Some thoughts on practical skills I practised during SIP:
1) IV plug setting
- I practised this many times in A&E, anaesthesia, medicine SIP and now surgery SIP
- how I do it now:
- I get the IV plug set from the nursing counter - checking that the blue plug and all the necessities are intact
- I apply the tourniquet to the patient's hand, checking there are no contraindications to plug setting/ blood taking eg. mastectomy, AV fistulas
- I look and feel for veins at the usual sites eg. the houseman's vein
- I poke the patient (after cleaning the site of course)
Somehow I am not always successful, and I may end up poking a second or third time :(
2) Drain removal
- First time I did this is actually in medicine SIP (chest tube removal)
- I am somewhat new to this procedure, having performed it only 5 times to date
- Today I learnt a few lessons:
- One - use chlorhexidine for dirty wounds and normal saline for clean wounds
- Two - use normal saline after you have used chlorhexidine
- Three - watch out for those metal instruments! they are very expensive and are a headache if lost (thank god for nurses who count the instruments after I use them)
- Four - always clean up after yourself (the nurses will be very grateful). even better if you can assist them in cleaning up and applying a fresh layer of dressing
3) Time management
- Haven't really practised this much, because much of the stuff I do is delegated to me by HOs (and this is only a tiny fraction of what they do)
- See the sick patients first! Then do all the rest later.
- Try to finish all the changes on CPOE during the morning round, then do all the blue letters/ calls etc.
- AIC can be a headache.
- Try to get help if overwhelmed?
4) Knowing thy patients
- doing/ reading discharge summaries can be a good way to know the patient quickly
- but the best way to know thy patient is to clerk him/ spend one hour setting a difficult plug on him
- unfortunately sometimes there are a lot of patients, and it still takes time for me to put the face on the name....
5) Making referrals
- See above
6) Buying drinks after morning rounds
- get the money from whoever's treating
- take the orders
- buy the drinks
- try not to keep the change.
7) Having fun
- try not to think I will be a HO in 6 months time
- eat waffles and roti prata for breakfast every day.
- sleep every day if possible
- study for MBBS if possible
- go out during weekends while I still can - heh!
NB: Please note that the above is a concoction of fiction and half truths. Believe it at your own peril.
