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Saturday, October 24, 2009
Finally get to meet today...
But Fion and Maiyah wasn't around. hais..
miss them..
Hugs to e both of u..
had craby meal today. very full, yummy..
plan to go k on tue. Fion, u must join us hor..
life is unpredictable, pls cherish every moment
7:57 AM
Thursday, October 22, 2009
Today, is my 4th day of sch..
Has learnt abt a bit of sociology (i never like before), psycho, bio (chim), advance nr practise (counselling), bladder scanning and research (very boring)
Got a lot of assignment to write. mostly abt 1000-1500words. research got 1 individual assignment must write 3000 words. siao lo!!
attachment period also need to submit written assignment of 4000 words.
when the lecturer mentioned all this, the 1st person on mind is han.
she can help me to do grammar correction and editting.
2nd person : Fiona (to give me idea on wad to write)
kk..
i got one ICA presentation coming.. in week 6.
5 more weeks to go..
it's abt counselling. any counselling scenario (10 mins)
need to do recording..
i have chosen who to help me.
Han: my counselle
Fion: the recorder (to make me look good at all time)
Jas: help in my script like wad i shld say
zihui, chengxia: supporter
haha.. haha....
u guys got to help me....
these few days, i go home straight away after i finished my class.
i thought on how we used to dine together post work, lying around on the tearoom's sofa.
so much to complain post work.
we got endless things to talk....
miss all these very much....
hope u guys are doin fine in the ward. noone bully u guys..
i miss work place and the chronic pts.
miss guma's laughter and e connection, zihui's softness and care, fiona's bird face and seriousness, han's laughter and jokes , jas's voice, ahbu's care, ah ji's fierceness and "ahbu"
not forgetting shenhui: "where's e imr? meds given!" (joking..) i miss u saying hello to me..
cant wait for saturday to come..
miss u guys very very much.
life is unpredictable, pls cherish every moment
2:57 AM
Monday, October 19, 2009
I am updating bcos someone is reading..
Learned abt roles of uro-nephro nurse:
to teach / share ur knowledge with ur junior staffs
act as an advocator (speak on behalf of pt)
act as a counsellor, resourcer
clinical nurse
leading and managerical roles
advanced practise nurse
almost wad i am doing now.. so role as a nurse it's still e same as before
1st speaker : Dr Tan seng hoe - gleneagles
covered on complication of UTI
dun look down at simple diagnosis like UTI
when u have a male pt, having a UTI, it is a serious matter and has to be investigated further.
as male pt's anatomical structure unlikely to cause UTI (long urethra)
collection of mid-stream urine:
should wash perineal area
ask ur pt to pass first bit of urine (do not collect)
pt continue to pass, nurse then collect the urine.
this is e correct way of getting specimen
not to ask pt to pass abit then hold (this is not a mid stream urine)
when DR look at FEME result EC (+) means the sample taken isnot from midstream
this is when DR starts to ask to repeat FEME and write in treatment order (midstream, clean catch)
gram stain test is done by putting dye into the sample and look at the type of bacteria growth.
can be gram (+) and gram (-)
however while waiting for result to come back, one shld start with an antibiotic tt covers pseudomonas bacteria as well. (as pseudomonas bacteria complicates UTI)
he is good, but his voice is too soft.
2nd speaker: Dr Ng Tsun Gun
covered on Acute renal failure in adults and elderly
divided into 3 phases:
pre renal
interstitial renal
post renal
we need to pick up and correct at early stage , otherwise pt will collapse (fatal)
once pt is dehydrated, shld start aggressive fld challenge and put pt on at least 2-3L of drip
once pt is dehydrated, shld start aggressive fld challenge and put pt on at least 2-3L of drip
monitor output at the same time.
if u r giving 4L drip and pt is passing 4L of urine, we shld increase further fluids (+ another 500-800mls, to compensate for water lost)
need to check daily u/e/cr to look at Cr level and K+.
biopsy when need to identify exact cause of ARF
when Dr asked to add test for mg, PO4, Ca is to look for metabolic acidosis, hypercalcemia, hyperphosphatemia..
we will dialyse pt if pt doesnt respond to resonium, calcium+insulin (for hyperK+)
NDAIDs like ponstan, synflex, etc causes ARF (we need to closely monitor pt esp elderly who are on NSAIDs, they r more fragile)
learnt a lot from him. best speaker. very clear and loud enough.
3rd speaker - Prof. Chan from NUH
covered on diabetes nephropathy
he is supposed to talk more abt diabetes, instead he keep emphasizing on treating hypt.
treating hypt improves the pt's mortality rate by almost 50%
dialysis pt still can conceive, however, to take into consideration tt pt will lose certain kidney's function, baby maybe premature, etc
anyone ever thought abt those on CAPD getting pregnant?
on top of carrying baby, u are carrying fluids at the same time..
i tink the 3rd speaker not touching the topic well.. but he is the HOD of renal meds dept in NUH
it was a long day..
pre-course test was quite difficult. anyway, it's not considered as ICA marks.
missing the rest vy much..
happy to receive jiayou msg from Zihui, Caiji and Rita.
i got to love the kidney anatomy..
life is unpredictable, pls cherish every moment
5:54 AM
Sunday, October 18, 2009
Shin is officially a student now......
9b, temporary goodbye to all of u..
U guys got to wait for me ya.. i will come back. we will work as a team again. i will miss u guys very much. wont forget u guys de..
i will study hard, work hard and meet u guys "hard". haha..
must meet up k.
each day, i will count down to 10/06/2010
missing ahbu very much.
so sweet of her to call me, telling me tt she wasn't around on my last day. wans me to come back to 9b. visit her when i am free..
thanks ahbu for appreciating and value-ing me.
thanks fion ke for the art piece. u rock!! i like it.
han, take care
jasmine, dun be too fierce ya.. miss u
wx: all e best
rita: hello, i am now in the same sch as u. wahaha..
big sis: thanks! great sis
take care everyone.. update me regularly hor.
jia you..
all the best for ur degree to come.
life is unpredictable, pls cherish every moment
6:46 AM
Tuesday, October 13, 2009
i am a human...............................
arh.......... arh................................
i wan to cry
life is unpredictable, pls cherish every moment
8:11 AM
Friday, October 9, 2009
went to nyp today..
the feelin was like the first day i joined in diploma course..
it was 2 yrs ago since i last stepped into nyp.
i was nervous, and excited at the same time.
my class consists of 30 ppls
for the past 2 yrs for nephro-uro (it only consists of 15)
i tot i gonna have half of the class (aunties and uncles)
haha..i very bad..
no la. actually,i tot dialysis centre will send quite a no.of their staffs for the course..
the course takes 8mths to complete.
starting from 19/10/2009 till 10/06/2010
i only have 1 wk of break for the whole 8 mths
i am in charge of photocopying materials..
on the 1st day of sch, Dr Tan Seng Hoe and Ng Tsun Gun goin to give a lecture.. yay!!
on my 2nd wk, there will be field visit.
uniform need to be ready by then.
i am starting to be scared. scared tt it will be tough..
but i MUST be able to do it.
yest i told maiyah tt i want her to be there during my graduation..
gals, i need to see u girls there on my grad's day
i am gg to count down.
ahbu i will miss u too..
i will jia you de..
i will join u guys again as a team player
life is unpredictable, pls cherish every moment
7:47 AM
