Quite a few people have asked me various questions regarding the 200 hours haemodialysis training. It has been on my to do list for some time.
Now I have a quiet moment, I can 'pen' some of my thoughts. The best time to write is always straight away, while the information is fresh. As I have experienced myself many times, the longer I wait, the less accuracy and detail there is to write. Within a few months the information can even be completely loss, which, the beauty of a blog is, the information can easily be retrieved.
Most people who opt to do the 200 hours training will be already busy with their daily job and what not, so I will also try my best to add tips which I find useful in juggling this additional act.
I love studying something new, I love new experiences, meeting new people, so when my husband asked me to take up this I gave an enthusiastic YES...nope, not really.
Instead I was very hesitant, finally I had settled into a new routine of 20 hours per week part time lecturing job in the sleepy town (relative in comparison to PJ - Petaling Jaya, not Putrajaya mind you), enjoying the laid back life while spending much time playing with Baby - my youngest of four.
Was it my idea? Nope, for some time my hubby's best friend (coincidentally a nephrologist) had been looking for a PIC.PIC is short form for person in charge, and usually refers to a doctor, whom is responsible for the running of a clinic. In this instance, the clinic is a haemodialysis clinic.
I thought, ok la, next year. Let me enjoy myself now. But it was not to be. When I started my part time lecturing job, another nephrologist, who is a close friend of another close friend of mine (not my husband this time) asked my help to become PIC for another dialysis clinic.
Ok la, being me, another one of my major weakness would be the inability to turn others down. I hate saying no because sometimes, I can empathise....anyways, so I tried putting it off but was told that application process itself could take months. This is Malaysia people. So ok la, I decided to apply.
To apply you have to go to Malaysian Society of Nephrology (MSN) website and click at the 200 hours training which is a yellow box at the far right hand side, which will take you to this document.
Print out and fill the form and then submit it.
Here are some unofficial tips which is not found on the website:
TIP NO1:
Although this year they have closed application for everyone except physicians and paediatricians, there are exceptions to the rule.
After my application was approved, I made an appointment to see the state nephrologist. This is a prerequisite prior to starting. He explained that Kelantan has a shortage of PICs for HD centers and as such, he believes the MSN should and does make exceptions on a case by case basis. Because it didn't really apply in my case, I just listened and nodded in agreement. I'm not sure if he is making a statement or arguing a case.
So, my advice for all those who are interested to undergo the training is to (especially if you do not fulfill the entry requirements):
1) Get the support of a nephrologist who is affiliated with any HD center that is short of PICs
2) Get the nephrologist to write a letter/email supporting your application
3) You need to fill in an address for which HD center you plan to work in the form, so might as well make it work for you.
The above tip was given by phone by the MSN secretariat, but it wasn't that easy to get through to them by phone.
TIP NO2:
You must complete the 200 hours training within 6 months of receiving the letter. For most people, time is of the essence. In the past there was a two-three day course that everyone had to attend which was a series of lectures describing many of the theories and management aspects behind HD and the running of a HD clinic.
Nowadays, to automate the system, the lectures are given in a CD form. Advantage - convenient. Certainly saved me from another trip back to my hometown and the ensuing complications as I have a baby that is still nursing and is very attached to the maid and on the other hand I have three other kids who are school going.
Disadvantage - till this day I have not reviewed all of the material. I actually forgot to bring my laptop and CD back for the past one week of hari raya haji holidays - perhaps that was deliberate at some subconscious level - I don't know.
But anyway, there is flexibility. Had planned to print out the whole thing but that also takes much time and the printer toner at home is now at low levels. Sigh.
TIP NO3:
There is a logbook similar to that of med students and other training programs for post graduates where you have a list of items to be completed and ticked off.
Here in lies a bit of tricks of the trade that can be mastered once you get to know a few things:
I dont know if the system differs in different parts of the country, but here in Kelantan we are given a punch card and the hours punched in will count towards the total 200 hours.
I had difficulty even punching in and out in the beginning. Another days story.
Please find out:
The dates and places for things like HD out patient clinic.
Mine is on Sunday 10am in the nephrology department. (sunday is an official working day in Kelantan, don't assume we are that workaholics).
Initially I was told there is a clinic everyday, from Sunday to Wednesday. Twice in the department and the other two in the specialist clinic area in a different part of the ACC building.
I soon found out (the hard way) that the clinic on Monday was specifically for peritoneal dialysis patients (ok if you are doing nephrology as part training for internal medicine subspecialty but probably not if your doing 200 hours training for haemodialysis and time is a limitation). The other two clinics were for CKD patients - again, not that relevant for 200 hours and I was told by another nephrologist when I showed up there early, I had waited 2 hours from 8am, clinic started at 10am -again, no ones fault, the admin staff has no idea and its not their fault), and after sitting in to see the first patient I decided to leave. Well, I spent two hours reviewing theory in the waiting room, it was not a complete waste of time but I could have spent it better.
Another thing I learnt the hard way was that HD machines are used from 8am till 7pm. In general patients take up 4hours for one session so they change at 12 noon, and again at 4pm. So initially I came at 8am only to find that ALL the patients had been hooked up to the machines. I found out that patients come as early as 6.30am and by 7am the staff are already busy getting patients on the dialysis machine, so I had to come in earlier. 10am is another possibility but parking is such an issue at that hour as it is in any general hospital in all the different countries I have worked in, in the world.
Parking is there, but its just a bit far when you're late.
Another thing to find out is regarding the AV fistula surgery. I have yet to attend that even though my own husband is a plastic surgeon and does a lot of these.
One requirement which isn't in the logbook and I suppose might vary depending on where you do your training is attending the nephrology ward rounds.
