Familliar Ground: Delusioned Menace

It seems that I always around when the security guards are activate to assist in handling difficult patients. This time, we got an alcoholic came in for seizure. During his first day of admission, he seems rather fine to me. Other than having an unsteady gait and sleepy for most of the day. We did not get any trouble from him.

As the days gone by, he became delirious. On the second day of his stay, he threatened one of the staff. Using the IV spikes from his drip, he told her not to touch her, or else. During the weekend, he absconded from the ward. He was found by a passer-by somewhere within the hospital's premise, asking around where he was. To prevent any injury to the staff and himself, a body restraint was order by the doctor to be worn on him.

During my shift, he would ask anyone for cigarettes. He would also find all sorts of excuses to get out of the bed and body restraints, be it logical or down right senseless. Once, while I'm attending to the patient opposite of him, he beckon me over.

'Hey... There's something at my hands...' he slurred.

'There isn't anything there, sir,' I replied, knowing he's up to his old trick again.

'No... There is... Take it off from me...' he said, while struggling with the restraint.

'What did you see?' I asked, patience slowing draining from my body.

'I cannot see la! Take it off...'

'Then how would you know something is AT for hands?' trying to sound as calm as possible.

Sometime I wonder whether he is really delusion, playing punk or acting. Towards the evening, a physiotherapist came to assess his walking ability. After the assessment, he refused to return to his bed. I went over the help coaxing him back, but without success. At one moment, he demand to see the the doctor. Then the other, he wanted to get out of the ward to smoke. After a while the ITE student came to aid. However, the patient stands his ground. This time, he wants to call the police. The CISCO security guards were activated. When they were on their way. The delirious guy turned to me and said, 'I don't want to talk to you. I don't want to talk to my enemies.'

'Now I'm your enemy?' said, feel a bit amused.

'Yes, you are my enemy.'

'Why is that so?'

'Because the sky is high.'

'Because the sky is high...' I repeat after him, perplexed by his reply.

Once the guards arrived, he demanded to go to the toilet to pass motion. Along the way, he again asked for cigarettes. In the toilet, he kept asking for a smoke despite the guards warn him that smoking is not allow within the hospital premise. Not getting what he wanted, he tried to threaten us that if he can't get to smoke, he'll beat us up. One of the guards counted the number of people in the toilet (six of us by now) to him and challenged him to try it.


Finally he gave in the went on doing his business. It took him more than half an hour to finish and he slowly fumble with the toilet paper. The guards who ran out of patience ordered him to quicken whatever he was doing and get back to the ward. The whole incident last for almost an hour. What make use most frustrated was that he choose the busiest period of the day, where medication needed to dispense, parameter to be taken and dinner to be serve.


Later the security guards told us that we're the well known ward for this kind of situation. Almost every week they're activated to come to this ward. Well, now at least you wouldn't be running out of job, I thought to myself.

Familiar Ground

For the past three weeks (plus one additional weeks before exams. I consider it a 'refresher course' week), I was posted back to the same C class ward that I've been during my year one, semester two.

For more information on my previous experience there, please click here, here and here.

One thing's for sure, working there is like a love-hate relationship. Love it because there will not be short of things and opportunity to do and perform. Hate it because of the exact same reason for loving it: I can never finish my work. Still, working there has been fruitful and enjoyable for the most part.

This time round, I'm no more the headless chicken I've use to be. Of course, I still have to run around the ward to find the one-and-only pulse oxymeter. Most of the staff there are still as friendly as ever and I'm able to adapt the ward routine easier and faster. Although I'm unassigned to a different room, I'm still able work with one of the cute staff nurses from my previous attachment there. But then again, there are more cute nurses in the ward now.

Hahaha...

For the first 2 weeks, I have a 'Shadow' following me and the other Nursing Student around the room. You might ask why do I quote this person as a 'Shadow'. That's because she follow us around but do nothing significant and speak little for most of the time. Though she relates to the patient quite well, she makes bare minimal communication with the staff and students.

From time to time, I'll see her either flipping through the case notes and the clinical charts, or stand beside someone whose doing a procedure. She's like some inspector or manager who was posted to the ward to either spy or keep an eye on us. Once, one of my classmate came over to mt room to look for some stuff. The first thing he said to me was 'what is she doing? Posing ar?'

