Clinical Clerkship: Medicine Life

So, I'm back using this blog again. Hello world, we meet again!

It's almost 60 days since we entered another world in medical school called Junior Internship. It's more known as Clinical Clerkship nowadays, just to keep us in check with the modern trends. Clerkship is considered the last stage (4th year Med) in medical school before graduation. Students in this level now assume the position of a clerk, whose tasks include interviewing and diagnosing patients, formulating diagnostic and treatment plans, perform various procedures that not everybody can do, and especially, monitor. Oh yes! Sounds a lot? You haven't seen anything yet.

Our group started out clerkship with the Medicine rotation, which is considered by majority of people that I've asked as the most "toxic," or more commonly, the hardest of all rotations. This is where 3 years of Patient-Doctor come into play.

If you ask what a Medicine Clinical Clerk does everyday in the hospital, well...

You initiate rapport with patients, handle them, and deal with them, especially the relatives. You learn how to do the "diskarte" factor when it comes to patient care, wherein you try to maximise your time handling more than just 1 or 2 patients. You also learn how to refer to different departments, where medicine is most of the time the starting point for all referrals. You also attend teaching rounds and subspecialty conferences to enhance your knowledge in certain areas of medicine. You answer to codes and either do chest pumping (for males) or ambu-bagging (for females) of the patient who's life is as thin as  a strand of hair, in short, at the brink of death. Much more, you learn how to THINK. Yes, THINK. To use the brain, to think, to analyze, that's how we do it. 

There's more to what medicine can offer to clerks, it's just up to you to discover.

This rotation of ours, which is set to end in a few days' time, is for me the best rotation...yet. There's a lot of learning in the Department of Medicine. Interns rotating outside of Medicine say that rotating in this department is hard, taxing, and most of all, "toxic." Yes it is, but learning is abundant because of the fountain of cases that can be found in the pay and charity wards, and don't forget the out-patient department. Rotating in the department has been a memorable experience, especially because of the friendly residents and consultants who are more than willing to teach what interns need to know. There are no dull moments with the house staff because they make you feel at home, despite the toxicity. The coolness of this department makes me think of pursuing Internal Medicine as a specialty in 2 years' time.

As the 1st chapter of our 12-month journey to graduation draws to a close, I'm proud to say that I've survived one of the most "toxic" areas of the hospital. What makes me a proud intern, a soon-to-be-physician, is that what was complex has been made simple because of experience. At the end of the day, the fund of knowledge is filled with new information and knowledge that is waiting to be shared to everybody who needs assurance from a person who knows health better than the layman does.

As seen in a Twitter user that I've been following for quite some time:

"When the complex becomes simple, it's pretty amazing."

Two months down, 10 months to go.

Looking Back at Nursing: the social 'trend,' training hospital issue and salary problems

(This is an unfinished post from last year, which I just finished now.)

It has been 3 years since I graduated from my pre-med course. Since then, much has changed within the atmosphere of nursing: the decline in enrollment rates, the appeal of AYNLA on nurses' rights, the still-uncertain future for nurses who are just left working in non-nursing jobs, and recently, based on FB posts, the nurses who keep pushing for the imposition of the salary grade of nurses stipulated in RA 9173 or the Nursing Law. Despite being on the other side of the fence for 3 years, I keep on looking back, even for just a sneak peek on what has happened in nursing since I jumped ship. It must have been a tumultuous road for nursing in the country, and I must say, the problems that have burdened the profession I was once a part of, but until now I still cherish and love, is somewhat overwhelming.

Nursing has been the course of so many people who believe that this course is the easiest way to a better life. Most parents entice or prod their children to take up Nursing so that these children will be the ones who will put food on the table of their parents and siblings once they have fulfilled their obligation to achieve the profession. Because of this humongous trend, a lot of  so-called Nursing schools have sprouted left and right, front and back, and lure students to achieve a Bachelor of Science degree and become certified Board passers in the near future. It turns out, instead of promoting the improvement of Nursing in this country, the overemphasized trend of Nursing as a "way to escape poverty" has backfired in ways unimaginable. Think about it: because of the increasing number of Nursing graduates who couldn't land a sure ball job as a nurse, there has been a surplus of nurses of unthinkable proportions. According to the Board of Nursing, there are hundreds of thousands of licensed nurses who still don't have a decent job as a nurse in a hospital. To curb that problem, the Department of Health has launched their pro-nursing campaign of letting fresh board passers to work in the community and gain experience.

On the other side, hospitals would launch their own "pro-nursing" campaign of hiring nurses and letting them train in hospitals, but for a certain price. These nurses pay training fees, and train without the certainty of landing a job. Because of this, in January 2011, the Association of Young Nurses, Leaders and Advocates International, Inc., or AYNLA, has been called in Senate hearings about this commotion between nurses and training hospitals. With this commotion, training hospitals became more stringent with their training criteria, and now would barely accept nurses for training. Despite that patriotic move from AYNLA, what they did, instead of helping nurses land better jobs, taking their complaints to the Senate made it worse because hospitals became more strict and impeded the flow of nurses who are supposedly to train. The thing about the hospitals is that they shouldn't be exploiting the number of nursing graduates and let them train for a hefty price with a big void of landing a stable job. It's also inappropriate for hospitals to become more strict with letting nurses train. AYNLA just wanted for proper nurses' rights in terms of training. Either way, there was no winner or loser in this case. AYNLA was a winner because they took their grievances to the Senate, but lost in terms that nurses now found it kind of hard to train in hospitals and land good jobs. The hospitals, on the other hand, won because the move by AYNLA made them more stringent in letting nurses train, which would save them more money in the long run. They lost in this case because they just let the trust and confidence of nurses down in their potentials to become great nurses someday.

Another issue is the appeal of nurses to uphold the salary grade of 15, amounting to PHP20,000 a month. If you work at a government hospital, it is a possibility to gain such salary. But, despite such law implementing such a salary grade, it's just a dream that is left unfulfilled for most, if not all, hard-working nurses. What's with the promise of a better life if the hospital that you're working for is not even abiding to the law that stipulates the implementation of salary grades? Earning 10k a month in a private hospital won't suffice to put a month's worth of food on your family's table, that's for sure.

Nursing is a noble profession, but, the issues that nurses handle in this ever-worsening society makes it losen its nobility because of necessity: hefty paychecks and a taste of the good life. What happened to nursing as a caring profession, a profession that doesn't crave for money, but instead for the respect of society? It's up to the nurses in this country to set the mindset of everyone that nursing is not a money-making profession and a way out of poverty. Rather, it is a profession that leans on care and trust towards the client/patient.

Think about it.

Intern's Log

Watch out for a blog page about life as a Junior Intern a.k.a. the lowest life-form in the hierarchy that is MEDICINE.

Onward to Junior Internship!