Anchita A/P Mottiakavandar, A175104, 30/7/2022

2. How is your progress?

I am very happy with my progress this week if compared with last week. This week I felt I have adapted more in the clinic setting. I was allowed by the doctor to take history and present it to them even before the doctor meet the patient. Every time I present my case doctor would praise me and he would correct me if I make mistakes. This week I was able to learn how a proper blood test will be taken form the patient. Firstly the patient will be asked to sign the consent form and since its under a company the patients’ are doing this blood test mandatorily, there will be baseline test requirements like the full blood count, renal profile, lipid profile, liver function test and etc. Later blood will be drawn in vacuum tube of different colors. For instance,  the lavender tube will be used for the full blood count. I was able to assist few more simple dressing procedures this week. I was also able to recall on the correct method to take blood pressure manually using the manual sphygmomanometer.

 

3. Points to remember from week 2!

- Phlebotomy specifically refers to the single-use needlestick for drawing blood specimens. Whereas venipuncture refers to the broader concept of entering the vein for either drawing blood or administering an IV for an extended period, phlebotomy is limited to blood-sample collection.

- It is very vital to check the patient ID and name multiple times before sending to the lab to avoid mistakes like handing the results to a different person.

- Its important to note that after alcohol do not re-palpate to locate the vein. Instead before using the alcohol we can use a small cap and make the impression on the area that we are going to insert the needle. In this way we wont have the necessity of re-palpating the vein.

-Its is important to note that all vacuum tubes should be gently inverted, and  labelled as soon as the procedures are done.

4. Your feelings & thoughts  

  I am feeling very happy as I am able to learn and recall lots of information from my clinical postings. Its very inspiring for me personally when the doctor shares all his clinical day memories. He have shared with me what are the do’s and don’t that I have to always pay attention as  a medical student. This experience altogether has made me feel very much elated.

5. ONE good thing from what you did that you can practice now!

I would say the technique of venipuncture. Even if I have been in whole full year in clinical years I would always feel the scariness when I have the thought that “am I going to find the vein”. So when the procedure was done to the patient the Dr took some time and taught me the ways to find the vein .I felt that I would be more confident the next time I am going to perform it myself .For example  ,I was told its vital to first know the vein involve which is the cephalic, median cubital and basilic vein. Later we can locate the vein by palpating.  However if for instance the patient’s vein is difficult to be located maybe because the person is obese then we can tell the patient to make a fist and again try locating it or else bend the arm little bit and try locating it in that way.

6. Any difficulties/concerns? How did you cope?

The difficulties would be that since its very rushing in a clinic setting its very important to be vigilant .Sometimes there will be some patients with new chief complaint and if I am busy looking at other stuff then I would miss it. However I am able to cope since the staffs there are very friendly so they would always help me out and tell me not to worry much.

 

7. Your plan for next week (Week 3)

My plan for next week is to engage and learn more on the hands-on part .Maybe next week I would also pay more attention on how the medications are prescribed to the patient accordingly.

Thank you.

 

4. Your feelings & thoughts
I feel grateful for this opportunity as I get to learn and apply what I have studied in medical school during my internship here. Not only that, I also manage to learn communication skills via consultation between doctor and the patient. It is truly inspiring to see how the doctor uses simple analogies to explain a disease/condition and the purpose of medication. This would help patients to understand their disease and would encourage them to be compliant to the medications. There are times that are challenging especially when I perform certain procedures but I aspire to keep practicing.

5. ONE good thing from what you did that you can practice now!
The good thing that I learnt this week was how to perform an intramuscular injection. Before performing the procedure, we have to ask if the patient is on anticoagulants or if they have any bleeding disorders as they are contraindicated in IM injections. I also learnt that before performing deep IM injections, I need to aspirate first to avoid injecting the vaccine/medication into the vessels.  I would also need to brush up on my anatomy to learn on the important sites to administer IM vaccine to avoid injecting the nerves or vessels. It was challenging at first and since it was my first time. Doctor also gave me some words of encouragement which inspired me to practice more and remember the crucial key points to be used in the future.

6. Any difficulties/concerns? How did you cope?
While I was administering the IM injection, I was concerned whether the patient was in pain and was worried if my method of injection would put them in further discomfort. I always made it a point to observe their body language and fortunately the patients were kind enough to reassure that I was doing okay. If the patient was not comfortable with having a medical trainee administering the injection, I would immediately allow the doctor to take over to put the patient at ease. To ensure that my technique improves over time, I would put in extra effort to practice on more patients so that in the future I will be able to administer these injections more smoothly. 

7. Your plan for next week (Week 3)
I wish to master my skill on phlebotomy since I haven’t been able to perform it. I am also looking forward to learn various other cases and broaden my horizon of knowledge not only in the aspect of medicine but generally as well. 

4. Your feelings & thoughts
For this week I am a little fearful since there is a lot of information to process. I am not only involved in the project bioinformatics but I was also involved in hands-on procedures. 

5. ONE good thing from what you did that you can practice now!
Always be ready to learn more about new things to broaden my view of this world.

6. Any difficulties/concerns? How did you cope?
Since it is new for me to approach bioinformatics, I was a little lost in the workflow on what to do next. I coped by asking my supervisor and seniors in here as they will have more experience on this.

7. Your plan for next week (week 3)
I plan to continue to arrange my data and start to list down the SNPs that are important in the disease and that are prevalent in my Orang Asli sample. As similar to last week, I plan to learn more on the bioinformatics workflow through my supervisors and seniors here.