My Thoughts on the Reproductive Health Bill

In government hospitals, we get to see the real state of health care in our country. I remember a particular duty when I scrubbed for a Caesarean Section, the patient, Juanita (not her real name), a 15 year old barrio lass, lay anxiously on the operating table. One can't help but feel pity for someone so young to undergo one of the most life-changing events in the life of a woman with so little knowledge or experience. Teenage pregnancies are considered high risk pregnancies, and with little to no prenatal check-ups, may contribute to statistics of maternal mortalities because of complications.

Juanita's case is only one of the many examples wherein education about sexuality and reproductive health could have helped. The recent clamor about the Reproductive Health Bill was largely centered on the Catholic Church's protest over artificial contraception as a means to control the burgeoning population. I am a Catholic myself, and have been schooled mostly in Catholic schools from Elementary, Secondary to Tertiary level, however being a nurse also means I have to be a patient advocate. It is not in my position to tell people that artificial contraception "is bad" and that natural methods "are good"- but rather provide all the information about both methods without bias and allow the patient to decide for themselves. Section 3, No.5 of House Bill 4244 states precisely that.

Note that HB 4244 also recognizes that abortion is illegal and punishable by law, however those women who are needing care post abortion (remember, there is a difference between an induced abortion and a miscarriage or spontaneous abortion- though in both cases involves the expulsion of the products of conception and the fetus before the age of viability) must be treated without judgment. Another favorable provision in the RH bill is the mention of Gender Equality- which was defined as "absence of discrimination on the basis of a person's sex, sexual orientation, and gender identity in opportunities, allocation of resources or benefits and access to services."

Going back to Juanita's case, I begin to wonder- had she been aware of the changes in her body as an adolescent- the fertility cycle, the risks of pregnancy, the enormous responsibility of being a parent, the cost of milk, diapers, and clothes, and the cost of education- had she been aware of all these, would she make the same decision? Not to pass judgment here, because there could be a number of reasons and circumstances why that pregnancy occurred, but my point is: if teenagers were aware not only of the risks but also the responsibilities, would that prompt them to be more prudent with their actions? The argument that age-appropriate sex education in school (Section 16 in HB 4244) undermines the role of parents to provide this to their children may not always be true in all families. From my own experience growing up, my parents and grandparents were so conservative that sex was an "off-limits" topic, and I would usually learn more about “the flowers and the birds" from friends and classmates. In sex education, the purpose is not to titillate or spill out lewd details, but merely to present in clinical manner, the facts about human sexuality.

The RH bill gives couples a chance to determine for themselves the size of their family, so that each child would be provided well with basic needs and education. Stating unbiased facts about both natural and artificial planning also ensures that people will make informed decisions in reproductive health. Indeed, a progressive country begins with healthy and responsible parents who plan and provide for their families- so I am personally for the RH Bill to be enacted as law.

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Top 15 Schools out of 470 who took the Dec 2010 NLE (50 above students with at least 80%)

1 Saint Paul University Iloilo 124 100%

2 Xavier University 330 98.48%

3 Saint Paul University Tuguegarao 193 98.45%

4 New Era University 51 98.04%

5 Pamantasan ng Lunson ng Maynila 196 97.45%

6 University of Saint Louis Tuguegrao 77 94.81%

7 Silliman University 447 94.18%

8 Southern Luzon State University Lucban 204 91.67%

9 Remedios T Romualdez Medical Foundation 209 91.39%

10 San Pedro College- Davao 455 89.67%

11 Central Philippine University 567 89.07%

12 Saint Mary's University 427 88.29%

13 St. Scholastica's College of Health Sciences Tacloban 204 82.84%

14 University of San Agustin 491 81.06%

15 Ateneo de Davao 385 80%

Note: Only the top ten were officially released by the PRC-BON. Still it was good to see that our batch Chrysoberyl 2010 did a respectable job at the December 2010 board exam. Congratulations new nurses!

Godspeed Batch Chrysoberyl

This week ko la natapos an akon mga cases, and han Friday ko la natapos pagpasign. Grabe talaga yesterday kay my head was still literally spinning as I walked the steps to PRC mga 4PM with my papers, imagine I have been up since 3am that day- I travelled to Ormoc para magpa-sign han Nurse Supervisor who happened to be night shift, then wait till past 8 para magpa-sign ha Chief Nurse,after that sakay hin van back to Tacloban straight to Bethany, then to EVRMC magpa-sign kan Ma'am Darang then wait for an hour for the Chief Nurse pero direcho nala anay school para magpa-sign han the rest na kailangan an signatures, then back again ha EVRMC, then finally to PRC that very same afternoon. Nakakaon ako han akon lunch 6:45PM na ha balay, an ak breakfast mga 9:00AM ha van nag-takeout la.

