eve88
10-01-2011, 12:06 PM
.... without knowing mandarin past ... oh, maybe primary 1 level.
But it was an interesting experience, and one that I don't regret doing. My self assigned hours were Monday to Friday, 8am to roughly 4-5pm; but I took afternoons off about twice a week (it *is* my summer holidays, after all). The first 3 weeks were in the neurology department, the final week in gastrointestinal department - both medical as I was a bit reluctant to try for a surgical ward (and time in the operating theater) due to my lack of Chinese / inability to comprehend even the most basic instructions ["Grab a 20cc syringe for me" "Huh?" (as don't know the chinese for syringe)].
From what I observe - and mind you this is practically my first exposure to clinical training (I went for this just after completing my pre-clinical years in Otago, NZ; but luckily we have been taught clinical examination skills and history taking, so I wasn't that completely lost) - the hospitals are run much like you'd expect any hospital to be run; and the doctors *are* generally willing to teach even though its difficult for them to get their point across. (Tangent : its the same at every hospital I've shadowed in, that the doctors do take the time to explain things, even at the very basic levels)
Daily schedule was general staff (doctors + nurses) meeting at 8am, going over new admissions and incidences (fever mostly, as far as I can tell, but also things like acute pain; collapses/falls) that happened the previous afternoon and night; then morning rounds each doctor (Resident + Houseman pair, or group of 3, or only Resident?) sees their own patients - the ones they admitted (they take turns doing admissions); but about twice a week every doctor sees every patient; headed by the consultant. After rounds generally comes paperwork - charting patients, discharge summaries, forms for lab tests, imaging (MRI, CT, Xray), ECG (which also can be done bedside) etc. And also new admissions (who continue coming in through the day).
All the doctors are there 8am to 11.30am, and then they are rostered for the afternoon shift 2.30 to 5.30, the evening shift 5.30 to 9?, plus on call doctor for the night.
But for me personally, I tag along on the rounds - which is the time i learn the most (there is a surprisingly large amount of information about the patient + a lot to learn just watching the clinical examinations carried out; even if i can only understand about one word in 4 if im lucky!) And also tag along for new admissions, and watching some procedures (a few bedside ECGs (1 with doctor, rest just me + student), spinal tap, catheter insertion (this was ... probably one of the most uncomfortable times for me personally, as was done in the ward lobby with just a screen for privacy; also all i did was watch the process without explicitly getting consent >.<), 3 ECRPs, ultrasound imaging)
There was plenty of "slack" time for me though, because I din't know enough (read: i don't know any) written chinese to help with charting and form filling (which is what they use the medical students for =p), and not enough conversational chinese to carry out most of the other errands (fetch and carry equipment, direct/accompany patients to where the imaging is carried out, etc). Mainly spent the time trying to figure out the patients diagnoses + follow the progress + talk with the other students and doctors + fill out my notebook of english-chinese terms (dint get very far with it, about ... 30 or so phrases/words)
Oh, and I saw them carry out acupuncture for one of the patients in the neuro ward. Which was .. slightly scary. Needles were inserted at nerve points about 1 inch into the skin (aseptic procedure iodine wipe over puncture points, metal needles dont know if they were sterilized, doctor not gloved) and attached to low voltage electrical stimulation.
Other random observations:
- Meal in hospital cafeteria cost 6yuan, fastfood (rice + 4 choices of veg or meat)
- If a doctor loses the patient chart, they are fined 1000yuan, apparently (hearsay, and this i know because one of the doctors was calling their (discharged) patient to bring the notes back to the hospital)
- Corridor beds ; when the normal rooms (2-3 beds per room) were full
- The more senior neurologists, when testing grip strength, cross their arms so their right hand is testing the patients right and vice versa
- Reminder for Abdominal exam : knees bent, arms at side.
- Nurses do BP/pulses/temp/drawing blood/cannula insertion.
Hmmmm okay thats enough of the textdump - just wanted to pen something down...
But it was an interesting experience, and one that I don't regret doing. My self assigned hours were Monday to Friday, 8am to roughly 4-5pm; but I took afternoons off about twice a week (it *is* my summer holidays, after all). The first 3 weeks were in the neurology department, the final week in gastrointestinal department - both medical as I was a bit reluctant to try for a surgical ward (and time in the operating theater) due to my lack of Chinese / inability to comprehend even the most basic instructions ["Grab a 20cc syringe for me" "Huh?" (as don't know the chinese for syringe)].
From what I observe - and mind you this is practically my first exposure to clinical training (I went for this just after completing my pre-clinical years in Otago, NZ; but luckily we have been taught clinical examination skills and history taking, so I wasn't that completely lost) - the hospitals are run much like you'd expect any hospital to be run; and the doctors *are* generally willing to teach even though its difficult for them to get their point across. (Tangent : its the same at every hospital I've shadowed in, that the doctors do take the time to explain things, even at the very basic levels)
Daily schedule was general staff (doctors + nurses) meeting at 8am, going over new admissions and incidences (fever mostly, as far as I can tell, but also things like acute pain; collapses/falls) that happened the previous afternoon and night; then morning rounds each doctor (Resident + Houseman pair, or group of 3, or only Resident?) sees their own patients - the ones they admitted (they take turns doing admissions); but about twice a week every doctor sees every patient; headed by the consultant. After rounds generally comes paperwork - charting patients, discharge summaries, forms for lab tests, imaging (MRI, CT, Xray), ECG (which also can be done bedside) etc. And also new admissions (who continue coming in through the day).
All the doctors are there 8am to 11.30am, and then they are rostered for the afternoon shift 2.30 to 5.30, the evening shift 5.30 to 9?, plus on call doctor for the night.
But for me personally, I tag along on the rounds - which is the time i learn the most (there is a surprisingly large amount of information about the patient + a lot to learn just watching the clinical examinations carried out; even if i can only understand about one word in 4 if im lucky!) And also tag along for new admissions, and watching some procedures (a few bedside ECGs (1 with doctor, rest just me + student), spinal tap, catheter insertion (this was ... probably one of the most uncomfortable times for me personally, as was done in the ward lobby with just a screen for privacy; also all i did was watch the process without explicitly getting consent >.<), 3 ECRPs, ultrasound imaging)
There was plenty of "slack" time for me though, because I din't know enough (read: i don't know any) written chinese to help with charting and form filling (which is what they use the medical students for =p), and not enough conversational chinese to carry out most of the other errands (fetch and carry equipment, direct/accompany patients to where the imaging is carried out, etc). Mainly spent the time trying to figure out the patients diagnoses + follow the progress + talk with the other students and doctors + fill out my notebook of english-chinese terms (dint get very far with it, about ... 30 or so phrases/words)
Oh, and I saw them carry out acupuncture for one of the patients in the neuro ward. Which was .. slightly scary. Needles were inserted at nerve points about 1 inch into the skin (aseptic procedure iodine wipe over puncture points, metal needles dont know if they were sterilized, doctor not gloved) and attached to low voltage electrical stimulation.
Other random observations:
- Meal in hospital cafeteria cost 6yuan, fastfood (rice + 4 choices of veg or meat)
- If a doctor loses the patient chart, they are fined 1000yuan, apparently (hearsay, and this i know because one of the doctors was calling their (discharged) patient to bring the notes back to the hospital)
- Corridor beds ; when the normal rooms (2-3 beds per room) were full
- The more senior neurologists, when testing grip strength, cross their arms so their right hand is testing the patients right and vice versa
- Reminder for Abdominal exam : knees bent, arms at side.
- Nurses do BP/pulses/temp/drawing blood/cannula insertion.
Hmmmm okay thats enough of the textdump - just wanted to pen something down...