Elective Posting: Day 09

Today morning I tried to set up a line in a asthmatic patient , but I failed go put the branula on both sides of the hand. The first one failed because I forcefully insert the branula into the vein, so I can't flush the heparin through it. After take out the branula, the HO found out that the branula is bent >.<. For the second one I didn't manage to push the whole branula in, and when I took the branula out there is resistant when taking out, and it bleeds much after the branula was removed. This time the patient was really not happy about it. The third time the HO put the branula, initially there is also resistant when she was tryin to flush the heparin, but after tilting the hand a bit she managed to flush it. Kind of sad because the veins were so prominent and I was given two chances, yet I failed, patient felt very unhappy, and I gave that HO so much troubles. But surprisingly in the afternoon before I left the hospital that HO told me that she need to reinsert the branula because the insertion site of the branula was swollen. I wonder whether I was not skillful enough, or something wrong with the patient's veins? Hmm...... 

Today I also has chance to do PR (per rectum, i.e. digital rectal examination) to palpate the prostate gland, because this patient has liver metastatic disease and prostate cancer need to be rule out by checking serum PSA and doing PR. The HO that taught me to do PR also taught me how to do BFMP (blood film for malarial parasite). A thick blood film and thin blood film need to be done. Today only I knew that this HO graduated from Ukraine. Suddenly felt very...... don't know how to describe it , is like meeting a fellow friend in a foreign country. Anyway glad to meet this HO. 

Those who did practical in medical ward must had follow a round ward with specialist or consultant. But have you seen a grandround ward? Today I saw my gastro consultant came with his MO in the afternoon, but there were many other gastro specialists and MOs came with them. They are known as the 'Gastro Team'. Very surprise to see so many doctors from other department came together to see some patients.  Even the specialists in my ward saw them, raised up their hands a bit, and said, "Hi boss" o_O. I wonder how many does it takes to reach their position. 

I attended the CME of medical department twice, I felt very disappointed. The way they present their case and topic is like...... reading the slide. You don't  need MD or MBBS to read the slide. Even some of my seniors can present better than them. Maybe I think I expected too much from their CME. But their HO teachings are quite good. There is a teaching about insulin treatment tomorrow, I hope medical student can attend also.