentas masa ke belakang mahupun ke belakang. Namun semuanya tak mustahil bagi Allah, dan tak mustahil pastinya jika Allah mengkehendaki sedemikian rupa.


Isu masa terlalu kerap dibincangkan di mana-mana. SOLUSI terbaru juga mendiskusikan tentang perjalanan masa dan umur manusia. Betapa manusia itu dalam kerugian dengan membiarkan masa-masanya berlalu tanpa sebarang signifikan berlaku pada waktu itu..Keterbatasan masa kita umat Muhammad ini yang dianggarkan oleh Rasulullah hanya berkisar di sekitar 60-70 tahun, membuatkan setiap waktu yang kita ada hari ini adalah sangat berharga. Maka benarlah manusia itu dalam kerugian.

Perniagaan yang menguntungkan

"Wahai orang-orang yang beriman! sukakah kamu aku tunjukkan suatu perniagaan yang dapat menyelamatkan kamu daripada azab yang pedih? Yakni kamu beriman kepada Allah dan RasulNya serta berjihad di jalan Allah dengan harta dan jiwa kamu. Itulah yang lebih baik bagi kamu jika kamu mengetahuinya"


Surah as-Safff :10-11

Menanam pahala yang berterusan

Antara amalan yang dijanjikan Allah pahala yang mengalir berterusan tanpa terhijab dan terhenti ialah:

1. Sedekah Jariah: Sedekah yang dilakukan sebagai pemberian ikhlas lagi bermanfaat kepada yang menerima. Lakukanlah semampu mungkin dan kepada yang biasa memberi pasti pernah merasa betapa rezeki kita sentiasa murah dan ada jalan keluar jika bertemu kesulitan. Keluarkanlah walau 10sen untuk bersedekah kerana mungkin itu amalan yang paling diterima Allah saat kita ikhlas mengerjakannya, lalu menjadi amalan yang menyelamatkan kita daripada neraka.
2. Anak yang soleh:  sabda Rasulullah, "Sesungguhya Allah benar-benar akan meninggikan darjat seorang hamba yang soleh di Syurga. Hamba itu bertanya, "Wahai Tuhanku, bagaimana hal itu terjadi pada diriku?" Allah menjawab, "Dengan permohonan ampun anakmu atas dosa-dosamu". Oleh itu, untuk membuat pelaburan yang besat untuk di sana, memperoleh anak-anak yang soleh adalah antara tujuan hidup yang serba singkat ini..dan untuk mendapat anak-anak yang soleh, segalanya harus bermula daripada kita. BEUSAHaLAH untuk menjadi anak yang soleh daripada sekarang. Tindakan dan doa kita yang akan menterjemahkan matlamat kita.
3. Memanfaatkan ilmu: Ilmu terlalu banyak bezanya dengan harta. Malah jauh lebih bernilai daripada harta. Ilmu itu harta tak ternilai. Dan ingatlah sentiasa bahawa levejl pengajian diploma, degree, master atau phd tak pernah mengangkat darjat manusia itu di mata Tuhan selagi ilmu itu tak dimanfaatkan. Memanfaatkan ilmu itu adalah sejauh mana ilmu itu membentuk diri kita untuk memberi dan menabur budi pada umat dan masyarakat. Ilmu yang dikongsi adalah rantaian yagn takkan pernah putus dan senantiasa membuahkan cabang yang baru.
4. Berjihad: Perkataan jihad mungkin kedengaran janggal buat umat masa kini, malah merasakan ianya tdaik lagi relevan pada masa sekarang. Ketahuilah, kehidupan masa sekarang memerlukan jihad yagn lebih besar berbanding pada zaman Rasulullah, Sahabat dan tabiin. Jihad kini adalah jihad menentang segala bentuk kemungkaran termasuk apa yang ada dalam diri kita. Berimpilah untuk menjadi seorang mujahid, kerana semangat dan darah pejuang sentiasa berada tinggi pada nilaian Allah.

fiey ahmad

harus ingat dan mengingatkan

Convocation Day 3rd October 2010

 

IIUM: I grew with so much things in your wonderful garden of knowledge and virtue

Mak Ayah : You both deserve this honour I receive today..In fact, you are the people who strive to give me what I have today.

 

thanks for being there my loves..forever love

Enough with those pic first.

What I try to share here is, convocation is not that  sooo IMPORTANT, that everybody should aim for..Convocation is just a ceremony to celebrate the newly grads where speechs are delivered, everybody is in big huge robe with square mortar board on top of the head, processions entering the hall, presentation of degrees (which is a hard file with a pic coupon and a congratulation messages), pics and more pics are snapped, and of course, tears of joy and gratefulness to delight the event. Different people have different thought and feeling about this wonderful day, and we just need to respect each other rite.