I've always been very vocal, I guess it's no surprise I'm writing this. I'm expressing myself partly in the vernacular para may emphasis na seryoso talaga ak. These are the things I'd like to say:

1. Para han akon mga batchmates, gogogo la guys! Duty la kun duty, be agresssive and explore all avenues. Leave all that resentment behind, sure dire na mababalik an three weeks na nawara, sure dako na it pressure yana pero just concentrate in completing those cases. Now is not the time to dwell on blame game, now is the time for SOLUTIONS. May two weeks pa kita.

Han akon pagpasign, both han new, revised new (LOL yes, natapos ko pati adto pagpasign tanan!), ngan finally an old form I've encountered students from different schools in the region. Dire la ha pan-okray ha iba, pero I know you guys very well since we all studied together the past four years, dako talaga it potential hit aton batch. I sort of have a radar for this, and I know we are not supposed to be make quick judgements but part of strategy is sizing up the opponents, but for the record I wish them well :-) It's like this- more or less the board exam makes use of percentile ranking, hard to explain here but let's just say the passing rate will be affected by the highest and the lowest scores- it is not always na super gin follow talaga nira to the letter na 75 it passing out of the hundred items because this is adjusted accordingly to the difficulty of the exam which manifests in the scores of the examinees. What I'm trying to say is, if your test-taking skills and knowledge is above average, and you belong to the upper group of all the examinees, dako an chance na mapasar ka talaga. And again I'm not saying that this is definitive because this is just a gut feel (but in my 29 years my gut feel rarely missed), dako an chance han Chrysoberyl na maupay an result. And when I look left and right, bisan pa diin na review center mayda talaga may potential mayda magtop, God-willing.

Why I'm saying this? It is because I see the potential and that must be DEVELOPED. I really wish our batch well, sorry kun "I love my own" pero I really believe that if MANAGED WELL, we could really bring out the best in ourselves. Ultimately in the end, depende iton ha individual on how DETERMINED they are in making it. That's the first point I'd like to make- be self-motivated. Well, wouldn't hurt if other people encourage you from time to time too :-) PRAY. Yana, kailangan gud naton hin miracle, not just for our sake but for the sake of our loved ones who sacrificed para mapa-skwela kita. Let us help each other, as in bulig-buligay nala ini after all kun maupay an result ha board exam everybody wins.

2. Salamat han tanan na nagbulig para maka-case la. Mayda mga CI na sobra it concern para ha mga students thank you talaga!!! You know who you are and thanks for helping us at this time na kailangang-kailangan talaga namon hin suporta from our mentors. Salamat han mga accommodating han pag-sign. Maaram kami na super inconvenient ngan almost annoying na sometimes pero these signatures are required by PRC, ngan usa pa you guys know also what our batch has been through the past three weeks. Apiki na talaga, we have to rush everything- in fact this month should have been devoted for studying for the board na. For most have us halos twice kami nag-utro, imagine nala han pagpa-sign mga NOD, supervisors, ngan chief nurses, makarima-dima talaga. So pasensya la, ngan thank you hin madamo. Like what Dr.Lim said, where else would we ask for help but from our own? After all, we carry the good name of the school and we are on the same team.

3. I do not mean to cause any trouble for anyone. I'm reasonably patient, and if actions are justified adequately I respect them, pero kun at this point na hataas hin duro it stress nga papakurian pa kami nga diri justified ngan diri reasonable, then you can definitely count on me to seek justice. If we lost precious time because of unjustified reasons, that someone should be held answerable for that. Waray personalan, this isn't about personality, its about professional behavior and as the two lawyers said to me I raised very valid, academic concerns. If anything, I have the right to free speech and express the factual narrative of all the events. Sorry la talaga, but I can't just let things like this happen and let it pass- otherwise it would just continue. In the first place, kun justified mo tanan imo gin buhat I suppose you have nothing to worry about.

