Wednesday, August 10, 2011

Hospital, Holidays and Ramadhan.. ooh no!!, Sem 7 already!!

HALU2 my beloved readers!!! im back!! *slapping my face* yes2.. i been away for almost a month.. miss me already ha? ngeh3.. anyway, HAPPY RAMADHAN to all the muslims around the world.. ececeh.. to non-muslim, you guys are also welcome to try fasting, even only for one day.. :) i asked my Chinese friend to try fasting for one day, and she can make it until 4 pm.. she's good for the first trial.. :)

anyway, back to the story.. this entry will be pretty long to cover for a month.. ngeh3.. as i mentioned from my previous entry, im doing hospital attachment for my pharmacy practice IV at HTAR, Klang for 3 weeks.. in these 3 weeks, my friends and i been exposed with several of pharmacy departments such as outpatient, mtac, inpatient, store, clinical support like tdm, tpn, cdr, and manufacturing.as well as dis.. basically, we had to observe all the works there, exposed with the protocol, standard operating procedure, worksheets, formulation, raw material, etc.. we were not involved with the production since we were not under clinical attachment..

this is the summary that i can conclude from my experience:

outpatient = the most busiest department ever especially on Monday and Thursday, where there are appointments with the specialist.. the counter started around 7.30 am and end around 4.30-5.00pm.. usually all the pharmacists and assistant pharmacists will rotate their lunch call to ensure a continuous process of screening, labeling, filling and dispensing.. lunch call means that person will work at the lunch time (1-2pm) and will have their lunch at 2-3pm.. some cases they can do lunch call and continue working till 4pm and can punch out early, but very rare la.. every prescription must do less than 5 minutes.. imagine how hard we need to check the prescription, find the drugs, count the pill/tablets need to be supply, etc.. they all work like machine!!

mtac = is medication therapy adherence clinic is a clinic for referral patients to do their follow up, usually organized by the pharmacist.. for example, mtac warfarin, so basically the patients are on the warfarin medication and need a close monitoring as warfarin is narrow therapeutic drug.. overdose of warfarin will lead to internal bleeding and lead other complication.. you guys can Google more if want to know details.. :) pharmacist will monitor and will consult the physician what are the option available.. other mtac available are also mtac dialysis, pain management, respiratory, epilepsy, etc.. however, only the referral patients or recommended by the physician will be involved.. mtac is varies depends to the hospital's availability..

inpatient = this department has a wide scope of works.. from the supply of dangerous drugs or other medication to the wards and up to counseling.. they have the scheduled when and what to supply.. for instance, lotion, cream, etc will supply on Monday as a floor stock.. for iv drips, etc will supply on thursday.. (if im not mistaken) apart of that, pharmacists have to supply the medication to the patients individually by unit of dose or daily basis with the aid of assistant pharmacist..

imagine with one trolley represent one ward with 40 beds, pharmacist need to checked the correct patient's name at the correct bed number with the correct medication before the second dose or 12 noon.. for ward supply, they will cover the ground floor, first and second floor and for satellite pharmacy 7 and 8 will cover the rest of floors..

for dangerous drugs like morphine, cocaine, etc, they have specific room to kept them with locked cabinet and strict documentation and protocols only pharmacists can handle all the stuff.. for instance, if the accidental and emergency (A&E) wants morphine syrup, pharmacist will record and prepared how much they want.. but of course with limit amount, so on and so on..

apart of that, we also have to do counseling or bedside dispensing.. we need to teach and demonstrate the patients how to use the inhaler (so many types of inhaler we need to know), the insulin pen, etc.. there are also procedures to do beside dispensing.. not simply give the drug and chow okey.. bedside dispensing is where pharmacist will dispense the medication in the ward before the patient discharge.. so easy for the patient because he/she will straight pay the bill instead went to pharmacy to collect the medication..

dis = or drug information service is a place where to get the drugs information.. the caller can be physician, sister, even pharmacist as well as public will ask inquires or report any adverse reaction.. so pharmacist job is to search and inform the information with limited time at least 10 minutes for urgent case.. apart of that, he or she must update the medication chart that been used in mtac as well as in the wards, update the pharmacy bulletin, do the statistic, etc..