 Frankly speaking, I did enjoy my day even I got nothing special to feel for my convo a day before. It will be just an usual normal formal ceremony, and again, it seems to be nothing for me. Feelingless. haha. Then, hectic moments started when, I attended the first session for a friend, then joined the volley team for two minutes only(serve the ball while stepping on the line & awien lol ), then my sister arrived at Duta, my two younger brothers stucked in Kuantan, misunderstanding that convo is at Kuantan, and my elder sister was on their way to KL that evening, and I was like 'hehhhh'...Where to sleep, what to do, how about mobile..Haha, then, alhamdulillah, Allah had give me way. Everything ran well even I slept only for 3hours that night to fetch my two brothers at 1.30 am and the other naughty one at 5.50am..We are just like COWBOY. What I wanna say here, I was so happy that day for the attendance of my beloved people even the most important two person in my life were not there, but I can feel their existence and love.

And I do realize, no matter what, family is the most presious thing in life. Flash back: I always dreamed of running away far far far away from this blood bond, yet, Allah loves me and makes me feel so blessed with this gift of siblings. Having wonderful and painful moments together. What else that can  make me refuse thanking HIM..What else.

And I have no doubt that my thankfulness wont never enough for everything He gifts to me. Too many, too precious, too priceless..

Right after the ceremony, I do remind and keep reminding myself, this is never the end of my study journey, it is just a beginning of contributing the people around me wether I am employed or jobless. Maybe IIUM emphasized on the employment achievement, but I do learn lessons beyond that throughout 6 years of studying. Happiness, sorrow, achievement, respect, give and take, friendship, family and so many to be mentioned. It is far beyond my expectations. Even IIUM gave me pain somtimes, the amazing moments for sure would not be forgotten.

University is a huge playground

Since I was a child, study is never my first priority. Never. And so in the university, I was not a study-oriented student or so-called full time student. For me, university is always my playground as I love to enjoy playing everything IIUM got. Sports, recreational activities like kayaking and climbing/hiking, anything adventurous seems to be temptatious for a 'playful' girl like me. Involving in programs and any academic and non-academic activities is also one big portion of my campus life. I know the fact that, we are so much different from each other, but here I just to share what I have been feeling about this and what it has brought into my life.

Participating in sports since matriculation center in PJ, mainly in netball has taught me lots about GAME. Life is a game. Sports teach me how to be a good teammate, how to be a good captain, to to respect to gain respect, how to appreciate and acknowledge good things and bad things about teammate, how to grow and maintain Ukhwwah how to manage anger and frustration when we were so down, how to communicate and to inspire our friends, how to be dependent and thankful to Allah and many more.

By joining programs, I learn how to contribute, how to speak, how to make a change by words and actions, how to picture the future to be ready for anything will happen, how to accept and adapt with people who has different style of thoughts, give and take, muhasabah myself when things didnt work, how to communicate with different levels and characters of human being and so on.

Precisely, I wanna highlight here, that I learned so much priceless things about life and how to get through life well through my non-academic activities which I rarely get in my classroom. Oh,now I am directly saying classroom doesnt emphasize on this life-value thingy but accomplishment in assignment and achievement in study and exam. Students are programmed to focus on how many As and CGPA to reach most of the time. Students are sometimes not allowed to be active and participative in non-academic activities as they think they would give negative effect to the student. Like we can see in the development of babies and child,  what would happend if we stop them from playing, prohibit them to do this to do that, at the end, they'll be like 'sayur lembik' that dont know how to survive alone. I dont know whats really real in their mind when people always see it some kind of doing wrong thing being active, but I always have faith that students who are actively involve in outside-class activities have the strenghs that can bring them live well in community soon. Believe me? If you dont, try it yourself then..=)

Dont stop this people who wanna be active, yet guide them, give them advice, lead them, shape their mind and character in good ways. This should be a part of education right. This is what I see have been missing in our education course during secondary school and it is worse during the university period. Again, different people different style. I have mine and other people have thier own. Respect will come in between. Hope so.

 

next: who am I? where am I? what I am?

Next is a give-away phase.

The field of area where contribution of what we have gained takes place. Start to give from now on, because we are running out of time. Our age is shortened by years, by day day, by hours and by seconds. Time is like wealth, there are Barakahs in every good thing we do with our age and so otherwise.It is not significant talking about number of age... yes, age incereasing in numbers, yet, the best to be highlighted is what we have done to our golden age. No matter where no matter what, no matter when, I'll strive to give the best I have..

Dont procrastinate, lets assume that there is no tomorrow for us.

" O Allah guide my step and dony let me go astray. You' re the only who can show m ethe way, the way full with your blessings"

fiey ahmad

try to improve my english..still learning, and ready to learn