Maybe she trying to redefine the meaning of 'Contact Precaution'.

There was one time when I'm helping out serving medication with a Staff Nurse, she just stood there and observe. So I turn to her and ask, 'Have you learn to serve medication in school'

'Y-Yes.' She replied, sounded a bit startled.

'So do you want to give it a try?' I offered.

'..........'

I give her some time to consider it. However, the next time I turn back to her, she was gone.

She went for break.

I wonder why she bother to join nursing.

That's all for now. Maybe I'll write more when I got the mood.

Ciao.

Damo's Twenty First Birthday

They say a picture speaks a thousand words. So let this collage do the talking.

Oh by the way, today is his actual birthday. So Happy Birthday and Happy Lunar New Year to you Brudder!

Farewell

Today, I've lost a friend to a car accident.

The news came to me as a shocker as he's only 18 years old. Even until this moment, part of me still can't accept the fact that he left us for good.

After my BCLS theory test, me and few of the NYPCO members took a cab to the Mandai crematorium to bid him farewell for the last time. The ritual was simple. After some chanting from a monk, everyone walked pass his coffin and then he will be cremated. There will be no funeral. The sad reality hits me suddenly as I walked him while holding back my tears.

He has really left us.

The scene at the viewing hall was heartbreaking. His mother weeped endlessly, while calling her son to come back home and not to go into the flame. By now, I could no longer stop my tears from rolling. His ashes will be scatter into the sea. His mother told me that he is still young and had not see the world enough. This way, she hope that he will be able to go anywhere he wants in his afterlife.

We return to school after the ceremony and gathered in the practice room. Mike gave a speech after 3 minutes of silence for our dear friend. He too had been devastated by this unfortunate event.

Though I'm not close to him, both of us will at least say hi-bye. At times, I'll tease him when the chance present. He's a cheerful chap. As what I can observed, he always brings happiness to those around him. Ever so energetic, so cheerful.

So full of life.

We have not only lost a good friend, but also a talented musician. What infuriates me is that he have to pay the price for someone else's mistake. However, what was done cannot be undone. We could only pray for him and his family members.

Farewell David. You will always be the member of NYPCO and EVCO. You will always be with us in our hearts.

May your soul find peace.

Reunion

Today I had my dinner with Meow, Stuckup and a friend that I haven't seen for at least 5 to 7 years: Bel. The last time I remember talking to her is during my 1st year in NYP. One day, I accidentally dialed her number and we chatted for a while. It's quite an awkward for me as I don't really know what to say. We haven't been in contact for a long time then. After that conversation, we didn't contact each other until I started Facebook-ing. I found her through Stuckup's profile and we've been sending messages to since then.

It feels great to see her once again after so long.

After our dinner at the Soup Restaurant (I called it the high class 'Zhi Cha'), we went to Hagen Das to chill out and do some catching up. Talking to her brings back some fond memories during my time in TP... After some many years, she still looks the same. Which is a good thing, meaning she still looks young.

Hahaha...

And here my 1st collage for the year 2008!

Gone fishing...

Posting, Over and Out.

Horray! I've survived another attachment!

*give a pat to on my shoulder by myself*

As messy as the ward may be, I’m glad that the staffs in the ward are approachable and helpful. Amongst their hectic work load, they still answer my questions and let me do some minor procedure such as, NGT feeding and oxygen therapy. Many Staff Nurses in the ward are fresh new grads. So most of them are also need to be assess by more senior staffs. I guess graduation is just the beginning of all things to come...

Other than us, NYP students, there's the ITE students as well. Many Peeps have an impression that ITE students are composed of delinquents, but I dare to differ. These group of nursing students are diligent and know their stuff well. Some know more 'bout basic care than me. And they don't look like the Ah Beng, Ah Lian we see in the streets. I feel fortunate to be able to work with them.

ITE does not means 'It's The End'.

I agrees with what KY said: ITE means 'It's The Enlightenment'.

Of course, there's exceptions (read here and here for NYP's) from both institutions.

One of the ITE guy can communicate with most of the patients well, but he seems quite lost when it comes to the ward's routine. Though he does help out in the ward, but only when being asked to. Sometimes things were either done half way or never at all. In my opinion, he's either real forgetful (I thought I'm the worst), or he's just lazy.