Just wanted to emphasize again, I believe so much han potential han aton batch. Let's help each other para makatapos na and concentrate on the review. Para han amon mga schoolmates please pray for us, because prayer helps a lot :-) Thanks gihap in advance. Having been through these trials makes me realize all the more how much I value the license. Guys, do you best. Do it for your family- an nagsacrifice hin bonggang-bongga para paka-graduate ka la hin Nursing, do it for the school to bring honor, do it for God because that would be your gift to Him, and do it for yourself- you've worked hard the past four years and now is the defining transition from student nurse to professional. Godspeed batch Chrysoberyl! I'll always be proud of you guys no matter what :-)

What They Didn't Tell You in Nursing School...

I was once asked to speak at an orientation for freshmen Nursing students, and the anxiety in the room (not coming from me for a change) was palpable- these kids were really eager to hear the trade secrets of surviving Nursing school. These tips are learned from my actual experiences, but I sure hoped someone told them to me beforehand so I could have prepared better. So here they are- hope these are useful to future or current Nursing students:

Fact #1: Though you will be swamped right away with 31 academic units on the first semester, but that will be your best chance in getting the highest grades you can get- because in your junior and senior year they will only decrease.

The curriculum may have changed already and I am not sure if the same policies apply, but back in our time there was a grade cut-off every semester or every year in other schools. In our college, we needed to maintain 2.2 (83%) General Weighted Average to be eligible to proceed to junior year. This meant acing the very basic subjects like Organic and Inorganic Chemistry, Physics, Communication Skills, Math, Statistics, Anatomy,etc. The passing grade for quizzes and exams is only 50% (ie.in a 100 item exam, if you get 50 items correct you'll get a 75% rating) so this makes it easier, come third year the passing rate is set at 75%- which now means in a 100 item exam you also need 75 correct answers to pass. This is done to help prepare the students for the board exam. Moreover, the topics in the later years which covers actual nursing theories and practice are a lot more difficult, so if you are aiming for honors, better get those 1.0's (95%) from PE, Basic Computer, and other "giveaway" subjects.

Fact #2: Starting your 2nd year, skills matter.

During the first year, you need little more than a sharp mind to get the best grades since it is almost purely theoretical. Related Learning Experiences- starting with the very basic vital signs, to enviromental sanitation, to physical examination, to giving bedside care and administering medications including giving injections- skills comprise half of the grade. If you are jumpy or tend to forget things when nervous- this could significantly affect your grade even when you get high scores in pretests, post-tests, worksheets, and major exams. Work on your confidence to boost your skills, and the way to do that is to practice constantly.

Fact #3: Junior year will be the most stressful because of your transition to the clinical area, and at the same time tackle the major Nursing subjects like OB Pedia/ Operating room nursing/ and Psychiatric nursing.

The clinical exposure during 2nd year is very minimal, but after the Capping and Badge-pinning ceremonies, students are officially immersed in the hospital setting. Three days a week (plus one day for nursing audit) will be devoted to honing your clinical skills, and of course this will bleed into the lecture hours at school. During audit day, most students do not sleep because they need to finish all the requirements otherwise they will not be allowed to go on duty the following day. Most finish their requirements by 5am, just in time to take a bath and go attend to their patients like a zombie.

The studying gets even more ridiculous, because if in the second year you needed to finish reading four chapters of two different books before going to class, in junior year you finish the three inch Operating Room Nursing references in four days. The only time devoted to this topic is two weeks, including learning instrumentation, and before you know it- you begin a new area for discussion. Another fun fact: you will work will all sorts of temperamental Clinical Preceptors who will rate you according to both knowledge and skill, and get this- attitude!

You need to develop a study habit by this time because unlike the first two years when one can just relax, you will not survive if you have no discipline. Come up with a way to "detox" after having a stressful or toxic exam or duty- like listening to music or taking a walk, because if you won't find a way to cope you'll burn out (and perhaps lose the will to live, I'm kidding).

Fact #4: Sactions are a bitch.

Always have been, always will be. Make-up duties (they usually give three days once you have an unexcused absence) eat up the days between semesters when you should be resting, so try as much as possible to follow rules and regulations and don't piss anyone off.

Fact #5: You need to have a very good foundation of all Nursing areas in promotive, preventive, and curative nursing, including community and psychiatric nursing because in your senior year, you will integrate and synthesize everything for your Compre.

