searching for my own meaning of life

Posts tagged ‘Malaysia’

Chapter #8 Part 1: RRT and Code Nurse

بِسۡـــــــــمِ ٱللهِ ٱلرَّحۡـمَـٰنِ ٱلرَّحِـــــــيمِ

Assalamu`alaikum and greetings to all…

All praise to Allah SWT, another milestones achieved in my nursing career when I was assigned as the Rapid Response Team (RRT) nurse. Meaning that I am competent enough to hold such a big responsibility. It is a privilege for any critical care nurses to be a part of the RRT or Code Team and each member have their own pager or bravo phone. The phone is going to ring whenever there is an activation of RRT (Adult) or Code Green in the whole hospital.

Basically, after working for 6 months in my Medical-Surgical Intensive Care Unit (MSICU) the Head Nurse can ask my Charge Nurse to assign me as the Code nurse. It is an extra assignment on top of being a bedside nurse. The Code nurse must be a BLS and ACLS certified. My responsibility is to attend any call for Code Green – cardiac or respiratory arrest for adult.

Our code team consist of a Dr from ICU as the Team Leader, an Anaesthesia Dr who will perform intubation (if needed), a Respiratory Therapist (RT) who will maintain patient’s patent airway, a staff nurse from Department of Emergency (DEM) who is responsible for administering medication, a staff nurse from MSICU who is responsible for defibrillator machine, a Pharmacist who will prepare the medication and a Nursing Supervisor who will do the documentation of all the events in a code sheet.

Meanwhile, RRT Team consist of one Senior Resident Medical Dr, one RT and one staff nurse from MSICU only. For me, being a RRT nurse is more challenging compared to Code nurse because we have to manage the situation wisely before patient’s condition deteriorate to cardiac or respiratory arrest. That is why only after working for 2 year and 6 months in my unit, my Head Nurse assigned me as RRT nurse for 2 weeks. Overall, I had 5 RRT’s calls which 3 of it ended up to Code Green. What a busy day!

Back to my two previous hospitals in Sarawak, Malaysia we do not have this kind of RRT and Code Team system. Probably because we do not have enough knowledge, manpower and technology to create such a great team. In staff nurse point of view, ACLS certified nurse are only those who already have post-basic in ICU and their numbers are limited. In terms of technology, we do not have the pager phone and even the overhead speaker is not working most the time.

Hopefully the nursing management in Malaysia is working on this RRT and Code Team. I am looking forward for the system being implemented especially in the government hospital. Indeed, it can improve patient’s safety and prevent delay ICU admission.

“Attention! Attention! RRT Adult….”

“Ya Allah, sesungguhnya aku berada di Arab Saudi ini untuk mencari rezeki yang halal dan diberkati-Mu, mengikut sunnah Rasullullah SAW dan ajaran Al-Quran, dan berbakti kepada kedua ibu bapaku. Ya Allah, Engkau permudahkanlah urusan kerjaku. Lindungilah aku daripada segala kesilapan dan kecuaian yang boleh membahayakan pesakit di bawah jagaanku, pekerjaanku, dan orang-orang disekelilingku. Engkau lembutkanlah hati orang yang bekerja denganku agar mereka senang bekerja denganku. Engkau lancarkanlah lidahku agar mereka memahami perkataanku. Hanya Engkau tempat aku berharap dan meminta pertolongan. Hanya Engkau yang berkuasa menentukan segala urusan. Aku merayu, aku meminta dan aku memohon kepada-Mu ya Allah, makbulkanlah doa hamba-Mu ini. “

(Doa harianku sebelum turun kerja)

Until we meet again.

May peace be upon you.

Kota Kinabalu-Semporna-Kundasang

بِسۡـــــــــمِ ٱللهِ ٱلرَّحۡـمَـٰنِ ٱلرَّحِـــــــيمِ

Assalamu`alaikum and greetings to all…

Wah!!! Kali terakhir aku menulis dalam blog ini 6 bulan yang lalu dan antara sebabnya: tiada idea hendak tulis tentang apa atau sibuk dengan urusan kerja. Alhamdulillah… hari ini baru ada kesempatan untuk aku kongsi pengalaman bercuti dengan keluarga di Sabah. Seperti percutian kami di Thailand pada tahun 2016, tempat pertemuan kami semua kali ini di Kota Kinabalu. KUL-BKI, BTU-BKI, dan KCH-BKI. Aku mengambil pakej 3 hari 2 malam Semporna (RM650/seorang) dan 2 hari 1 malam Kundasang (RM350/seorang).