Since the first day of the posting, AZ and the other ITE guys have been eyeing one of the NYP year one student. They complain that I didn't have time to chit-chat with them because I've been busy taking care of her. Sure, I've been helping her, but I too busy attending to my patients' needs most of the time. And when GF was there for the second half of our posting, AZ again complain that I only hang around the student bay when she came.

That, I don't deny. Hahaha...

The patients in my room are not as difficult to handle as the other previous posting. Many of them are under palliative care. On my first day, I talked to a Indian patient in my room. He seems friendly and well orientated to his surroundings. So I thought, well, this should be an easy case to handle.

Man, how wrong could I've been.

Few days down the road, he keeps absconding from the ward. He gets violent, especially towards female staffs, when ever we try to stop him from leaving the ward or his requests were not done promptly. Even his female kin not spared from his wrath. There was once he even reach his home and demand to be let in. Eventually, he was brought back to the ward by one of his son.

This time round, I've got a strict CI. Though stern at times, she do helps us to look out for procedures to be performed. She explains in detail the rationales of the procedures and share she experiences with us. During a wound dressing procedure, I took a very long time to prepare all the equipment.

As I have not done this procedure for around half a year, I fumbled here and there. Half way through, she took over as I’ve broke sterility and the patient begins to get impatient. As expected, I got a lecture from her, but she gave me a second chance. This time round, I’m more composed and I managed to complete the procedure under her guidance.

Friday was our last day, and also our busiest. As it's the last day of weekday (TGIF!), AZ's room experienced the 'Kampong Phenomenon '. One of his patient had the whole family and relatives visiting him. Thus, the place it's cramped with adults. Kids are running around the ward like it's there own backyard. Once, I almost banged into one of them while carrying a urinal.

Sometimes I feel like telling them,'Oei boy! You think your grandfather own the hospital ar!? Run here run there like nobody business. Smack you backside then you know! And you all! Think what? Zoo here ar? Bring your whole family on a tour and picnic ar? The room very small leh! You think only you all visiting ar? Got other patient's relative also leh. Be more considerate and take turn to come into the room, 2 to 3 people at a time lah. '

Of course, I didn't say all that to them. Heck, I'm too busy with other stuff to even talk to them!

After our shift, I bid farewell the patient and thanked the Staffs for their guidance. Before I finally left the ward, I transfered one of patient back to his bed for the last time. After making him comfortable. He took my hand and squeezes tightly.

'Thanks for your care in the past two weeks.' He said.

'There's no need to thank me. It's my duty to care for patients. Anyway, hope we will meet again. But I'll meet you outside of the hospital okay?' I replied.

Tears start to rolled down his cheeks. 'I don't think I'll make it...'

'Don't say that, Uncle. You have to me more optimistic. Besides, the nurses and doctors here will help you to recover...'

'I know... but... hai...'

'Think positive, Uncle. Think positive. The nurses are very good. they will definitely take care of you. I've got to go now Uncle. Bye and take care.'

I left the ward with a heavy heart. Most of my patients are on palliative care, which means relieving or soothing the symptoms their disease or disorder without effecting a cure for them. In other words, many of them are wait for the Inevitable. I do wish for his recovery. But if he doesn't, that means I've gave him false hope. I'm not sure what I said to him is the right thing for him.

Like I mentioned in my previous entry, I feel that we as nurses should not get too emotional and attachment to the patient. If we do, someday we will have too much 'emotion baggage' to clear and may collapse or breakdown due to them.

But it's easier said than done.

Andy Chia's Recital "New Horizons"

My buddy here are having his recital on this day. Not only he's performing traditional pieces, other style such as jazz will be feature in the concert. So Come and support him (and me)!

Last Office

Around late evening, AZ told me one of his patient passed away. Under the guidance of a Sister (in case some of the Peeps do not know who's Sister, it is what we call a nurse who holds a high rank or position in the ward.), AZ and I removed all the medical equipment that are attached to the deceased. After that the two of us were told to get the sponging trolley, shroud, apron, gloves and the necessary documents.

And thus, my 1st Last Office begins.

