What happens when a chapter ends?

Last Thursday, 25th February, I spent my last morning shift in NTFGH Ward B11, a General Medicine and Geriatric discipline ward. I have spent my last 3 months as a nursing student there, struggling to adapt and to learn. Lucky enough for me, I managed to pick up rather quick, by the end of third week I was ready to have at least three patients under my care, of course with the help of the staff nurse in charge.

It became a daily routine; shuffling through the tiring shifts, waking up at five in the morning for AM shift, having a light breakfast in the staffs' room before going in for work. I have learned to have at least a cup of Milo before going into morning shift, because during my third or fourth week, I worked throughout the whole shift and only managed to have my lunch AFTER shift. I was quite proud with myself, to be honest. I still dreaded the short transition that we have when we go from PM shift to AM shift.Our PM or afternoon shift starts at 1pm, and ends at 9.30pm but of course, everybody goes home after 9.30pm. If you stay near the hospital, lucky for you but if you stay a little further, that's too bad as it would mean that you only have four to five hours of sleep and then there you go, finding yourself getting ready to return to the ward you left just seven to eight hours ago. It was only for 3 months, or 12 weeks yet I hated the shift work when I still have ten years down this road.

Going into the beginning of the past 12 weeks, I was terrified, nervous and all the stories told by our lecturers of how students failed when they were towards their end PRCP made it all worse. I was hoping that my assigned preceptor would be a great one and that the staffs in the ward would be friendly. I think I had a rough start with some of them, I'm not really the social type. As weeks went by, I started getting closer to some of them and we would talk about other things instead of just work. I had a change of preceptor as well, not that the previous one was not good but obviously I liked the later one more. A good preceptor - preceptee relationship was really important as it may affect how well I can perform.

Hours went by, weeks went by; day by day I was getting more and more familiar with the workflow. I was proficient (I dare say) in serving medications. Towards the end of week five and starting of week six, I was taking all six patients under my care with the guide of the staff nurse. Initially, I struggled because six patients would mean dozens of different orders, and tons of different medications. I gave my best in trying to remember the orders I would need to complete by the end of my shift. It was at that point where I was under tremendous stress and was at the point of breaking down. I felt that I was so close to the edge of the hill and I was about to fall off and die. It was also then that I realised why some nurses and doctors are so tasks-oriented because the workload is simply just too heavy. However, I refused to give in. I chose this path (though initially I wanted to study medicine) , and I chose this because I wanted to help those in need, to learn more about medicine and diseases. So in the midst of all the demanding tasks, I tried to give my best care to patients, by answering to their demands promptly, showering them with care and patience instead of rushing through, feeding them slowly. I guess I did it, because in between those weeks, I received my first ever official compliment from a patient's family member. It was a huge boost to my confidence, and it definitely helped pushed me through the second half of my internship.

Another few weeks went by, and I found myself making phone calls to doctors/labs/family members on my own, and receiving cases by myself. I received three transferred patients on my own during one of my afternoon shifts, something I would have not imagined myself to be capable of so soon. I was proud of myself.

 Then came the graveyard shift which probably was every student's nightmare. Being in a geriatric ward, I prepared myself to babysit my patients throughout the night. Thankfully, all my three nights went by peacefully. I even had time to sleepily make my way to the staffs' room and catch a thirty minutes nap. Long before we even get to do this graveyard shift, we were scared mostly because of the 'strange encounters' we heard from our seniors and lecturers. Unexpectedly, those did not even cross my mind at all. I was glad though. 

(photo via Facebook)

This is 99.9% the truth when you're in a geriatric ward, no joke. 

I felt responsibilities getting heavier on my shoulders as I continued my final journey as a student. I felt that I ought to get everything completed even if it means extra half an hour of work. 

Somewhere in week eight or nine, I had a patient whom suddenly went into a comatose state, probably because of his diagnosis. I did not know why but I was devastated; he was fine the day before. I was serving medications that morning and I had thought that he was still asleep but when my staff went to wake him up later on, she could not despite numerous times of calling. The patient did not even respond when she inflicted pain on him (one of the ways to check for consciousness). I had been caring for this patient for days; what happened was sort of expected but it came so sudden. I was sad, and one could only imagine how his family members felt.

Another of my first encounter, I was on morning shift the day when my patient deteriorated rapidly but thankfully, not coded. He came in for shortness of breath (SOB), but he was not on any oxygen. That morning he was fine, he was taking his medicine, he was eating his breakfast (full share). His morning vitals were great, saturation within satisfactory range. When his physiotherapist went to asses him later that morning, she took his vitals and informed me that his blood pressure was really high. So after five to ten minutes or so, I went to re-check on his vitals. He was still responding verbally to me, but I could clearly see that he was struggling to breath and his lips were turning purple (a sign of oxygen deprivation in the body). True enough, his saturation was only 70% which was really low (normal range would be >95%). And his blood pressure was really low as well, despite trying to re-take a few times. His pulse was so weak that I could not even feel it. If my staff guiding me was not there, I would have panicked. Thankfully after fluid resuscitation, and putting him on a non-rebreather mask, his condition stabilised after awhile. No words could describe the joy in me when I saw him so well a few days after that incident.
When I revisited that incident, I thought what if I did not re-check his vitals? What if I had forgot to do so or what if I waited longer? He would have died. I can only thank God for guiding me.