Welcome to KKIA

Terdapat 2 pilihan untuk sampai ke Pekan Semporna. Pada awalnya kami bercadang untuk menggunakan jalan darat. Homestay pun sudah ditempah tapi disebabkan perkara yang tidak dapat dijangka, kami semua menaiki kapal terbang dari Kota Kinabalu International Airport (KKIA) ke Airport Tawau. Sedikit pengajaran mengenai homestay di Pekan Semporna, sebelum menempah silalah bertanya dengan Tour Guide sama ada rumah itu sesuai atau tidak.

Pulau Mabul & Kapalai – Dari Jeti Umum Semporna, kami menaiki boat ke Pulau Mabul dan perjalanan mengambil masa lebih kurang 30-45 minit. Memandangkan kami akan bermalam satu malam di sana, Helmi mencadangkan untuk membeli sedikit makanan ringan di Giant Supermarket takut lapar pada waktu malam. Kami menginap di Arung Hayat dan tiba hampir waktu Zohor. Selepas checked-in, solat Zohor dan makan tengah hari, boat man akan membawa ke tempat snorkeling. Jadi, kena guna sun blocked dan baju renang siap-siap. Jika ingin mengambil gambar di I ♥ Mabul, bayaran akan dikenakan melainkan anda menginap di Water Bungalow Resort. Kami mengambil gambar dari jauh dan atas boat sahaja. Hehehe…

Larissa 19 & Bajau Laut

Selepas jam 4 petang kami kembali ke tempat penginapan, berjalan-jalan di sekitar kampung dan melihat matahari terbenam. Di sekitar tempat penginapan, anda dapat berjumpa dengan orang Bajau Laut menggunakan sampan dan mereka menjual buah kelapa, makanan laut seperti kerang, ikan dan lobster.  Bolehlah beli dan minta tukang masak di tempat penginapan masakkan untuk makan malam. Pada waktu malam, tiada aktiviti atas air dibenarkan. Waktu ini kami berehat dan siapa yang ada internet Digi, Celcom atau Maxis boleh muat naik gambar di laman sosial. Tune Talk tiada dalam perkhidmatan.

Amina Holidays

Pulau Bohey Dulang, Mantabuan & Sibuan – Selepas checked-out dari tempat penginapan, kami menuju ke Bohey Dulang. Disebabkan hujan turun pada hari itu, aktiviti mendaki secara automatik tidak dibenarkan dan kami hanya dapat mengambil gambar di bahagian luar. Pada waktu tengah hari, aktiviti island hopping dan snorkeling diteruskan di Pulau Mantabuan dan Sibuan. Subhanallah… pantai yang sangat cantik dan laut yang membiru. Apabila hampir Asar, kami bertolak balik ke Pekan Semporna dan menginap di Warisan Inn.

Sibuan Island

Pekan Semporna, Bukit Tengkorak & Jambatan Pakalangan – Di Pekan Semporna, kita boleh membeli barang cenderahati di Dragon Inn. Mendaki Bukit Tengkorak dan singgah sekejap di Jambatan Pakalangan untuk bergambar.

Bukit Tengkorak

Kundasang & Ranau – Setelah kembali ke Kota Kinabalu dan berehat selama 1 hari, aku teruskan percutian dengan mengunjungi beberapa tempat menarik di Kundasang dan Ranau. Antaranya:

  • Pekan Nabalu
  • Pintu masuk Taman Kinabalu
  • Tagal Sg. Moroli Kg. Luanti Baru Ranau – RM5 Dewasa rendam kaki
  • Sabah Tea Ladang Nalapak – RM5 Tree House Experience
  • Kinabalu Park Heritage Site, Poring Hotsping, Canopy Walkway – RM3 Conservation Fee + RM5 Camera fee
  • Arnab Farm Sejati Kg. Poring Ranau -Entrance fee
  • Kinabalu Pine Resort
  • Sayap Ayam Madu Wak Ali
  • Mount Hill Villa – Entrance fee
  • Sosodikon Hill – Entrance fee
  • Desa Dairy Farm – Entrance fee
  • Mesilou Cat Village – Entrance fee
  • Culvert View – Entrance fee
  • Mirolinet Enterprise menjual barang kraftangan

Mount Kinabalu

Disebabkan kesihatan yang tidak mengizinkan pada hari terakhir, terdapat beberapa tempat aku terpaksa abaikan seperti Jambatan Tamparuli dan Rumah Terbalik. In shaa Allah, panjang umur dan murah rezeki aku akan kembali ke Negeri Di Bawah Bayu ini. Terima kasih diucapkan kepada Mie Babat dan Mie Mania yang telah menjadikan percutian aku kali ini sangat indah.