It is a known fact, the subjects which have the greatest mortality are Foundations of Nursing, Promotive and Preventive (NCM 101), and Curative 1 & 2- in fact our batch shrunk from 500+ in the 1st year to 200+ in the 4th year. The most toxic time would be the final semester because you will have in-house review during the weekends and intensive lectures and seminars during the weekdays. In short, for the month of January and February, we only had a grand total of 2 days that were free.

We had 13 areas in Nursing which had 75 item post-tests, 200 item pre-tests from the in-house review, and two major exams. Do the math: that's 3,175 questions answered in the four month semester. It's a miracle our heads didn't explode.

Tip: Photocopy or buy NCLEX reviewers which will prepare you for the exams, especially if reading the actual books on the concepts cannot be accommodated on a single night. Which is why again, you need to have good foundation since your 2nd year. One of the things I did was create a summary (or bullets) of a certain area, for example psychiatric nursing, I made a reviewer using two books as reference in the third year, and kept it so I could use it as a reviewer for the Comprehensive exam in the 4th year.

FINAL WORD:

Relax. It isn't really as bad as it sounds- believe it or not we also had our inuman sessions or gimmick like regular students do. The trick is finding a balance between studying and fun. Join clubs in school or do engage in something athletic. Gather your strength from your friends and groupmates- you guys are in it together to finish your bachelor's degree. Value the time you are in the hospital or community because experience offers better lessons than those learned in the classroom. Most of all,learn to love your work. Being a nurse gives your great opportunities to touch people's lives by taking care of them. When your heart is really set on finishing Nursing, with a little hard work and prayers, support and inspiration from your loved ones, everything else will fall into place and you'll surely be a success.

Happy

"Grandslam Batch" History

In response to the rapid turn-over of health professionals due to the trend of migration and overseas work, the Missionary Benedictine Sisters of Tutzing came with the idea of establishing a college of health sciences. St.Scholastica's College in Tacloban formally opened in June 2000 with 336 students.* By June 2006, the school saw the largest batch of enrollees to date- with more than 500 1st year students of BS Nursing, BS Pharmacy, BMLS, and BS Biology, adding to the increasing student population which was at a record high of more than 1,300 that year.One of the peculiarities of this batch was the large number of second coursers and transferees, with students coming from different areas in Region VIII, and some as far as Manila and Mindanao. All first year students had full academic load, with courses taught by some of the best General Education faculty, coming from respected institutions such as Divine Word University, University of the Philippines, and Leyte Normal University. Students were molded to achieve excellence in accordance to the four thrusts of the college: Christian Dimension, Instruction, Community Extension, and Research and Publication.
By the second semester there were 9 sections left out of the original 10 from the College of Nursing, an indication of the stringent promotion and retention which the school is known for. A maintaining grade of 2.2 (83%) General Weighted Average was required to remain in the college. The Dance Concert, National Service Training Program (NSTP) graduation and the annual First Year Research competition were the highlights as their first year concluded.
During the second year, the students began to have their major subjects under the tutelage of their esteemed instructors, mentors, and clinical preceptors. The batch showed excellence also in extra-curricular activities such as athletics- bagging the top spot in the Sportsfest for two consecutive years, when the competition was by year level. Before the summer of 2008 the students lined up at the Dean's office during the so-called "judgment day". Only those who met the grade requirement will proceed to summer classes.
One half of the entire batch in the College of Nursing did not meet the requirement, hence those students either shifted to another course or transferred to Nursing schools in Ormoc, Cebu, and Manila. The Dean's Listers were pooled together in Section A, as a strategy to "breed topnochers" according to the Dean of College Dr. Antonio Lim Jr.- this began with Batch Sugilite. After the summer class in Foundations of Nursing, 252 Nursing students attended the Capping and Badge-Pinning Ceremonies, signaling their transition into the clinical areas. The batch, set to graduate in 2010, was officially named Batch Chrysoberyl.
Nursing students were exposed to the different areas after their lecture and training in Maternal and Child Nursing, Operating Room Nursing, Emergency Medical Services and continued as well with Community Health Nursing, which began during the second year. The clinical performance and well as the grades in Preventive/Promotive and Curative/Rehabilitative Nursing became the basis of the selection for the students to proceed with the Psychiatric Affiliation and Community Immersion. In 2008, St. Scholastica's College Tacloban formally opened the 2-year Diploma in Midwifery.After a commendable case presentation of the first batch in the Psychiatric Affiliation at Vicente Sotto Memorial Medical Center(VSMMC), and a successful Community Immersion in Alang-alang and Babatngon, Leyte, the batch returned for the Communicable Disease lectures and enhancement duties before embarking on their fourth year in the college.
Students of different courses worked on their respective researches/ mini thesis as the 1st semester commenced. For BSN level IV, a grueling four-month review, loaded with pre-tests and post-tests on 13 different areas in Nursing, topped with comprehensive major exams tested the student's competencies and readiness to be released into the "working world". Meanwhile, hospital duties and case presentations added to the rigor to ensure the student's clinical skills will be at par with professional standards. Meanwhile students of BS Pharmacy and BMLS also had their respective pre-board exams. Batch Chrysoberyl once again proved that they excelled in extra-curricular activities when they were hailed Champions during the 2010 College Days- earning the moniker "Grandslam Batch". When the final evaluation came, there were 190 candidates for graduation from the College of Nursing- barely 35% of the original population. Honors were given to Maita Amores, for the highest Academic Achievement from BS Pharmacy, and With Academic Distinction to the top six students of BS Nursing: Jessica Marie Dado, Keno Francis Parado, Ma.Hyacinth Pelias, Thaddeus Hinunangan, Carmella Delos Santos, and Stephanie Sim. The first batch of the 2-year Midwifery course also joined the graduation, along with the BS Biology and BS Pharmacy candidates.A salute to all the graduates of St. Scholastica's College Batch 2010, may God bless and guide you on the journey ahead.
* paraphrased from the Student Manual
***Special thanks to the Administration, the Faculty, Staff and Maintenance of our Alma Mater.

