Apa itu House officer?
-Houseman adalah doktor pelatih ( house officer atau pegawai perubatan) Gred UD41, yang baru tamat pengajian dari medical school dan dalam period atau tempoh pemerhatian dan penilaian sebelum dia dibenarkan untuk berkhidmat dan full responsibility atas semua keputusan dibuat terhadap pesakit
Tempoh Housemanship
-for 2 years = 6 postings which are :
1. Medical
2. Surgery
3. Orthopaedic
4. Paediatric
5. Obstetric and Gynaecology
6. Emergency
7. Anesthesiology ( several hospital only)
Waktu cuti Houseman
1 year House Officer posting will include :
-3 postings
-25 hari cuti tahunan ( Emergency Leave & MC included)
Cuti for every posting consists of:
- only 8 days cuti x 3 postings
- weekend off ( 3-4 hari depends pada ketua jabatan)
Tagging
- baru masuk each posting
- learn from oncallers till 10pm
- kepentingan : pengalaman tagging akan diguna sewaktu kita start oncall nanti, jadi guna waktu ini utk belajar flows sebaik mungkin supaya boleh function under our M.Os.
On call
- pengalaman tagging days akan berguna disaat ini.
- overtime bila doktor bertugas lebih masa selepas waktu pejabat
(8am - 5pm)
- Isnin - Jumaat - OnCall mula 5pm - 8am (15 hrs) + Office hours =24 hrs +-
- Weekend - OC mula 8am-8am (24hrs)
- frequency OC - in 1 month depends availaibility MO, ramai MO = kurang OC, if kurang MO = banyak OC ( EOD 3x/months)
- specialist ada Active OC dan Passive OC
- MO klinik kesihatan, kerja waktu pejabat only 8am-5pm dan cuti weekends, plus passive OC.
- MO emergency , no OC, guna sistem shif
- Tugas Doktor OC
Tugas Doktor On Call:
1. Lakukan ward round malam dengan MO dan doktor pakar on call di acute cubicle, di mana terdapat pesakit yang memerlukan pemantauan rapi.
2. Tulis dokumentasi pesakit yang baru masuk ke wad.
3. Lakukan round bersama MO dengan pesakit baru.
4. Ambil darah jika perlu, pasang branula jika ada yang tercabut.
5. Lakukan pemeriksaan segera jika pesakit tetiba demam mendadak atau susah nafas (shortness of breath) dan sebagainya.
Tugas MO
1. MO akan terima, review dan manage kes yang dirujuk pada hari dia on call, 8.00am hingga 8.00am keesokan paginya.
2. Attend to acute cases in ward after orang lain balik
3. Buat round
4. Assist HO jikalau they need assistant
Elaun Doktor On Call?
Doktor bertugas akan menerima elaun on call yang bukan base on hours tetapifixed rate weekday/weekend. RMxxx per call.
Every Other Day (EOD)
-sambung kerja lepas berehat antara 5pm 23 april - 8am 24 april
- on 24 april kerja spt biasa 8am-5pm dan OC 5pm-8am 25 april
-balik berehat abes kerja 5 pm 25 april.
Active & Passive OC
-sentiasa standby di hospital, jika perlu bantuan doktor Passive OC dipanggil perlu sampai in 10min.
Contoh Routine Houseman
6.15am:
-Leave the house. Reach hospital usually in 15-20mins.
6.30am:
-Find a parking space, punch in around 6.45am, then go to your respective ward.
6.50am:
-Check the whiteboard to see the list patients you have been assigned to. Pray hard that you dont get a complicated case.
7.00am:
-On average, there are about 5 HO and 5 nurses in a ward, but there are only 5 computers. If you're lucky, you can straight away use the computer to see what's the history of the patient. If not, wait for your turn. Print out the history, jot down the trend of the vital signs, laboratory investigations, imaging results, current medications, patient's progress overnight, and latest plan of management. Find patient's medication chart to confirm the list of drugs and current doses, and if there are any procedures planned, make sure the consent form is filled up and signed by the patient. Go to the bedside to check up on your patients, get relevant information and history as required, and do a quick clincical examination. Bear in mind that you don't always get co-operative patients.
7.30am:
-MO will start their rounds around this time. If you havent finished reviewing your patients by this time, then be prepared for some scolding. Even if you finished reviewing your patients, you're gonna get scolded one way or another, either because you missed some minor details, or forgot to carry out some orders. etc. If the current plan of management is wrong, despite the plan being ordered by another MO, and clearly it's not your fault, you're gonna get scolded anyway.
