NARRATIVE

First things first.
I told myself I didn't know what to do. The day before was still a relapse of memory - shocking and reverberating. I called Paul Gines to assure if they were on-duty for 12 hours the following day, and he said yes adding that Mark Balonquita was his partner (but, didn't say Brian Santos was too). That does the conversation. Period.
The thing is, I called at the spur of the moment. I called on a whim. Not planning anything ahead or whatsoever.
And the next day, I was sure the only thing I brought along sans the immunology lectures and applications/lab skills was myself clad in a head-turning OJT uniform at 6:30 am on October 16, 2010 in the Veterans Regional Hospital, Bayombong, Nueva Vizcaya.
The idea was not being totally stupid. I was there as "an observer" - where I should have been really a part of it supposedly - because I wanted to learn, I needed to experience, I had to feed my mind, I bent beyond certain circumstances. Simply put, I was ignorant at the same time innocent. I was "more or less an observer".
Still...
Upon entering the lab area for examination, I thought I saw myself in retrogression. This was unspeakably familiar. The time was 7 am. Being the newcomer, I was frequently asked by the staff of chemists, medical technologists, lab technicians, doctors, et al. As for courtesy and authority-awareness that were two things that shouldn't be forgotten during OJTs, I had to remind myself about it.
Thereafter, anyway, I tailed the three masculados into the stock room/ small lobby to leave our bags. I managed to watch them, with one of the staff - a Ma'am, keenly prepare the desk at the out-patient department (OPD) area of the lab. The basic paraphernalia were Terumo needles ranging from 20, 23, to 25 gauges, syringes of 3cc, 5cc, and 10cc, compartmentalized cottonballs (with and without alcohol), micropore, scissors, small test tubes (generally used for 2 purposes: (1) blood chemistry analysis [red-capped] and, (2) complete blood count-actual platelet count / CBC-APC analysis [blue-capped] ), Kahn tubes, to-fill-in and filled-in lab test request papers, trashbins (non-bio and hazardous), and what struck me most was the madeshift tourniquet - a spared surgical glove [shouldn't the hospital have enough supply for it?]
The first patient was an old man who was venipunctured in the arm by Mr. Gines. The latter performed the plebotomy quite easily and swiftly in less than a half insertion at approximately 25° angle with the bevel faced up. I mentally noted that. Then, the old man was asked to return at 1 pm that same day. After collecting the blood, I took note on how he removed the needle off the syringe pulling it and not turning, transferred the blood diagonally into the blue-capped tube filled up to the black marked line and labeled it with the patient's name and the test requested. I had to back-off sooner since the space required a very very limited number of people. Meanwhile, Mr. Balonquita had his first patient at the emergency room (ER) area too and didn't bother for our assistance.
At circa 8 am, the blood bank opened. Mr. Balonquita appointed himself at the ER. Mr. Gines gave his stead in the bloodbank to me, and hence, busied himself at the OPD where patients started to arrive and pile themselves. Lastly, Brian had to take care of me in our designated area.

This was unspeakably familiar.
The picture depicted in the bloodbank room as soon as we entered was like this:
The percentage of the patients waiting in the plastic benches comprised mostly of babies. Doctora "Anne" was busy with the microscope while the Head Medtech was checking the serum bags in the refrigerator. Ma'am Mads, called for the first patient and the mother. And there, on the background the two of us stood. As soon as Ma'am Mads took the baby and the blood testing sheet, instinct told me to follow her. I held the baby in place at the bed hushing, noticed how Ma'am took off the baby's booties, and looked at the medium plastic tray that contained the needed paraphernalia. She venipunctured the base of the foot with a Western tennis-like grip on the sole, tightened until pea-sized blood dropped blotching the four circles in the blood testing sheet. Then, after she covered the pricked part with cotton and micropore, I initiated dressing the baby. Seeing how I held the baby with both of my hands, Ma'am Mads was seemingly in awe finally asking how I knew the proper handling of a baby. Thanks for the couple of years I was exposed in the medical field. Now, that's where things started to fall in place.
After that, I was asked to take blood pressures too. However, Dra. "Anne" said she'd be the one to handle it since there were still prerequisites. I extensively assisted in baby patients, was even queried whether I liked to try venipuncture. I did. But, I was too vulnerable in handling babies in fear of their fragility. That's why I only performed twice, wherein one of those I only squeezed the blood into squirts. I really better practice more so that there would be no repeat of the said incident.
The first adult patient I took care of for phlebotomy made me really nervous. I admit I did fail on that one. Failed in terms of the duration of needle exposure right after the extraction and the obvious shaking of my hand. Yet, I did apply what I have observed earlier from my classmates. After taking the syringe from my hand, Head Medtech and Ma'am Mads called my attention, carefully taught me the proper mechanics with the next patient: the fingers properly placed, the thumb and index finger are lightly but firmly placed on the head of syringe (not needle) on both sides, the middle finger supporting the "pull" of the syringe. The insertion is made half-way into the vein, making sure the needle is almost inside to prevent spilling of the blood; meanwhile, upon entering the needle, the bevel - faced up - was twisted slowly without making the patient notice it until the bevel faced the side wall of the vein (this is to prevent the walls to collapse, that's how I remembered). A cotton is placed before the release of tourniquet and the needle. The cap is placed with the needle horizontally to avoid spillage. The whole proceeding is very very and/or somehow different from what I have observed form others. This is only one part that I wanted to write in detail as a sample of what we actually did. Sooner, I almost did fine.
Mr. Santos and I were next called to regard attentively the two types of bloodtyping, one of which they refer to as the "Golden Bloodtyping", which is of course the universally used: Anti-serum A, Anti-serum B, and Rh testing placed on slides. A few briefing and recaps (where I got sleazy in putting my mind into engine - a big mistake) were conducted. Later on, we performed and even wrote on the sheets of the patients the results. What was also important were to drop the reagents away from the other reagents and a tad far in terms of height, to have it in equal ratio with the blood sample, and determine and verify the amalgamation twice to thrice, direct and under the light. As the two types have different methods, their output determination are also opposite, but almost the same in output. Almost because there may have a difference in the Rh-typing.
At around 10 am, we were summoned back for the cross-matching. While waiting, I assumed assistance where: Before placing the blood sample on the centrifuge, a check for possible presence of hepatitis and AIDS was conducted. Anyway, the manual preparation of saline solution wasn't anymore necessary since it has its own modernized/commercialized version already. Hence, we proceeded to the measurement, dropping, and mixture of the blood with the saline solution. Each on a very precise manner. A 5% approximation of the solution into a Kahn tube is equivalent to __ micropint. It was always noted that whenever bottles are nearly empty, it should never become fully-emptied due to the presence of residues. So, jumping to the final process of cross-matching, it was done 15 minute each machine accurately timed.

