Wednesday, February 21, 2007

The week : the one with Music and Lyrics plus reading week.

A week has just started after the 2nd semester reading week "break". It was terribly dreadful having not doing anything during the break. But I had the chance of getting myself back into work last week, finally!

Tuesday (reading week), went to meet up Ka Fizah for a movie catching up. We watched Music & Lyrics. It was her call and she paid my ticket. In return I just share my LARGE popcorn. I didn't know the large one was that L A R G E. Imagine the mall popcorn.. 3 times more than that. Little did I know, Fizah doesn't really eat popcorn. GREAT! awahaha. Neither do I. But impressively, walaupun inda nyaman, managed to finish up around 90% of it. Kenyang kembung perut makan popcorn.

Last week - We have just started our inter-professional issues. The unique thing about this is that it's a new approach as to create awareness what each profession does and nurturing multidisciplinary teamwork. It comprises of Podiatrists, Physiotherapists, Nurses, Midwives and some other health care professionals working in a team of smaller group. My group consists of a pod (myself), 2 nurses and 2 other physios one of which I already know before hand.

The challenge is really on how good we can communicate things diplomatically across the professions, and how effective care can be delivered to a patient. We will also see the overlapping of interventions and will be anticipating more other challenges as well. At the beginning, the nurses in my team were more of a follower than being a contributor. I dont know why. They looked kind of intimidated but I was just assuming. It reminds me of my batch and I when we were nursing students back then. So I initiated many things during a discussion.

We had to bring up some idea on presentation which our assessment will be based on. The assessment should show the interdisciplinary approach. No one could come up with better idea since the physios are just looking things from their perspective, whilst the nurses they admit when I said "should be no problem for you guys cos nurses will be doing basically anything and everything." They just noded their heads to agree.

Looking at myself coming from 2 backgrounds and with some experience, I regurgitated my ideas. Those experience I had managed to make me seeing things in a bigger perspective. The nurses were thinking of doing something on legislation and ethics, whilst the physio were looking at infection control and MRSA since they had an assignment on that. Looking at those decisions, I thought, those are so overlapping and not much could be discussed to differentiate and relate between professions. I suggested, why not we integrate everything through a case study? Brilliant huh? ahahha

I thought of this
"... a diabetic patient who has necrotic lower limb who is non-ambulatory and confined to bed to several months in a ward. She is scheduled for below knee amputation."

Looking at that simple scenario, it involves many people. Still up to that point they were not quite clear. So I broke it down further for them to digest the bits.

Since patient is non-ambulant and confined to bed, she will developed scondary problems such as chest and lung accummulation of fluids etc. So one of the physios could be dealing with chest and respiratory therapy. Reaction: "oh yeah.. I didn't think of that!" says one of them.

Physio two would be dealing with the obvious physical rehabilitation following below knee amputation and regain back patient's normal activities of living, physiologically.

Nurses: obviously, the care giver in the ward delivering that holistic care approach, from medical regime, daily care, and other intervestion as necessary.

Yours truly the pod will obviously will deal the invasive surgery during below knee amputation surgery, the follow up care, and necessary podiatric treatment that should be carried out forsuch case.

Would be interesting if we had occupational therapist with us as well. Too bad we got none. Nevertheless, that was quick. Impressive! One of them aksed how I managed to come up with all those. So I had to say it out telling them I'm a Regitered Nurse. Both nurses looked at me and posed a huge smile!! Whaha. Then onwards they loosen up a little and we talked more knowing each other better. Finally she said "will look forward to work with you." HEHhehe. Great isn't it??

Clinical today:

Was a great day today. Had more independence in treating patient more thann ever. It's about time now lecturers are almost invisible for our sight. We work as independent as possible with guidance from a year 3. However, the lecturers were still around if needed, it's just the numbers were cut down. Before we had one lecturer in for every 4 students. Now we've had 2 lecturers for 18 students!! Plus a yr3 for every 4 or 6 students.

I had typical patient but who had macular degeneration causing her partially blind. Hence, the podiatric intervention.

I must say I'm getting good with my body posture, communication skills as well as confidence. I was not even nervous at all!!! I was in control!! Hahaha. That was super cool!! I carried out my own assessments, debridement and scalpel handling plus note writing. That was like 70% from my effort. Cool! Biggest bit was of course being so confident. I must say thanx to my almost 4 years nursing experience!!!!!

Patient: you are so gentle that I couldnt even feel anything when you did all those. (her nerves were very good on assessment, that means she had a very good touch and feel sensory. Could easily feel any pain. But I was happily scrapping her debris and skin cells. I'm happy.
Lecturer: one of them asked a colleague of mine who wrote the notes. Colleague mentioned it was me. Why? She was quite impressed with it and she said it was very good. Oh well, to early to be happy. But I;m glad. We're all still learning!! hehe.


  • Start data collection for research.
  • Start up on initial write up for Cardiovascular assessment.
  • Look up on clinical portfolio see which bits can be started off soon.
  • More reading!!!!! Especially on assessment and clinical diagnoses.
  • Off to London in 2 days time... (meeting up Eda, Rahey and Hairol insya-Allah)
  • Off to France with coursemates in March.

Saturday, February 10, 2007

New Semester new Work Load.

As expected this semester will be more busy.

  1. Field research on the effects of exercise to the cardiovascular system. My group has decided to carry out the effects of "Harvard Step Test" to the cardiovascular looking at effects on pulses, blood pressure and respiratory activities pre and post 2mins exercise on the steps.
  2. A project write up which is a individual writing on the above research.
  3. Clinical portfolio of 5000 - 6000 words on clinical activities. From physical assessment and clinical reflections. (more crtical thinking than the previous 6000 words portfolio we had before)
  4. I will be doing more shadowing with Yr 2 and Yr 3 Clinical rota and I will have to critique their clinical skills in writing.
  5. More to come!!!!!
Sometimes I do not know why have I committed myself to a more complicated and heavier subject! ahahha. But no regrets so far! I've committed and steered myself towards a better position Insya-Allah.