The Fainting Intern Award

When I took off my scrubs today, it was still soaked in sweat. Today was a perfect example how humbling it is to be reminded that one's strength is finite. You see, I'm the kind of person who usually thinks he can take it all, and more often than not, I do prove in the end that I can do more than your average person. But maybe that was the problem- I'm not a person who excels because he's born gifted, but rather an ordinary chap who tries so hard to be better.

When I looked at the board, I tried to review the things in my head. Primary Classical C-section- indicated when the baby or mother's health is at risk and NSVD (normal spontaneous vaginal delivery) is not possible. A breech position of the baby, active herpes blisters on the mother's vagina, cephalic-pelvic disproportion- these are just a few of the reasons. Blood loss at around 800mL.

I imagined the instruments and materials we would be using: needle holders, sutures, clamps, retractors, Metz, bandage scissors, ovum, cautery machine, os, lap pads. Anticipate the needs of the surgeon, be snappy when serving the instruments, pay attention!

After scrubbing and gowning, I served the gown to the surgeon, then gloves after. So far, so good. The draping went well, and when I gave the first knife, cutting time had begun. First the skin, then superficial fascia, then deep fascia and muscle.

Bleeders were cauterized. I was to the left of the First Assist and was even allowed to sponge the surgical site when there was too much blood and the surgeon and first assist were busy with free ties. The room started to smell faintly like burnt flesh. I ignored it.

Secretly, I have a phobia with the sight of blood- although during NSVD and other cases I am still able stand it. During after the delivery of the baby, however there was a lot of it. The uterus looked like a small basketball with a vertical slice where the baby was delivered from.

As I served sutures, I was beginning to feel faint. Blood flowed generously from the side of the incision. The scrub nurse suctioned the blood while the first assist used one lap pad after another to absorb the blood. As the layers of the uterus were sutured, the surgeon started asking us questions- pretty basic actually: what are the layers of the uterus? which layer are we suturing now? The questions did not bother me, the blood did.

I began to feel extremely thirsty (and at this point according to those who were watching me, I looked pale as a ghost) so I begged for water. Blood was still oozing. There was blood on the instruments (which I mechanically began to wipe off with a wet os), blood on my gloves, pieces of flesh and clotted blood on my gown. My nostrils were assailed by the sickly sweet, coppery odor of blood.

Breathe. I willed myself. My heart pounded and I was afraid people could hear it.

My mates gave me water to drink. I drank a few drops with my parched mouth, and tried to control my fear. But it was too late, and my confidence was shaken. I wish I was like the first assist coolly assisting the surgeon. She looked so composed and skilled.