Dan di antara (kebesaran)-Nya, Dia memperlihatkan kilat kepadamu untuk (menimbulkan) ketakutan dan harapan dan Dia menurunkan air (hujan) dari langit, lalu dengan air itu dihidupnya bumi setelah mati (kering). Sesungguhnya, pada yang demikian itu benar-benar terdapat tanda-tanda bahagi kaum yang mengerti.

(Surah Ar-Rum 30: 24)

Until we meet again.

May peace be upon you.

Chapter #7 Part 3: Master of Nursing (Nursing Education)

بِسۡـــــــــمِ ٱللهِ ٱلرَّحۡـمَـٰنِ ٱلرَّحِـــــــيمِ

Assalamu`alaikum and greetings to all…

Credits to Mr Rasheedan Ellin for sharing the photos in his Facebook page. To obtain a Master is one of my wish lists which not yet come true. In shaa Allah, after gaining a total of ± 10 years experience in nursing field, I will came back to Malaysia and further my study. I do realise that the more we study, the more we do not know. Knowledge is something that does not have an ending and all praise to Allah S.W.T.

My XP Level: 7 years 6 months. Basically, I have another 2 years and 6 months to stabilise my financial status and make sure everything is under control. Indeed, I can only plan and the best planner is always Allah S.W.T.

Bittaufiq wannajah! Wish me all the best my readers!

UNIMAS Gemilang!

“Dan kepunyaan-Nya lah segala apa yang ada di langit dan di bumi dan untuk-Nya lah ketaatan itu selama-lamanya. Maka mengapa kamu bertakwa kepada selain Allah? Dan apa saja nikmat yang ada pada kamu, maka daripada Allah lah (datangnya) dan apabila kamu ditimpa oleh kemudaratan, maka hanya kepada-Nya kamu meminta pertolongan.”

(Surah An-Nahl 16: 52-53)

Until we meet again.

May peace be upon you.

Chapter #7 Part 2: Time Back

بِسۡـــــــــمِ ٱللهِ ٱلرَّحۡـمَـٰنِ ٱلرَّحِـــــــيمِ

Assalamu`alaikum and greetings to all…

After came back from my second vacation last month, I had been working every three to four days with only one day off in between. This is expected during holiday season like Christmas and New Year, regardless which hospital we work. It was tiring but worth with the payment that we received at the end of the month.

One of the good thing I found working in KSA is they are really strict about working hours. Here, we work for 264 hours in 6 weeks. Compared to those working office hours, we have to work another 12 hours in other to be equal like the office hours staff. For your information, the office hours on Sunday until Wednesday is from 0730-1700 hrs, Thursday 0730-1600 hrs, Friday and Saturday is day off.

As a staff nurse working in shift hours 0700-1900 hrs and/or 1900 hrs-0700 hrs, our day off can be fall on any day. During this day off, if we attend a course or a workshop, we are entitled for a time back. Meaning that no hours being wasted just like that. Once our time back reached 12 hours or more, we can request for a day off in any day of our regular duty. Another option (depend on the management), the time back can be granted as over time and we can earn money from there.

In my case, I got a day off and it stretched for 7 days. Yikes! Longest day off I ever had as a staff nurse. Hopefully, the nursing management in Malaysia will implement this kind of system too.

Use every chance to visit Al-Haram Makkah

“Demi masa. Sesungguhnya manusia dalam kerugian. Kecuali orang yang beriman dan mengerjakan amal soleh serta saling menasihati untuk kebenaran dan saling menasihati untuk kesabaran”

(Surah Al-‘Asr 103: 1-3)

Until we meet again.

May peace be upon you.