Honestly, I could go on with the things that I have encountered/experienced during my three months but that would be too much. I love and I hate this profession.
We are nurses, but we are also part-time babysitter, part-time cleaner, part-time translator but above all that, we are the ones who probably sometimes care most for our patients. Our patients can sometimes be mean, or their family members, but nothing beats that joy in our heart when we see our patients get discharged home healthily, or at least better. At least to me, I feel happy when I see my patient gets discharged.

I have finally completed my diploma, which means another phase in life is over. While I'm excited to start a new chapter, I'm also wondering what else that I wish to do. In a few more months, I'm going to be a 'staff nurse' or a 'registered nurse'; I pray to God that He will guide me, and give me the strength (physically and mentally) and also patience to be a great nurse.

Two amazing SN who really guided us throughout, missing them already! And two other great students. 

Only she knows

Tears threatened to burst from her eyes, like an open dam. She held them back by biting her lips, so hard that she could taste that familiar iron taste; blood. Mentally, she reminded herself not to let those tears fall. She's not that weak, her heart could withstand any pain; it wasn't made of flesh, it was made of steel. Hence, she did not cry but she walked on like she's fine. 

She gave up trying to express herself because nobody would understand, they don't give a fuck about how she feels. In their eyes, she's nothing but someone who has been disrespectful, someone who's caused trouble and someone who has no sense of forgiveness. She's done, she's a wrecked child, both inside out. 

What happens if they see this? Oh, they would only think she's a drama queen, she's out of her fucking mind. No, she doesn't care; this is for herself.  

They don't know what she had done to herself, all those time after each fight among themselves. Instead of erasing the emotional pain, she turned it into physical pain. No, she doesn't want to let them know because she could still use it as a way to breath, even though she has long escaped from it. Falling from one black hole to another, she wonders when she'll be free, really free. 

It's not much that she's asking for; she just wants them to understand. But to understand would be very very difficult, when she's at fault most of the time. She wonders if they had pour everything out onto a table, would there still be today? 

She couldn't hold everything in anymore, she needed to move on. But now, she's stuck in another black hole where she couldn't move, at all. No matter how hard she screams for help, nobody hears. It's a silent plea, only she knows. 

01/12

Hi my love ❤️ It's the 1st of December 2014 already. One year passed by so fast. I still remember how it felt like when you asked me to be with you a year ago. I was really really happy and excited back then, because you finally asked. Those feelings of when we were just together are different from now; nervousness, shy, not yet so comfortable with each other but now we're so comfortable we even fart around each other. 😁🙈 I love the time we spent together when we were just friends, how you always keep me suspended about your stories and how we waited for each other every day to go leveling together in Cabal. 

You asked if I wanted to meet up with you, I'm really glad I agreed to it because if I didn't, there wouldn't be 'us' today. I swear I was really nervous that day; nervous about your first impression of me and if we will have anything to talk about. Surprisingly, we clicked quite well and we just talked and laughed. You were such a gentleman to have paid for our lunch and even took the same train with me, even though you could've went for the shorter route to go home. From that day onwards , we grew closer to each other, as friends, up until when I asked you out for a movie. On that night itself, you confessed that you were growing fond of me 🙈. Honestly, I liked your choice of words. I'm not sure if you were just too shy to pop the question, or if you just wanted to wait till 1st Dec but, thank you having the courage. 

I wouldn't forget our first date. I wish we had taken a photo together but I guess both of us were too shy. I had butterflies flying in my stomach that night. The moment you offered to hold my hand, I was beyond happy. You held it tight, so tight that from then on, I knew you wouldn't let me go. I guess I was really overwhelmed that I even boarded the wrong train home. 😅 

Our fourth date was to celebrate our 1 month and you brought me to Clarke Quay. Your plan was to bring me to dinner and then have a stroll there, since it's quite a beautiful place but it rained so heavily that we had to change our plan. So, we went to watch Paranormal Activity at The Cathay instead. After that, I thought we were going home as it was pretty late but you took me for a walk. We sat down, near the 'istana' place at DG; we talked, you had your arms around me, then you told me to close my eyes and that was when you gave me the necklace. That night was also when you first kissed me, on my lips. ❤️😚 Besides this, I loved it most at the time when you turned me around and kissed my forehead before I we went off. 

We have so many memories that I can't list them all down here. I'm thankful and blessed to have you, as the one who loves me, and will love me. You have been taking good care of me, making sure I eat and not fall sick. Not all of our memories shared together are joyful ones but I guess they made us stronger, and more attached to each other. Thank you for staying and being there for me, thank you for the surprises you gave. Thank you for loving me, and for everything else. 