8.00am:
-Carry out orders after the MO rounds. Blood taking, insert branula, update patient's bedside folder, order medications, request for imaging procedures, refer cases to other department, etc.
8.45am:
-Specialist rounds. Present the history, findings on admission, current findings, current issues, latest medication and investigation, vital signs and their trend, and latest plan of management. Get scolded again, and this time by both the specialist and MO.
11.00am:
-Finished specialist rounds. Carry out new orders. If there are new cases, you need to clerk them.
12.00pm:
-Finished carrying out the orders. Enter the notes for the morning rounds. Wait for your turn to use the computer again.
12.45pm:
-Done entering notes. Grab something from cafeteria and have a quick lunch. Sometimes you might finish carrying out the orders and entering notes as late as 2.00pm. By 'sometimes', I mean about 3 to 4 days per week. If you finish lste, then you wont have the time for lunch.
1.45pm:
-Review patients again and prepare for the afternoon rounds with MO.
2.30pm:
-Afternoon rounds with MO.
3.30pm:
-Carry out orders for afternoon rounds. Enter notes for afternoon rounds.
4.00pm:
-Occasionally specialist will do afternoon rounds as well, usually around this time.
4.30pm:
-Carry out orders. Enter notes.
5.00pm:
-Clerk new cases, help others take blood, do procedures, whatever. You can't be seen sitting around doing nothing. If you're a junior, simple procedures might take up to 1 hour. If you're a senior, please guide your juniors.
6.00pm:
-Pass over case to the evening shift HOs. I usually finish around 6.30pm.
6.30pm:
-Punch out. Drive back home.
7.00pm onwards:
-Do whatever you want. Sometimes you need to prepare for seminars and other presentations, sometimes you need to study for your assessment. Some department are using the BD shift system, which means some of you can't go back and have to stay at the hospital until 12 midnight, or come back to work at 11pm and work until 2pm the next day.
So there you go, a brief outline of a houseman's daily routine. There are days you need to work evening or night shifts, so the routine is a bit different. And the shift system will mess up your body's circadian rhythm, so you hardly get any sleep prior to your night shifts.
http://thedrasyrafhafiz.blogspot.com/2016/03/housemanship-introduction-to-routine.html#.XWIy3bhGRd1
-Houseman adalah doktor pelatih ( house officer atau pegawai perubatan) Gred UD41, yang baru tamat pengajian dari medical school dan dalam period atau tempoh pemerhatian dan penilaian sebelum dia dibenarkan untuk berkhidmat dan full responsibility atas semua keputusan dibuat terhadap pesakit
Tempoh Housemanship
-for 2 years = 6 postings which are :
1. Medical
2. Surgery
3. Orthopaedic
4. Paediatric
5. Obstetric and Gynaecology
6. Emergency
7. Anesthesiology ( several hospital only)
Waktu cuti Houseman
1 year House Officer posting will include :
-3 postings
-25 hari cuti tahunan ( Emergency Leave & MC included)
Cuti for every posting consists of:
- only 8 days cuti x 3 postings
- weekend off ( 3-4 hari depends pada ketua jabatan)
Tagging
- baru masuk each posting
- learn from oncallers till 10pm
- kepentingan : pengalaman tagging akan diguna sewaktu kita start oncall nanti, jadi guna waktu ini utk belajar flows sebaik mungkin supaya boleh function under our M.Os.
On call
- pengalaman tagging days akan berguna disaat ini.
- overtime bila doktor bertugas lebih masa selepas waktu pejabat
(8am - 5pm)
- Isnin - Jumaat - OnCall mula 5pm - 8am (15 hrs) + Office hours =24 hrs +-
- Weekend - OC mula 8am-8am (24hrs)
- frequency OC - in 1 month depends availaibility MO, ramai MO = kurang OC, if kurang MO = banyak OC ( EOD 3x/months)
- specialist ada Active OC dan Passive OC
- MO klinik kesihatan, kerja waktu pejabat only 8am-5pm dan cuti weekends, plus passive OC.
- MO emergency , no OC, guna sistem shif
- Tugas Doktor OC
Tugas Doktor On Call:
1. Lakukan ward round malam dengan MO dan doktor pakar on call di acute cubicle, di mana terdapat pesakit yang memerlukan pemantauan rapi.
