Paul Baloche, Michael Rossback, Stuart Garrard and Carl Abrecht came to Asia

 

I followed the band from Singapore to Kuala Lumpur. What a wonderful weekend of good music! You would never know how much I appreciated the sessions and how blessed I was.

Foto Friday

Today I celebrate the completion of my tuition fee loan payment.
Got myself something useful in terms of service unto my Boss.
Going back to what I once loved doing.
 

First deployment to the CCU

This week has been quite good to me despite how I might have perceived it to be. I believe it is important to have regular checks on your mood roller coasters and reflect on your feelings, actions and words, because sometimes what we feel may not be legitimate. Feelings can be real but they might not be appropriate.

Very recently, I had the opportunity to work a day in the Coronary Care Unit. I am still quite a junior nurse so there should be many more "first times" ahead in this career; every day is a time to learn new things. Anyway, the CCU was short on staffing during my shift so I volunteered to help out when my charge nurse was planning the day's staff assignments. I went over, expecting relative easier work; as it is an unspoken common courtesy to assign simpler tasks to deployed staff, after all I do belong to a different unit though still the same department; not to complain but I ended up extubating one of my patients, discharging another to a general ward, and even admitted a man who just had a heart attack and surgical intervention. Honestly, I did have a good time.

Happy to realise how far I have come in intensive care nursing! A few months ago I would not dare work in a less-familiar environment without the assurance of observation and guidance by nurturing seniors, what more volunteer to work in a different ward?
This deployment may not be some great accomplishment but it meant something to me.

Cheers!
 

Foto Friday

It has been a rough week or two, many of my shifts had been really busy ones. Working with people under stress is stressful, and I believe I had my share of unpleasant encounters with a few colleagues this week. No need to dwell on such things that should belong in the past. Amen.

By the end of most shifts I find myself not desiring any conversations anymore.
After work I would rather not talk at all, it helps when there is no roommate; what a luxury, by the way.
On a day off I struggle between the need for meaningful fellowship and my wish for near-total silence. Hence the little dilemma of a single working man.

ICU, 4AM

I began to view myself as a real nurse only ever since I started working night shifts.
Most of the doctors and allied health professionals go back to their homes, they have lives to live too. But the patients still need to be taken care of, somebody has to be around.
Nurses on night duty are like guards watching over their patients, making sure they are well through the night. Or at least in the ICU, for, as educated to me by my preceptor, ICU nursing is very much about monitoring; you see something not right, you report it to the doctor.
Well, I like making sure my patients have quality rest, as best as they can take.  

Asystole

My husband has chronic obstructive pulmonary disease, he went to the hospital last night due to some shortness of breath but had to wait and be treated in the Emergency Department as there were no beds in the wards. I needed to sleep so I said good night to him over the phone.

This morning I got up and noticed many miss calls from an unfamiliar number a few hours ago, I was still asleep then and therefore did not answer the phone. Anyway, I decide to give my husband a call first just to check on him and the hospital admission status. If everything goes well I would get the children ready and take them to visit their grandfather before lunchtime. I dialed, and I dialed again. 

For every second he did not answer the call I began to worry more. At last the caller ring tone stopped, but the voice on the other end of the line was definitely not my husbands; somehow at that moment my heart sank.
It was a male nurse's voice, asking for my name and availability to make a trip to the hospital, and advising me to make it there as soon as possible.
"What happened to my husband?" I asked, already nearly bursting in tears.
"Sorry, madam, his heart stopped early in the morning, he was resuscitated for about thirty minutes, intubated and thereafter brought to the Intensive Care Unit," said the nurse in a deep voice.
The household and probably immediate neighbours were awaken by my crying; I broke down upon hearing the terrible news and could no longer feel my feet as my daughter had to sit me down and take over speaking to the nurse.

On arrival to the ICU I walked pass a few patients, dreading to see my husband as I may not be able to handle the sight. Alas, I recognised the man there lying unconscious, on a mechanical ventilator helping him breathe. I broke out in tears! I cannot take it! The doctors and nurses were busy around my husband's bed; I waited fifteen minutes and a medical officer comes to explain to me what had happened in the ward earlier this morning. She speaks and she speaks and all that she said did not make any sense to me as her words do not bring my husband back to breathing on his own.

I feel even more helpless and fearful as the doctor's answer fails to comfort me as I enquired, "so will he get up again?"
She can never give me a guarantee, and I cannot blame her for that. 

Just like that, my life will never be the same!

What makes a man?

What differentiates a man from a boy? How does a guy earn his right to be known as a man? Anybody can age but growth is actually a choice. I have gotten into a certain age group where I find myself at times in an awkward position not knowing if my identity should be a man or just the guy that I had been for the past decade. Of course, the latter is more natural, comfortable and convenient, but it is time to grow up and move on.

"A man takes initiative, responsibility and is not afraid of commitment," Lydia Tang.

"A man knows how to rise above his emotions," Paulus Lee. 

I agree with the above, and I know there is much more to being a man than just the above.
No intentions of undermining the roles of my female counterparts here, for life on Earth is no doubt difficult; being a man is challenging. Very challenging. To me, he is supposed to be a leader and provider to his household, in times of adversity he needs to rise up and play the role of a protector and comforter. And there is so much more aside from what I have mentioned.

To me, being a man means doing the right thing even when no one is observing.