With both shame and trepidation, I stepped back a little. When the operation was finally over, I wiped the sweat off my brows. I decided not to be too hard on myself, I mean, if I'll feel bad just because I made one or two mistakes in a quiz, or beat myself up because I didn't do things perfectly- or that I got overwhelmed, I'd probably go crazy. There is a learning curve to this, and as far as conquering fears is concerned, the first time you face it is always bad. But like the past diving incident in Coron, the best way to conquer fear is to get right back to it.

So tomorrow, I go first on deck.

Of Dewy Mornings and Impatient Patients

I am a morning person. It is the only time of day I can sit quietly in content, or feel the gentle breeze against my face when I go jogging. Early morning hospital duties and last-minute readings however, are constant interruptions to this rather peaceful habit of mine.

For someone who has not taken the Nursing profession to heart, I was not at all prepared to give up the easy delights of sleeping till late morning, or having some time to lounge about and watch television. I thought to myself: if I do decide to give those up, what do I stand to gain? Higher grades, or maybe a glowing recommendation? Unable to commit, this left me reluctant to face the rigors of Nursing school. But days spent learning the ropes in the hospital, of endless auditing and vital signs taking, of hurried lunches, or irate patients uttering unreasonable demands seems to have, if anything, found its way into a corner of my heart. Though I wouldn’t dream of feigning affection during an indwelling catheter termination or maybe a teeth-gritting skin test, I have come to understand and empathize with my patients.

They are human beings in various stages of illness, and as part of the health care team, I am there to assist in bringing them back to wellness (no matter how puny a student nurse’s contributions may be). I’ve learned to look past blunt and sometimes uncalled for remarks, because beneath that, I know they are simply afraid. Sickness manages to rob people of their vitality, and sometimes the sense of dread in them permeates into my guts. You can’t be a Nurse if you have no strength to empathize with someone who has cancer, or have the patience to deal with a squirming toddler who is terrified of a thermometer, or have the fortitude of going through a sixteen hour shift and still attend to the needs of your own family afterward.

Whoever said “Nursing is easy” was lying. The reality of the situation is that the profession is among the most underpaid and overworked in our country. But money matters aside, the real value of the profession is providing care to the sick in spite of dismal conditions.

I’ve learned to be a little bit stronger and, applying the concepts and principles taught in school, have the constancy to monitor my grandmother’s health, and be more patient of my two year old nephew’s tantrums, as I am aware that this is expected in their developmental stage. I’ve learned to clean bedpans and sputum cups, and I’ve learned to tell patients like it is, in order to orient them to the reality of the situation without sugar-coating. I’ve learned to do tasks that could otherwise be considered nauseating or even scary, but I do them anyway because it is necessary.

I guess those lazy mornings would never lose its appeal to me, but I don’t mind forgoing the extra hour of sleep, so long as what I do is fulfilling- never mind the side glances from some patients.

Gatekeeper

There are certain things one has to remember when being in the Psych ward, such as: number one, sharpen your peripheral vision- you never know whether your once-calm patient would suddenly have the irresistible urge to pull your hair or perhaps throw feces at you (excuse me for those eating at the moment). Number two, treat your patients with respect you would give to a fellow human being- so when someone bites you don't bite back (kidding), just maintain control and restrain your patient. You are the sane one, remember? Number three, stay calm. When chaos erupts don't run for the nearest exit, it's your job to make sure patients don't hurt others- or themselves.

With these in mind, around fifty of us tiptoed through the double-locked (from the inside and from the outside) iron gate to finally meet with our patients for the first time. Being fidgety amateurs must give off some kind of potent pheromones because even catatonic patients rolled their eyes, as if they could sense the fear permeating from our pristine white uniforms.

Though I cannot divulge certain information or descriptions, I can say as much that I'm thankful my patient was neither too unruly nor violent. But of course, either due to fear, inexperience, or the language barrier (my first language is Waray, while patients are Cebuano- and though we tried to improve our Cebuano speak the past months, it was simply impossible to be fluent in a short period of time), blunders are unavoidable. For example:

Female Psych Patient: "Gwapo, hampa hampa ta!" ("Handsome, let's f*ck")

Granting that I knew only a few Cebuano words, I uttered the first Cebuano word that flew to my mind: "Unya, unya!" (Later, later!)

I was supposed to say "Dili pwede" (No, that's forbidden!)