I love you, Lim Wei Rong. 😚 Happy one year anniversary. ❤️❤️❤️ 

For you…

I'm going to maybe just dedicate this post to a special someone who holds a special position in my heart, one that no one else can replace. 

For the past few days, I have been down with gastroenteritis(inflammation/infection of the guts due to virus/bacteria) and I haven't fully recover yet at the moment but I am much better compared to previous days. If it wasn't for you and your parents, I wouldn't have recovered. Most of the time I'm alone at home and I have nobody to look after me but I have you now, and I'm very very thankful for that. 

You shower me with love and care all the time, even more when I'm sick. When my cough didn't recover and I had to go for an X-ray, you accompanied me. You went to the doctor with me, because I didn't want to go alone. This time, you had me stay over at your place just so you can look after me. Trust me, I really wish I could stay with you because your presence makes me feel safe and not alone. You made milo for me, prepared medicine, get water, and rub oilment on my tummy for me and when I threw up, you were there trying to comfort me. All these make me feel deeply loved by you.  

You pamper me most of the time, if not all the time. I wanted you here on my birthday and spend the day with me, you did despite it being Father's Day as well. I like it when you come over unannounced, like the last time you came with unagi and a bottle of sparkling and then cooked dinner while I was sleeping like a log. I like going to sleep while hugging you, and waking up next to you. It makes the day better, brighter. I love it most when you make me feel like I'm a baby. 

It's your turn to fall sick now and I wish I could look after you because it's probably my fault. I'm so sorry ;( It's making me worried about you, thinking who's going to do cold compress for you if your temperature goes high. Why can't I be there for you like how you did for me? Please recover fast. 

And my dear, I love you, so much. Thank you for everything :* 

Life lessons

The things that I have learnt in my 19 years of life;

1. Memories will always be a part of us
Sweet or bitter, when something occurs and the impact on us is strong, it will stay in our memory (possibly for life) unless we encounter any accident which wipes our memory clear. Often the memories that stay are the bitter ones, and sometimes they happen during our childhood. So there, a scarred childhood. But memories play an important part in our life; they remind us of the bad things that we do not want to repeat and also the sweet ones brighten our life. Memories are precious. The effect they have on us, is up to us to decide.

2. Nothing is perfect, nothing
Life, family, studies, relationships, work, etc. None of those are perfect, so are many other things. Family, it can be a happy one but problems will always stick around and if we can't handle those problems as a family (a whole) then it will slowly fall apart and the same problem will be brought up the next time another one hits. Studies? No, never perfect, at least not to me. And life? It can never be perfect because in life, that is where you have your family, studies and every other things. On the brighter side, its good that they are not perfect because only then we will have room for improvement, and also we get to learn from our mistakes.

3. Things don't always go your way
Yeah, you might have planned something out so 'perfectly' and waiting for it to happen and 'BOOM', plan ruined! Plans get ruined because sometimes, we can't foresee any obstacles and that is perfectly fine because what's life without surprises? You'll just have to take it and learn to improvise your plans and maybe make better, smarter ones next time.

4. Things are easier said than done
A very common example is New Year's resolutions. I mean, c'mon! How many of us do actually fulfill our resolutions? Maybe one or two, but never all. Most of the things, we say them easily but to actually do them, its hard. It does not have to be something big. It can be something as minor as telling a person you will be there early for a meeting or a date next time but then again, you are late. It is like making empty promises but we are not, we are just not doing the things that we said we will do.

5. Words are important
Words, words, words and words. Words are powerful, each word has their own meaning and at times, words can be hurtful. We have control over what we say but at times, our emotions take over and we lose that control. Words come speeding out when we are in anger and by the time we sit and reflect on what we said, its probably too late because those words, have already hurt someone and sometimes, it takes more than an apology to fix things. It takes time. On the other hand, words can be affirmative. They can be assuring and warming. I personally prefer to hear words of assurance especially from my loved ones. Something as simple as 'thank you for the things you've done' shows that we really appreciate what that person did for us. It does not even require a gift to show appreciation or love. Words, if we choose them carefully and rationally, they would be beautiful to hear, or read.

6. Backstabbers 
Backstabbers are. . .ugly. They are the ones who put on that mask that coax you into believing that they are fond of you and then the next moment, insulting you behind your back. They are the ones who will not help you when you are in trouble, but purposely make matters worse for you. We can't trust people completely, and when I say people, it includes our own family members. Scary, isn't it? The thought of not being able to even trust your own family, what more when it comes to trusting strangers.  Even your own family members can be backstabbers. This is one of the many signs of an unhealthy family. What I mean by this is that they don't bring problems to the table and solve them together, instead they talk about them to someone else. For example, person A in the family is unhappy about person B in the same family. Person A does not open up the problems and solve them, instead he/she complains to another person and pretends that everything is fine in front of person B. Others might perceive this differently, but to me, it is consider as backstabbing. Same goes to friends and colleagues and other people around us. Hence, do not give away your trust 100%.