For a guy who seems to have been challenging authority and boundaries since childhood, being a man is indeed quite a journey with plenty of obstacles ahead.
Walk with me.
 

First time deployed

To another ward, I was told to report for work this afternoon. The surgical high dependency unit was short on staff today so they required manpower from the other departments. Who knew I was worthy to be deployed to help out at other wards!

Naturally, I was not thrilled when I first found out I was going to be working in an unfamiliar environment, moreover a surgical unit; I did several postings in the orthopaedics discipline and my internship at a surgical ICU, but it has been medical ICU the moment I stepped out of the nursing student uniform. Well, the shift went by and I did okay, with the help of the kind nurses in the ward.

It has been a long time since I filled up a an OT checklist.

And the learning continues.
 

Night Shift

Walking to the work place while the masses travel home after dinner, buy some supper to ease your hunger. Get changed, get ready to watch the patients through the night. Receive the handover, check on your patients, then turn off the lights. 
 
Faithfully, charting parameters and serving medications; and feeling sorry for the patients who fail to fall asleep. How can one ever rest well when an automatic door opens at least once every hour? 

Come the second half of the shift, you start struggling to stay awake. Write a report, continue watching the patients. Await the dawn of a new day. 

You may go home and rest soon enough.

Foto Friday

Mr. W, I wonder where are you.

Are you in India? 

Are you in Singapore? 

Are you in a better place? 

I really do miss you.

Why do You Never Run Out of Grace?

In moments like these when I am aware 
of the ugliness within, 
I take of my shoes and dare not face You. 

The promises left unfulfilled,
the wrongs to be corrected,
and what could be but is not yet; 
Proofs of my worth as a steward. 

In moments of facing such truths:
of realisation of my empty-handedness, 
why do You never run out of grace?

© Joel Yap

Foto Friday

The stuff I use for taking pictures are pretty much all here except for a couple of light stands and umbrellas back home in Kluang. Finally keeping these things somewhere I can feel a little more at ease with regards to worries of lenses attracting fungi growth due to low usage. Time to keep these stuff away and focus on the work I am paid to do- nursing!
By the way, however, photographer for hire! Heh!
 

33 hours awake

So a friend needed a favour, and not to boast, but I offered more than what was requested.

I had work and other commitments, janji perlu ditepati, so I did not have as much free time as I wished. For the sake of easy reading here, I shall cut a long story short; in order to fulfill my commitments over the weekend, I stayed awake for at least 33 consecutive hours. Dozing off on the wheel was really dangerous thus I ended up slapping myself multiple times while driving well below the speed limit. Struggling to stay awake at church was not a pleasant experience either. Sleep is so important that it is supposed to take up one third of the day.

This is neither me boasting nor complaining, but I remained awake gladly. All the catching up brought much joy to heart and the travelling was surely worthwhile. What are friends for?

Cheers to friendships that last!

AN flying solo?

It was a bumpy ride this morning shift. Four nurses were on sick leave, and the ward could not call back any one else to come and help out. They had no choice but to let me play the role of an assistant nurse in the intensive care unit; for the first time without direct supervision.

It is because of today that I realise how capable the nurses in this unit are, or how much harder I need to work in order to(if ever possible) be on par. The workload was reasonable but I still could not complete my tasks on time.

In the ICU, most of the patients have a tube that goes into the stomach for the purposes of feeding. Part of the care of such tubes involves checking the placement by means of aspirating stomach contents to be tested with pH papers. Since gastric juices are acidic, we know that a patient's nasogastric tube is in the right place as long as acidic contents can be withdrawn out. According to the hospital's practice, nurses are required to check the tube placements every four hours. Generally, the assistant nurses in the ICU do it; so I did it today, but my speed was far from that of any of the experienced assistant nurses. The above was only one of the tasks that I was slow in performing this morning shift.

On a whole, I kept on forgetting things and had to finish whatever I missed later than whenever I was supposed to. The distractions did not help either.

Flying solo was not easy today. Appreciating the nurses whom I "follow" even more now.
I am new, but it is not an excuse to be lousy at work!
 

Foto Friday

Life is like a roll of film; there is no turning back, and you usually get only one shot.
Receiving undesired results is a normal thing to go through.
You just need to remember to put your focus on the right things in future.

"I want to speak English"

When asked if she could have a superpower, what would it be. A Chinese first-year nursing student answered, "I want to speak English well."

And my heart broke upon hearing giggles among some others who were listening.
 

1, 2, 3, 4, Goodbye.

One 86-year-old admitted for loss of consciousness associated with low blood sugar.
Two days in the Intensive Care Unit.
Three continuous doses of inotropic agents at their respective maximum dosages.
Four limbs mottling away.

Sometimes goodbye can be a merciful thing to say.

© Joel Yap

Foto Friday

 

Remembering people like him 

reminds me of what drives me 

in striving to be the best nurse 

I can be.

Foto Friday

This picture means a lot to me.
A big shout out to all who volunteered to observe GE13!
 

133:89

Results are out for Malaysia's thirteenth general election.

Dear all, please refrain from reacting too emotionally. Try not to make yourself look like a fool by the words you use and information you share. Be more wise lah.

80% voter turnout. Well done, people. I'm sure we can do better than this come next GE.

What to do in the next three to five years? Register as a voter! Start paying attention to what is going on in the country. Stop complaining.