Last night we had a blackout for an hour. SO I just went to sleep. It was damn cold as the heather was cut off as well.

Oh btw! I found more asians shops around! Whahaha. I found udang karing for £3.50 a pack of 200gms! ahaha.


The day I got a hair cut and I cut my patient!

It's my first day of clinicals for the semester. (06th Feb 2007).

I was paired with another colleague of mine. This time we were already treating patients on our own and supervised from a far by lecturers. This is to get us to work autonomously from now onwards. Lemme share...

Disclaimer: the case study below has no mention of names of any particular person(s). I hope the information below will not be violated. It's part of my learning and reflection too. Thanks.

Case Load:
      • 81 year old female referred by her GP for Diabetic Podiatric care at Leaf for many years now.
      • Socially, an active lady who enjoys swimming at the university’s sports centre’s swimming pool.
      • Had history of trauma due to motor vehicle accident and had surgery on the ankle of R/F done in Portugal. So far no complaints after surgery.
      • Medical History Background:
        • Diabetes Type II – NIDDM with diet and exercise control only.
        • Hypertension treated with several anti-hypertensives including Aspirin. BP reading on the previous month was 130/80 mmHg (normal high reading for hypertensives).
        • Allergic to Penicillin.
      • Clinical Note:
        • S – I cut and file my nails but with difficulty as it’s hard for me to bend down and reach my feet. I only file my foot soles to smoothen up the hard skin. I noticed my skin on both legs are dry which I applied some moisturises every now and then. I also use foot spray.
        • O – O/E, skin integrity feels warm with pinkish colour and dry skin. Pulses (DP and PTP palpable). Feet are not symmetrical, R/F presents with hallux valgus with little discomfort when wearing appropriate footwear. On the plantar aspects of both feet, callouses mainly present at the head of 1st and 5th Met. head of B/F. Nails are short with evidence of poor cutting.
        • A – Nails cut and filed with blacks file and diamond deb style files on B/F. Debris removed from sulci with help of Hydrogen Peroxide. L/F 5th toe bled during cutting – patient informed. Wound cleaned with irrecleans spray and applied sterile melolin and tubigauze. Callous debrided on BF.
        • P – Advised pt to keep dressing intact for 24 hours and to contact the hospital if problem arises. Advised to apply moisturiser for dry skins on both legs. To see again in 11-13/52.
Yes! I cut my patient. Well it's not really bad, cos everyone will actually experience. It's just like going to the dentist having your mouth for scaling. Surely your gums will bleed isn't it? Besides, my patient was comfortable and happy. She assured me it was alright. However, it was my first time and really got upset by that. I however did not show how panic I was. Thanx to my nursing experience by which I experienced more bad happenings than that. But it's just that legislation wise made me nervous, worse than I had experienced in Brunei!!

Oh well, it was a learning processs. But on a positive note, my scalpel handling and skills were excellent. The lecturer was pleased that the job done was even better than a Yr3 could do.

That ain't stop me from going forward!

Following that, I was feeling soo much in my chest that I had to do something. Headed town and I was soo irritated by my long hair looking so "gorilla-ish". Went to Buzz and made an appointment. An hour later got my hair cut! ehehe.

So tada! will intro you to the new me alright!

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Aberdeen trip - The one with emergency landing.

Had a proper week break during the assessment forthnight. I decided to go to Aberdeen. Last minute decision but not regretted. It was after my final semester exams.

On the way to Aberdeen, it was an evening flight, days before the BA crews decided to carry out strike. Gatwick was empty than ever. Had a quick chat with this check in counter guy. He's a Palestinian and have been working in the UK for quite long. We had a chat about Brunei and he had a thorough reading on my passport. It was interesting to hear stories from people who works in the airline... ehhe. True enough, he predicted that the proposed week long strike was called off.

Flight to Aberdeen, first it was delayed. We were welcomed in the plane as usual but this time, a female captain. Fascinated and excited to experience a woman flying me from point A to B. She sounded so excited as well. A full flight and her announcement was long!! Yes, but more of like being in a concert show or sumthing! hehe.

20mins after taking off from Gatwick, another announcement came saying problem with the aircraft's wheel. So engineers at Gatwick summoned her to bring and land the aircraft back. We had fire engines, ambulance and police cars, sirens everywhere behind us soon as we landed. Good thing was that, I must applause the care taken by the crews that night. Especially the purser she made sure individually onboard was alright and not panicked.

Landed safely in Gatwick, disembarked and waited for half an hour. We got onto a new plane and flew off safely to Aberdeen. Suprisingly it was warm around 9deg on landing. Overall, it was about 2 hours delayed arrival.


Aberdeen was great as ever before and even better. Josh is full of character now and balamory song is still tinggling in my ears! Hahhaa. I can see a bright future in that kid already. For a week in Aberdeen was a bliss and blessed. I had a good time with the family, good foods and good time cooking definitely. Meeting their friends as usual was never a boring one. We had karaoke night before I left.

I also got the chance to meet up with our x-neoghbour back in Brunei, Nicola. Was so pleasant to meet her again and the two kids. I didn get to touch any of them. I was so scared of the chickenpox (varicella zoster).

The highlight was of course tennis, golf etc on wii! ahaha. Will look forward I guess to a next wii game!

All and all, great one, really appreciated it and definitely needed it. Thanx!