2. Tulis dokumentasi pesakit yang baru masuk ke wad.
3. Lakukan round bersama MO dengan pesakit baru.
4. Ambil darah jika perlu, pasang branula jika ada yang tercabut.
5. Lakukan pemeriksaan segera jika pesakit tetiba demam mendadak atau susah nafas (shortness of breath) dan sebagainya.
Tugas MO
1. MO akan terima, review dan manage kes yang dirujuk pada hari dia on call, 8.00am hingga 8.00am keesokan paginya.
2. Attend to acute cases in ward after orang lain balik
3. Buat round
4. Assist HO jikalau they need assistant
Elaun Doktor On Call?
Doktor bertugas akan menerima elaun on call yang bukan base on hours tetapifixed rate weekday/weekend. RMxxx per call.
Every Other Day (EOD)
-sambung kerja lepas berehat antara 5pm 23 april - 8am 24 april
- on 24 april kerja spt biasa 8am-5pm dan OC 5pm-8am 25 april
-balik berehat abes kerja 5 pm 25 april.
Active & Passive OC
-sentiasa standby di hospital, jika perlu bantuan doktor Passive OC dipanggil perlu sampai in 10min.
Contoh Routine Houseman
6.15am:
-Leave the house. Reach hospital usually in 15-20mins.
6.30am:
-Find a parking space, punch in around 6.45am, then go to your respective ward.
6.50am:
-Check the whiteboard to see the list patients you have been assigned to. Pray hard that you dont get a complicated case.
7.00am:
-On average, there are about 5 HO and 5 nurses in a ward, but there are only 5 computers. If you're lucky, you can straight away use the computer to see what's the history of the patient. If not, wait for your turn. Print out the history, jot down the trend of the vital signs, laboratory investigations, imaging results, current medications, patient's progress overnight, and latest plan of management. Find patient's medication chart to confirm the list of drugs and current doses, and if there are any procedures planned, make sure the consent form is filled up and signed by the patient. Go to the bedside to check up on your patients, get relevant information and history as required, and do a quick clincical examination. Bear in mind that you don't always get co-operative patients.
7.30am:
-MO will start their rounds around this time. If you havent finished reviewing your patients by this time, then be prepared for some scolding. Even if you finished reviewing your patients, you're gonna get scolded one way or another, either because you missed some minor details, or forgot to carry out some orders. etc. If the current plan of management is wrong, despite the plan being ordered by another MO, and clearly it's not your fault, you're gonna get scolded anyway.
8.00am:
-Carry out orders after the MO rounds. Blood taking, insert branula, update patient's bedside folder, order medications, request for imaging procedures, refer cases to other department, etc.
8.45am:
-Specialist rounds. Present the history, findings on admission, current findings, current issues, latest medication and investigation, vital signs and their trend, and latest plan of management. Get scolded again, and this time by both the specialist and MO.
11.00am:
-Finished specialist rounds. Carry out new orders. If there are new cases, you need to clerk them.
12.00pm:
-Finished carrying out the orders. Enter the notes for the morning rounds. Wait for your turn to use the computer again.
12.45pm:
-Done entering notes. Grab something from cafeteria and have a quick lunch. Sometimes you might finish carrying out the orders and entering notes as late as 2.00pm. By 'sometimes', I mean about 3 to 4 days per week. If you finish lste, then you wont have the time for lunch.
1.45pm:
-Review patients again and prepare for the afternoon rounds with MO.
2.30pm:
-Afternoon rounds with MO.
3.30pm:
-Carry out orders for afternoon rounds. Enter notes for afternoon rounds.
4.00pm:
-Occasionally specialist will do afternoon rounds as well, usually around this time.
4.30pm:
-Carry out orders. Enter notes.
5.00pm:
-Clerk new cases, help others take blood, do procedures, whatever. You can't be seen sitting around doing nothing. If you're a junior, simple procedures might take up to 1 hour. If you're a senior, please guide your juniors.
6.00pm:
-Pass over case to the evening shift HOs. I usually finish around 6.30pm.
6.30pm:
-Punch out. Drive back home.
7.00pm onwards:
-Do whatever you want. Sometimes you need to prepare for seminars and other presentations, sometimes you need to study for your assessment. Some department are using the BD shift system, which means some of you can't go back and have to stay at the hospital until 12 midnight, or come back to work at 11pm and work until 2pm the next day.
So there you go, a brief outline of a houseman's daily routine. There are days you need to work evening or night shifts, so the routine is a bit different. And the shift system will mess up your body's circadian rhythm, so you hardly get any sleep prior to your night shifts.
http://thedrasyrafhafiz.blogspot.com/2016/03/housemanship-introduction-to-routine.html#.XWIy3bhGRd1