Chapter #7 Part 1: My Hope for Nursing in Malaysia

بِسۡـــــــــمِ ٱللهِ ٱلرَّحۡـمَـٰنِ ٱلرَّحِـــــــيمِ

Assalamu`alaikum and greetings to all…

If I have a super power, here are some changes that I will do to make nursing in Malaysia much better. This is based on my personal opinion and experience working in three different institution, at two different country. Honestly, I can rant about all the negative issues I encountered when I was a Jururawat U41 but let just put it aside.

The Road Not Taken in KSA

Nursing Education

We all know that knowledge is power. The qualification of all nurses in Malaysia should be at least Bachelor of Nursing a.k.a Degree. When all the nurses have same basic education background, their knowledge can be reflected on the nursing practice and hopefully they can provide a quality nursing care.

What is going to happen to Jururawat U29? At certain point in their years of service, I think they should upgrade their education level and this requirement must be put as compulsory. Otherwise, the old-school-unwilling-to-change-nurses should be removed from the system. Their presence is just like a parasite. As time goes by, their grade will goes up by default and until now we did not see any different because they just counting days for retirement.

Moreover, all Degree nurses should be encourage to further study. The Institut Latihan Kementerian Kesihatan Malaysia (ILKKM) should stop producing Diploma nurses and focus on training specialized nurses in Intensive Care, Hemodialysis, Labour and Delivery etc. There are numbers of experience nurses out there who can become a very good Clinical Instructor and Lecturer but unfortunately we do not have enough post for Pengajar U41. 

Those who are working in specialized area must complete and renew their privileges every 3 years. It begin with attending a class, sit for exam (if applicable), get a check-off during the class and after that hands-on in the clinical setting. This is to ensure that their knowledge and skill is up-to-date with evidence based practice.

Nursing Development

Since most of us graduate from different nursing school, the standardization of nursing practice is very important when we come to the clinical area a.k.a hospital. Here, the management level of nursing play a major role by ensuring all appointed nurses in the government passed the Lembaga Jururawat Malaysia test and passed all subject covered in the nursing syllabus. Failed in English and Mathematics is not acceptable as later on we will be dealing with a real patient. Patient’s safety should not be compromised just because of incompetency of the nurses.

The nursing management team should come out with Internal Policy and Procedure (IPP) for all nursing practices that is going to be applied in all hospital under Ministry of Health (MoH). In the IPP, there must be a Title/Description, Index Number, Effective Date, Replaces Number, Applies To, Approved By and complete details on how the procedure must be done.

Honestly, I did not know what are the job scope of the Dark-Blue-Nurses working in MoH. For me, those nurses working office hours and sitting in front of the computer most of the time should review, update and sometimes drop the IPP from the system based on current research findings. Continuous search, read and appraise the research article is the main task and it is time consuming. A lot of thinking and writing involved here. Therefore, they should have access to all reliable databases which I don’t think we have at the moment.

I always wondering what happen to all the Final Year Project or research done by nursing students? Where we can get access to their paper? Does the management have effort to publish the papers in any database? You tell me the answer.

Nurses in the clinical area should only become the end-user of the IPP and not the one who have to do both management and clinical responsibilities at the same time. This is one of the reason why I happily resign from the MoH because of the unclear and unfair job distribution.

Nursing Practice

Sooner or later, we have to work towards a paperless hospital. Everything should be computerized and system generated. At first, it is going to be complicated but once we get used to the system, our work will be much easier.

Should we changed to 12-hours shift? Personally, I do not think it is a good idea because our nurse-patient ratio is not ideal and our huge Bed-Occupancy-Rate (BOR). No matter how much working hours we have, it will never get enough. Everybody should aware about this and that’s why we have continuity of care.

Furthermore, the National Nursing Audit (NNA) should stop focusing on the 5 procedures only: Administration of Oral Medication, Administration of Intravenous Infusion, Aseptic Wound Dressing, Blood/Blood Component Transfusion, and Pain as 5th Vital Signs. Please move on and cover other procedures also.

Nursing Payment

Once we manage to improve on our nursing model and development with a clear career pathway, that’s the only time we can ask to increase our basic salary. When this happen, all nurses working abroad will faithfully come back and serve for people of Malaysia.

 

“Berubahlah. Bila kita anti-perubahan, kita sebenarnya tidak berfikiran terbuka.”

(Azizul Azli Ahmad – Otak Power)

Until we meet again.

May peace be upon you.

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