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:
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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!!!!!

Comments:
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.

Regards!!


Plans:
  • 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.

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