We begin by removing the decease's pajamas and clean his body. Thereafter, we help to dress him up in his own clothes. During the procedure, we still speak to the deceased. We ask him to help us to turn him, put on the sleeves, etc as hearing is the last time to go. Although he had passed away, we will still respect the dead. After dressing him, we cover him with a white shroud. After his family had view him for the last time, we then cover his face. A blue tag is attached to the shroud and all we have to do now is wait for the Peeps from the mortuary to can collect the deceased.

Mortality

Throughout the whole procedure, rigor mortis (stiffening of the whole body) did not set in and the body is still warm. Thus it is like helping a sleeping patient to change clothes. The two staff that were with me did not show any emotions. I understand that it had been a routine to them. But what surprises me is that I too did not feel any fear or anxiety. Maybe I feel (or the lack of) this way because it is not the first time I handle this kinda things. I've heard from my friends that some feels very scared, one even quit nursing after doing the procedure.

Facing death is part and parcel of the Nursing profession. I believe that nurses should learn not to get too emotional when handling deaths. By doing so, we can ensure every possible things that can be done by us are done properly for the deceased and their families. On other hand, One should not get too comfortable with deaths as well.

New posting, new enviroment.

It's been three days in the Oncology ward and I'm still getting use to the environment. The layout is quite different from other ward I've been to. I had a tough time finding the stuff I want. Like what AZ said,'It's like TV Mobile; It's everywhere!' However, things are not so bad as I have a cute year 1 student in the same room as me. Now I'm looking forward to go to work everyday.

Hahaha...

If you receive a letter from Odex.....

After reading one of the entry in DarkMirage's Blog, I've decided to post part of his article here.

"Odex does not have a foolproof case in court.

There is little precedence to work with, but there are many holes in their argument. The only evidence they have of your infringement is the IP address, which may not be enough. Various people have also reported that they were turned away when they went to talk to Odex with a lawyer, which is an indication that Odex is uncertain about the validity of its claims. At least one person was advised by his lawyer to ignore the letter and delete all the things he downloaded. So far Odex has not taken any actions against him. If more people refuse to pay up, Odex may be forced to either sue someone to make an example of him or to give up on this whole endeavour. If they do sue, there is no guarantee of victory and it is very hard to guess how much damages the court will award even if they win. It may even be less than $3,000-$5,000.

You are not guilty until proven so in court.
You are not obligated to show anything to Odex just because they send you a letter. You do not have to admit to anything and you should not incriminate yourself. Ask them for all the evidence they have against you. Ask them to explain clearly how each piece of evidence proves their claims. Ask them for a breakdown of the payment and why the amount varies from person to person, especially since they claim that it is supposed to be for the fees they have incurred. Do not sign anything. Seek legal advice if possible."

Thanks to DarkMirage, I think we have some knowledge of the things we can do if we receive the so called "love letter" from Odex.

SG Anime War: ODEX VS Otakus in Singapore

For those who are still not aware of the situation, here's what happened in a nutshell:

Comic strip by NCH85

This is my knowledge of the situation:

Odex, a Singaporean Anime distributor company Thus issuing out letters to alleged copyright infringer demanding minimum of $3000 for compensation. As a result, it causes an outcry from local anime community.

Odex claims that their sales dropped dramatically due to illegal anime downloading. However, part of the sale decline is the poor quality of the product compared to the downloaded version. Some of the local Otakus claims that the titles that Odex produces do not cater to local anime community. Further claims include inaccurate subtitling, lack of features DVDs and poor video quality.

Here are some Anti-Odex website which can provide you more infomation:

Xedo Defense
Odex Revolution

Odex has put up a clarification article on their website.

I only have one thought in my mind right now: Never bite the hands that feed you.

One night in Boat Quay

It's been a long time since I've hang out with my EVCO mates until late night. Pat, Xiu and I met up with Xin after her work. We took some (or rather lots) photos wile we having supper.


Ya, I took some real spastic pictures. It's just some of the many stupid stuff I did in my life.

Hahaha...

我的家就在这里，有很多好吃的东西。。。

Here's a parody of this year's NDP theme song, 'There's no place I'd rather be', by Yes 93.3 FM.



I think this is more 'close to heart' for the local.