tpn = or total parenteral nutrition is part of clinical support.. keje xsusah tapi sangat CEREWET! i mean it!! gee.. why? because to prepare the solution, you have to enter the clean room, have a proper aseptic technique in terms of clothes, materials, equipments, etc.. if you skip one step, congratulation, you killed the patients.. choy3!! the calculation for formulation is tough, i almost cried doing that stuff..

tdm = or therapeutic drug monitoring is basically to monitor narrow therapeutic drugs like warfarin, theophylline, gentamycin, etc.. most of these drugs will lead to renal failure and other complication if not been well-monitored.. some of drugs like acetaminophen been monitored for the case of poisoning.. actually the term of poisoning of acetaminophen is more to suicidal attempt, sort oF..

cdr = or cytotoxic drug reconstitution is involved handling the cytotoxic or cancer drugs.. and yes, its dangerous!! yang ni LAGI CEREWET dari tpn.. everything must be double.. double mask, double clothes, double gloves, everything la!! for personnel's safety.. :) pharmacists will rotate every 6 months in these departments.. bak kata orang, nak prepare ubat untuk patient, alih2 diri sendiri low white blood cells, means affected..

manufacturing = involved in pre-packing the tablets, lotion, cream, etc.. as well as prepare the bulk material for storage.. 2 days in this section, nothing much i can observe since most of the preparation already done..

store = this is where all the bulk raw material been ordered, delivered and stored before been issued out for the ward supply.. ada bahagian store ubat-ubatan dan store alatan.. ubatan means all the drugs involved and for alatan means like syringe, bandage, etc.. this section is more to paperwork and technical.. which is boring.. hahahaha.. *joking*

orite!! thats all for my attachment's experience.. 3 weeks went to hospital, and 1 week of holiday.. yup, thats all i got.. thankz!! hahaha.. our school of pharmacy have only long sem like IPTA except we start early a month, August and end same with the IPTA.. so yup, less than 3 months holidays and if we got another attachment like industrial attachments for this sem 7, we dont have the holidays.. ooh thank you!! im so happy!! *der!!*

*dushh!!*cut the crap!! my 1 week holiday which im totally forgot its during Ramadhan time.. baru je ingat nak menghabiskan duit mummy and daddy makan2 kat monrod, black canyon, steak house, semua tinggal harapan.. hahaha.. anyway, i still have the blast holidays..

for the weekends, my family and i went to cameron highland.. ada jemputan berbuka pose disana, petang jumaat.. sabtu ahad makan sendiri.. hahaha.. apa lagi, melepak la kat Heritage Hotel.. mekasih!! i suka!! for sahur, they give home-made chicken burgers, serius memang tebal and sedap, siap ada hirisan carrot lagi dalam isi tu and sandwich.. l

ike my daddy said, benda2 simple macam ni klau kat hotel, semua sedap.. geee.. for our bukak pose, we prefer ordered from room service.. dapat2 makanan still panas compare beli bazar, dah sejuk sampai hotel.. muhahaha.. and of course a small shopping.. small la sangat, penuh bonet myvi dbuatnya.. geee.. since its not school holiday season, less tourist there, so basically all the stuff there sold with very3 cheap price.. apa lagi, borong strawberry, jagung, macam2 jenis sayur.. i got new bag, thankz mummy.. my mum bought new shawl for herself and for my bro's girlfriend.. so yeah, you guys should go there when its not school holiday season.. geee.. :)

end of my holidays.. start new sem.. get the result.. thank God i pass.. i really scared with ICP paper.. its the toughest paper ever.. done with registration.. sem 7, ill start with drugs abuse, clinical pharmacy 1, research project 1 veterinary, cocu.. 5 papers but only 3 exams to go through..*tetiba suka suki plak*

for clinical pharm 1, only got 2 options either Hosp Sg Buloh or HTAR.. so i choose Sg Buloh with my friend.. it doesnt matter which one you go because for clinical pharm 2, we will exchange the hosp, ill go HTAR.. so its still the same, experience both hosp.. for research project, ayoo already garu kepala.. im still dont know what i wanna do.. just brief discuss with my friend, both of us prefer disease/clinical but of course different disease.. im really worried regarding the lecturer's selection..

orite!! done!! pretty long ha? i told you already.. ngeh.. thats all for now then.. thank you for reading.. :)


t
ill then..

foot note: will blog walking for those who leaved the link.. sorry for the delay and thankz for visiting my dusty blog.. :)

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