the house officer’s survival guide - .doc

HOUSE OFFICER’S SURVIVAL GUIDE VERSION 3.1 BY FONG SAU SHUNG Edited NG KAR HUI, GERALD TAN, HOW CHOON HOW Online version at: /school INTRODUCTION Congratulations, you have passed your MBBS, and are about to embark on the very first year of your continuing odyssey of medical training, which is the year of the House Officer. This is actually the end of the beginning, although it may feel very much like the beginning of the end. This book is a guide to survival in the ward. It does not aim to replace your textbooks, guidebooks and drug books. Even the accompanying ‘common drugs list’ should be used with caution and a little intelligence. What it strives to do, as with all previous versions of the book, is to prepare you for all the practicalities of a house officer’s job. This version is significantly different from the previous versions of the House Officer’s Survival Guide, which was pioneered by Dr Gregory Leong Goh Han in 1998, with revisions and additions by Dr Ong Yew Jin and team in 1999, Dr Phua Dong Haur in 2000 and Dr Ng Yeuk Fan in 2001. This author, however, strives to retain the spirit and soul of the original, and hopes that you will find this revised format even more useful. THE AVERAGE DAY IN THE LIFE OF A HOUSE OFFICER The typical day begins at 0730 hours in preparation for the morning ward round. Work involves changing the intravenous cannulae (plugs), giving bolus intravenous drugs (IVs, not required in all hospitals. These are sometimes the duties of nurses), taking fasting bloods and laryngeal swabs and trough levels of antibiotics. Ward round generally begins at 0800 hours with the arrival of your MOs / Registrars / Consultant. Your job here is to present patients unfamiliar to your senior doctors, update them on the patient’s conditions, and note down their orders in the clerking notes, treatment and diet sheet and inpatient medical record (IMR). Do not worry if you cannot remember all of your patients in the very beginning. This will come with