After viewing it in YouTube, I found another interesting clips by Dick Lee.



And one thing lead to another...



Hahaha...

CDC attachment

Being attached to CDC had been an eye opening experience for me. Other then having to be familiarized with the different documentation format in TTSH, I had to get use to ward environment and the working pace again.

The buildings at CDC have been there for around 50 years. So there is a kinda relaxing, kampong feel to it. They are also spaced far apart. I guess it built in these way to prevent dieases to spread among the wards.

There are two important lessons I've in CDC.

First, HIV and AIDS do not kills you. It is the other illness you caught after it that gets you. As the patients has very weak immune system, it's very difficult for them to recover from infections. I've nursed a patient that has a very bad infection around his pelvis and buttock area.

Every morning we had to assist our Clinical Instructor (CI) to help change his wound dressing which cover the big wound filled with pus. Although we've learn and seen graphical pictures regarding the infection, it is not enough to get us prepare for this experience. Every time the CI use the cotton wound to clean up the wound, pus will just flows out like water.

The pain is excruciating and he will groan in agony.

Second, never die of that disease. The medication taken by the patients are have many adverse side effect (e.g. depression, hallucination, diarrhea, vomiting, severe skin rashes) and will only slow down the inevitable. Some of the treatments they get are very traumatizing too. One example is the Intra-vitreous Injection.

First, the patient will have their eyes numbed with analgesic eye drop. The doctor will then disinfect the eyeballs by pouring iodine directly onto them. after that, medication will be given to the patient by injecting it into their eyeballs.

Sounds gross? It is. And very pain too, even with painkiller eyedrops.

People who has HIV and AIDS has been stigmatized by the society. No matter how you get it, be it from casual sex or through blood transfusion, majority will thinks the you deserved it.

Dying from it will gain you no dignity.

Black Cat's Eye Openers

I came across this website, The Pinky Show, from BM's blog. It's about Pinky the Cat addressing all sorts of topics. I particularly like this episode regarding the Iraq War issue:





How true are these? Well, it's up to you Peeps' own discretion.

And for those current and future nurses who wish to work in the US, here's an insight to the current issues happening there.



I have to agree with BM, the whole concept is serious in a cute way... Serious!

So now, what do you all think about the Peeps in US who always talks about 'Freedom'?

Happy Birthday Sayuri!

Well, today is not really our Japanese friend's birthday. Her one had past a few days ago. But we still help her celebrate at Marina Square's Yaki Yuki. Not to waste food, we bought 2 tarts as a replacement for her birthday cake.



After our dinner, we went to Ministry of Food which located at the ground floor along with Kenny Roger's and Genki Sushi. The desserts there are quite nice, but Stuck Up complained that his Red Bean Paste with Japanese Glutinous Rice Balls are too sweet for him.




Sayuri came to Singapore to take a course on Chinese Language. However, her textbooks are China based. So some of the terms she learned does not use here. Ah Mui suggest that she should get some of the local textbooks. As we're enjoying the food, Stuckup attempted to translate the suggestion form from English to Chinese. The results was disastrous, but he manage to get everyone to laugh. Ah Miu told him to meet up with Sayuri in the weekdays to polish up his Chinese.

Maybe I should too. Hahaha...

Surprise SC! Surprise to me!

All ICAs are over!!! No more presentations! No more role play!

Today, my efforts has paid off. After my group's presentation, we show a video clip of the whole class and our mentor wishing SC Happy Birthday. To my expectation, she cried throughout the video. After the clip, the lecturer ask the Birthday Girl to give a speech to the class.

I can't really make out what she say but it goes something like this: "I wanna tha---(sniff) you all for---(sniff). No one has made a vi---(sniff) for my birth---(sniff). Thank you s---(sniff) much... (sniff)(sniff)(sniff)"

Yes! Mission Accomplished.

After the whole commotion, Fi, Hid and the others stayed back to give SC her present. We bought her a pair of Converse sneakers, with ribbons as the shoe lace.


See how happy she was? Well, it feels great to make someone's day.

While I was slacking in the library after lunch with my dear classmates, I received a call from a good friend asking help from me. He asked me to stand-in for one of his practice today. Though I think that I'm not suitable for the job, I reluctantly agreed. He will not required my aid if he could find other alternative.

