Wednesday, September 22, 2010

First day in O&G (21st September 2010)

-Came early (appear in ward) 5 minutes before 7.00am. Is this early enough? Just nice, still can be improve.

-Kenanga 4 , multidiscipline under obstetric and gynaecology department, (postnatal and antenatal care). I, Nazihah and Shadia still in the same group, and same timetable. 7am until 2pm for Tuesday and Wednesday.

-8am finished passing report. We’ve being orientate by SN Rusmina Abdullah, friendly called mama because of her very particular, well done job and shouting to teach and rectify our mistakes. Before going to ward, i’ve been informed by senior that this ward is quite messy with student, and containing of SN that seems like to be anti-student. Therefore, I did reverse psychology to my mindset that i will change the situation and make sense of myself with all of them. Alhamdulillah, I realized that information given was not that accurate, but it helps a lot. It just a matter of attitude and a matter of how we see the things. I take it as normal and good for my future career and life, insyaALLAH.

- 8am learned about POG (period of gestation). Taught by community student nurses how to get the POG or POA (period of amenorrhea) just the same things as told by Sr. Hong. 1st step; Take the balance of the day for the month (any day, eg; today, 22nd September 2010) which means 6 days. Plus 6 days with day of the EDD (estimated due date) eg; 20th October 2010 which means 6+20=26days.

-26days substract with 7 got 3 weeks and balance of 5 days. (the formula (substract with 7) is like this, i still wonder why and how they got this formula).

-3 weeks and 5 days minus the 39 weeks and 7 days, so we got 36 weeks and 2 days. So, the POG of the fetal is 36 weeks and 2 days equivalent with approximately 9 months. Fuhh, seems like difficult, but actuallt it’s too easy. It just a matter of balance plus EDD days, substract with 7 and the result minus the 39 weeks and 7 days.

-9am try to hear the fetal heart rate using peanut device. Can hear, but very slow...not clear. The lesson is, hear more, practice more, make use with knowledge and practical.

-Sr. Hong came and teach us some terminologies. Some of it we already know, just keep hiding in the pile of notes we seldomly open and read, make us forget and feel alien with the words.. Hu. Some of the words is; APH (anti partum haemorrhage), LPOL (latent phase of labour), CPD (cephalo pelvic dysproportion), ARM (artificial rupture membrane), IUGR (intrauterine growth retention).

-Also some revision about physical examination to the patient. Start as usual with greet the patient, introduce myself, make me and patient comfort (change the bed height if needed), explain procedure and ask permission from patient and secure privacy.

-Actually, should do head to toe examination before doing this physical assessment for getting the probable and positive sign of pregnancy.

-Then, start observing the patient in term of existence of striae gravidarum, stretch pigmentation, linear nigra (in line of the mother tummy from the symphisis pubis up to sifis sternum), look for any scar if any history of scissorian or abdominal surgery. Then look for the abdominal shape. It is whether oval shape, rounded or pendulus (sagging-like).

-Ah, I got the right definition for lie in term of medical term. It’s sounds funny when I said that lie is ‘baring’. Sr. Hong kindly rectify and give the correct definition which is “lie is the axis of the baby’s spine against the spine of the mother.” Both spine should be accordingly lie.

- ah, next do the palpation on the stomach to know the 1) Fundal height 2) Fetal part and 3)Baby presentation (whether it was head or buttock. If head, we can feel a little bit hard and it is ballotable. If it was buttock, it will be soft). Reminder! Don’t go to palpate the private part. Just ask the patient whether she got any varicose vein, discharge or any bleeding.

-I need to stop here guyz. It’s already late. A lot of thing I need to study for tomorrow, prepare for another three assignments to be submit, and my coming final exam next month. Uh, lastly. Keep writing for your goodness. *Sometimes I hate to write because once I start I can’t stop until 2-3 hours. Hu. Planning for simple and shortnote about 200-300 words, but now already blubbing near to 800 words. bed + sleeping bag. Nite!

-In the Name of Allah, I live and I die-

*** Correct me if any wrong concept or terms used. Love all!

777, Mohd Nuruddin Mohamed,
Seberang Temerloh Park,
1.30am 22nd September 2010,
13th Syawal 1431.

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