       (After we atelunch, we headed back to the OPD waiting area. Talked about the upcoming NBA finals, whose side is who, which team is stronger, and the different historical moments of the game's stars. Oh yeah, I took part.)  

                            (It was already nearing 1 o'clock, we strutted towards the lab.)   

As soon as lunchbreak was over, my hands busied itself whether on the blood blank, scribbling a tabulated data in the logbooks, or at the ER assisting Mr. Balonquita. During the times when I was the only one at the the blood bank, I was luckily coached by Dra. in a more detailed one in the various situations within the area. From the refrigerated bags of bloods and sera to its expiration and to its proper handling when transported, to hepatitis and AIDS determination, to the other tests conducted to the patients, to the machines and its different uses and technicalities. All in a step-by-step fashion. Whenever I started to become quaint and was piqued to the smallest of intrigues, she gladly and tenderly gave answers, expanded it, and extended beyond.
When the clock strIked 6, we had a terse break and we were invited for some cake and coke at the lobby. They were really friendly. And we were "timid".
We waited, and tended, trifled, and yet remained attentive until it was time for us to check-out.

INSIGHT

There are always multifarious ways of addressing, yes addressing insights according to the beneficiary. One, the "first person" - I. The other is the "others" whomever this may concern.
First Person.
They say never start anything, a write-up for that matter with a sorry; but, I have to overlook that. I am not sorry for myself, in-fact, I am quite grateful that the entire event happened as it is otherwise I wouldn't be noticing my flaws. Even though I never got the chance to continue my remaining 12 hours and listened to worthless predicaments, it turned out that I already acquired a handful and it was just right since there were circumstances following. The only regret I had was the masculados never gave me the chance to perform four other procedures even if I was already instructed and stuck me to only two. Still, it's great that I was lucky enough to adjoin my knowledge of the past and the present.
To whomever this may concern.
I do think, deem, and not just surmise, that in order for one party to be accomplished, the other should cooperate no matter how large, domineering, absurd, or complex the difference is. Really. Proper mechanics should be followed. Proper conduct should be observed. Proper disposal and management of arguments, ideas, and facts should always be remembered.
Shouldn't the students be more practical, conspicuous, alert, yielding to what is true, and grab the opportunities they are given in experiencing and most especially in caring for the patients (well, they know for what reasons)? Shouldn't there be an "ironed" and made-well known to the public set of rules and regulations inside the hospital to prevent misunderstandings with the patients? Shouldn't there be a wider scope of looking into things, I am referring to the patients to avoid, er, unpleasant incidences? Shouldn't there be an official and universal teaching for the students to not be confused or if not at least a bigger conjunction among the ideas? And, shouldn't the government be more aware and capable of figuring out what is what in the real situation inside the hospital?
After all, these only point to one consequential matter: saving lives.
It is not to be overlooked, however, that there are lots of people within the hospital who are earnest with their jobs just to fulfill their responsibilities, and are more than willing enough to pass what they have to the next generation. Without them, we, I wouldn't know anything.
Last but not the least...
The most significant part that I learned... Never ever make even the least mistake when life is at stake.

Filed under kyooiku kankei no | hn. your pen's toilet