To my surprise, I have to take on more 'challenge' than we agreed on. Man, it was the slowest 3 hours I have yet to experience. As I'm not train in his field, I had to use what I know (and my knowledge for that field are very, very limited) of his and apply some of mine into the practice.

Yes, I have to somehow bluff my way through. Hahaha...

Though it's tough for me, it's still quite a fulfilling experience when the kid ask me when I'm coming back. Sadly it'll be a one-time-thing only... and I'll make sure it's the last.

No more bro, no more.

Fatigue and fustrations is my constant friends

For those who keep bugging me to blog, here it is

14 days after my Oz trip and I'm still feeling real tired. I still have one more test and presentation before my attachment. Yup, attachment again. While other school's student are having fun during holidays, I'll be at CDC, IMH and SGH nursing patients.

Weeeee~~~~

One more week before Mr Hu comes to conduct EVCO and I haven't finished practicing all the pieces! What's more, I don't think I have the stamina for the entire concert. Our concert is at the end of this month. Hope I can pull it off.

Something happened during last week and had Peeps discussing at Damo's blog (read more on his 22th July's entry). It may seems that we are constantly criticizing a particular individual (which we are), some may even think that we're just making a mountain out of a mole hill. However, our actions are not without valid reasons.

For any group or organization to function properly, each member have to do their part. No doubt that mistakes and hiccups will occur, it's important that we learn from them and not make the same errors again. If a person did not do or give the wrong information on his or her part, it will affect the all other people greatly. Precious time, manpower and efforts will be waste.

As for that individual, he has made one too many mistakes. Constant advice and chances had given to him, but there not much improvement seen from him. I understand that each person are different. Some are fast to grasp the situation, other need some time to adjust. However, not all situation have the time for adjustment.

I hope that he will REALLY learn from his mistakes for the sake of the masses and more importantly, for himself and his future. Keep apologizing will not solve any matter.

To Sydney and back Part 1

Hello Peeps!

Finally, I'm back to my ever hot and humid Singapore. Already after getting outta the arrival hall, I started to sweat like nobody business.

One piece of bad news:

I LOST MY CAM'S SD CARD!!!!

So there won't be much photos from me until I source from my friends and CO mates.

Hai~~~~~~

Anyway, the trip to Sydney is a fulfilling one. There's two reasons: First, NYPCO was rewarded Gold for the AIMF(Australia International Music Festival) competition. Second, I get to eat lots of good food there.

Other then feeling very happy (until some of the gals cried while embracing one another) we felt a sense of relieve as most of us spent tons of efforts in making the trip possible. Getting a gold reward has made all the hardships, frustrations and criticism worthwhile.

There was a time when people said
That NYPCO won't make it
But we did
There was a time when troubles
Seemed too much for us to take
But we did
We built a CO
Strong and free
Reaching out together
For music and harmony...

Sounds familiar eh? It the lyrics from the national song, We Are Singapore. The music just popped into my mind and I made some changes the the lyrics.

Hahaha...

I did not enjoy good food all the time in Oz. The first few days in Sydney were terrible. We had to eat lousy Chinese food in a restaurant across our hotel. It's only when Mike and I meet up with Brandon (a good buddy of mine during my times in TP. It's been 5 years since I last met him and he didn't change much.) we get to eat REAL food. He took us to several places in Sydney that serves good and reasonable priced seafoods and pancakes. Compared to our tour guide, my buddy is 10 fold better than him.

On Sunday, we when to the Blue Mountains. The view there was breathtaking.

So is the wind over there.

I can feel the ice cold wind penetrating my body despite having worn 5 layers of clothings. My hands were numb before I can reached the Echo Point lookout.

View of the Blue Mountians

The name did not means that the mountains are really blue. It derives from the blue hue that caused by the rapid evaporation of the oils for the eucalyptus forest.

The 3 Sisters

The 3 Sister are famous rock fomation in the Blue Mountian. Legend says that three sisters were turned into stones by a witch doctor to protect them from certian danger.

Here's more photos taken at the place.

Me attempting to act cute along with Sherryl.

学姐 Amelia and I

Brothers in arms - HxP and I

大伟 and I

That's all for now. I'll blog more when I gotten the photos.