I kept scribbling on my little notebook (praying I'd be able to decipher my notes later) during the history-taking and kept jumbling names calling one patient "Sheena" when her name was Shiela, or "Myra" when her name was Myrna. No wonder they all had puzzled looks on their faces. I must have confused them further.

Towards the end of the shift, I somehow found myself with my back against the steel gate. My only task was to open and close the gate for the food and medication deliveries. Temporarily, I suppose, with the few minutes of little to no interaction with the patients, I found myself more useful than a nuissance.

Another day approaches, with the hope that I get to be more efficient than a human padlock.

Blood, Needles, and Vajayjays

I acted like a complete ass (or as the British would call it, “arse”) during my first time to assist a delivery.

There I was, looking so important in my grass-green scrubs, gazing intermittently at the glass partition between the delivery room and NICU, making sure my hair was in place. The clinical preceptor was giving an orientation and final instructions, and I just nodded my head and joined murmurs of “Yes, Ma’am!” We were finally out of the classroom and laboratory, away from plastic mannequins and simulated environment. We were finally let loose into the clinical area.

“Gravida 2, 5 cm, her bag of water ruptured already!!” An orderly was wheeling in a pregnant woman in labor, her face contorted in pain.

“Vital signs and FHT now!” Barked our preceptor.

I felt like I was in the middle of Grey’s Anatomy episode (or Scrubs, more like it) as we scrambled to assist the woman to her bed in the labor room. One student took her blood pressure while we get a blanket to cover her lower extremities so we could expose her swollen belly to do Leopold’s maneuver. I could finally hear the baby’s heartbeat through the stethoscope; I counted, then marked the spot for future monitoring.

“BP 130/80 mmHg, the FHT is 130 bpm, contractions regular.” I said, wiping my brow.

“Another patient for C Section! I need two of you to scrub now!” Another patient came in a stretcher, and two students from our group scrambled for their OR gowns and start preparing.

Just as we thought it couldn’t get any worse, our preceptor screamed again. “Multipara, 10 cm already, I need you (pointing at me) and you (pointing at a friend) with me at the delivery room NOW!” The rest, stay with the other patient and monitor the progress of her labor!

“B..bb...but, Ma’am she’s not my patient, my patient is the one at the labor room.” I stammered nervously.

She just glared at me and walked hurriedly to the delivery room. I followed.

“Where’s the whiteboard marker for recording the time of delivery at the whiteboard?” She asked loudly while the patient was being assisted into the Lithotomy position.

My classmate and I looked at each other. “You didn’t tell me about any marker!” I hissed.

“Where is the Methergine ampule? Where are the sutures for the Episioraphy? Where’s your BP ap?”

“Uhmm.. ah.” I looked around in panic.

“Prepare those things NOW!”

And off we went. “Where were you during orientation?” My classmate demanded. “Oh shut up let’s just find those things.”

“Crowning!” The midwife and our clinical preceptor were instructing the mother how to push. Then the midwife did something that would take weeks to disappear from my mind: she took a sharp Mayo scissor and cut the woman’s perineum to widen the birth canal. The woman screamed in pain. Blood oozed.

I felt faint, I thought I’d collapse into the big bucket where they dumped the placentas. I wanted to slide the woman to the side so I could lie down for a while. Kidding.

The baby came out faster than I expected. No observable “internal rotation”, “extension” and all that cardinal movements we memorized in the classroom. The birth itself took no more than a few seconds. Just like that a person was born into this world.

“BP?”

“130/80mmHg.”

“Inject Methergine 1amp.”

I prepared the medication and administered it via intramuscular route. The woman was almost delirious; she did not even notice I stuck a big needle on her arm. The neonate was brought to the NICU for cord care.

We assisted the woman into her clothes and did the after care. As we watched her being wheeled away in a stretcher, my clinical preceptor asked me:

“Ok, so did you learn anything new in this exposure?”

“Yes Ma’am,” I said as I fanned myself.

“…Listen to instructions.”

Exhibit

These were from the recent exhibit that I spearheaded- all original photos from our community exposure. Our concept was to use photos that accurately depict what students do in the community (in dramatic black and white, sans the Friendster-intended pics lol!)- and we hope our exhibit, printed in A3 photopaper displayed in a Filipiniana or native design (using banig, bamboo, etc.)- will make a good impression to visitors. Many thanks to every single one of my classmates who helped- we did a great job guys!

Psychodynamics

Stage Fright

The lights seemed to hurt my eyes. Despite the constant whirl of the electric fan beside me, beads of sweat started to trickle down my temples. I was aware of my breath, and every pounding of my heart.

“Dear Brothers and Sisters,” I began.

“The reason why Jesuth (my tongue seemed to stick to my upper teeth!), our Lord, wath (damn, not again!) both popular and unpopular during his time on earth was His teaching which was ah, uhmm, contrary to the values of the world…”

Each time I spoke, my chest seemed to tighten, even as I kept telling myself to calm down. Epinephrine must have been pouring inside me by the buckets. My vision seemed to sharpen, as I saw every single face, all two hundred and sixty plus, gazing at me.

Luckily, this was only during rehearsals. I was asked to read impromptu, and at that time I was feeling problematic over the status of one of the projects assigned to me. Maybe it was the stress, maybe it was because I was unprepared, but damn! This was an unfortunate time to make bloopers.

Four out of the six sections submitted the wrong format, and I spent what was supposed to be a day of rest correcting the errors. With the help of five people however, we were able to submit the 725 slide presentation just in time. With that out of the way, I assured myself the possibility of me screwing up my part in the ceremony was null.

I practiced with Sister Isabel till I sounded as credible as any lector. The problem was that I am used to speaking fast, and I was certainly not accustomed to sounding as perfect and as flawlessly modulated and well paced as an electronic teller.

During the ceremony, in front of close to a thousand people, I got up to the podium calm and collected. I opened my mouth and screwed up- well, I didn’t mispronounce anything or spoke too fast- I did worse by missing some of the lines. To people who heard without really listening, they couldn’t tell what I did wrong, but those who listened to the words I uttered- their brows were probably bunched together from trying to decipher what it all meant. My mates told me I did ok so I thought great, no one noticed.

One day, I happened to bump into Sister Isabel.

“Thad, was it the electric fan?”

“Excuse me?”

“You missed some of your lines!”

“Sister… (I lost my head for a minute there Sister, that’s what happened. Memory gap, stress induced amnesia, stage fright…)

…Yes , it was the fan.” And I gave her a dazzling apologetic smile.

Thus concludes my short career as a lector.

The Longest Three Weeks

The Human Cloning exhibit
"documentation" kuno
Careful..

With a nice lady.
My trusty boots.
Prowling the meat section for the Nutrition assignment..

Close kami.
With Bonbon (my right) and the guy with the sliced head.
Trineustes gratilla- my sea urchin specimen from Calicoan for the Zoology lab last year

Let me think..
Cramming.
I'm so proud of this map I rendered, I bet my Prof at UP College of Arch. would have liked it too hehe

Preparing the Chapel. (We had no other venue)
My opening remarks (in Waray-waray): "Each time I eat a morsel of rice, I think of the farmers who planted them and I feel grateful. I can speak for the whole class in saying that we learned a lot as we interacted with the community. My deepest thanks to the residents of Brgy. Victoria for receiving us..."
88.5% of families here have a monthly income below 5,000. With the hardwork that they do, I have greater respect for farmers.

Beyond the white washed steel bars are acres and acres of rice fields as far as the eyes can see.
Ahh memories of Guiuan..
This boy hits the big 3-0 in two year's time. Gulp.

Sta. Fe, Leyte Community Extension

My toes wiggled inside my black rubber boots, under six inches of mud. At 10:30 am today, I found myself trudging a swamp-like area towards the scattering of houses beyond the rice fields of Brgy. Victoria.

I grumbled under my breath, and clutched my hands tighter on my book while I balanced my umbrella. I was assigned the task of a spot-mapper, together with a classmate. We followed the BHW in silence.

In the blistering heat, we went from house to house. Maybe if I had taken my breakfast I wouldn’t be too irritable, maybe if I had more sleep I’d be less grumpy, or maybe if I didn’t have to wear these heavy boots I’d be more comfortable. But today wasn’t about our comfort; we were here to do community work.

I swallowed my complaints and hurried along.

Here we go...

Vegetation.

First house.

With our BHW guide.

Kinarir ang itim na payong. The road less travelled.
Seryoso! lol

Tama na ang pagpa-picture..
The group walking past a cow.
Entertainment

Where's the toilet? Teka, eto na yata yun.
A lady and her husband (not in the pic) busy constructing their house.
A mountain of paperwork..
Finally home = )