my experience of doing supervised fieldwork
TRANSCRIPT
HOSPITAL BAHAGIA ULU
KINTAStudent : Siti Fairuz binti Latip
University Supervisor : Dr. Hazalizah bt HamzahField Supervisor : Mdm Suraya Banu binti Sallehudin
Organizational Background
Location : Tanjung Rambutan, Perak Originally known as Federal Lunatic Asylum Dr. W. F. Samuel was the first medical superitendant Establish in 1909, and started to function in 1911 The largest psychiatric hospital in Malaysia and it is the major referral centre for the northern states of Malaysia. (Kuala Lumpur, Selangor, Terengganu, Kelantan, Kedah, Penang, Perlis)
Treated 45 patients at early establishment
3 medical officers from Europe, were assisted by the local staffs
The name Federal Lunatic Asylum changed to Central Mental Hospital
another three mental institution in Malaysia :a) Hospital Permai, Tampoi (Johor)b) Hospital Sentosa, Kuching (Sarawak)c) Hospital Mesra, Bukit Padang (Sabah)
MAPS
ORGANIZATIONAL CHART
Organizational Chart for Department of Psychology & Counselling
Mdm. Suraya Banu Binti Sallehudin
Psychology Officer S48
(Counselling)
Miss Tunku Saraa Binti Tunku Badli
Psychology Officer S41
(Clinical)
Mdm. Ross Anizza Binti
Ramlan
Psychology Officer S44
(Counselling)
VISION
To improve individual, family, and community’s mental health through efficient, and innovative services. Besides, organization is customer friendly by improving responsibilities and community participating towards improved quality of life.
HBUK offers progressive training and education experience including innovative research efforts for treatment, care, and maintaining good qualities among patients.
MISION
To offer mental health promotion services, professional, high quality and efficient cure and treatment for client’s needs and satisfaction
SKOP PERKHIDMATAN MELIPUTI SEMUA ANGGOTA HBUK SEHINGGA NOV 2014JUMLAH PERJAWATAN = 1852JUMLAH PENGISIAN = 1619
Clinical Services
• Out-patient• In-patient• Community Psychiatry Treatment• Psychiatry Specialist Visit to district hospital and clinics• Promotion to Mental Healthcare• Training in Psychiatry Field
Out-patient
‘’Klinik Pakar Psikiatri’’ OPD Clinic Walk-in Clinic
In-patient
Do evaluation and psychiatry treatment Psychology treatment Counselling Psycho-education Rehabilitation
Patient Admission to HBUK
Promotion To Mental Healthcare (Campaign)
Responsibilities/Activities/ Experiences
In-patient case referral Out-patient counselling / psycho-therapy Home Visit (under Community Psychiatry unit) Ward Round with Psychiatry Specialist & team CME ECT Trip to JPN (under SWO unit) Psycho-Education (under Health Education
unit) Attend Courses/ Workshops / Sports Social Visit to Domestic Industrial Workshop
(Supported Employment) TCAs record and Checking Management and Administrative Works
Out-patient counselling
Join, observe, and dealing with patients under supervision
3 to 5 patients per day 20 to 30 patients per week Deep breathing technique :
frequently apply to OCD, Anxiety, Panic Attack/ Disorder, Stress/Depression, Insomnia
In-Patient Case Referral Major case referral for counselling : schizophrenia, substance-induced
psychosis Major case referral for psychology : IQ test
WAIS IV is used (at HBUK) After conducted IQ test, C-L Psy need to write case report
10-15 case per week Intervention : conflict resolution,, anger management, addiction
therapy, decision-making skill, problem solving skill, grift therapy, relapse prevention etc.
Home Visit
Under Psychiatry Community Unit, PPKs and doctor may also join the home visit
Follow up case for patient who did not come for appointment
As a social support for them Psycho-educate the patients as well
their family members on the patients’ diagnosis, medication, how to handle the patients during their active phase etc.
Ward-Round
Follow Psychiatry Specialist & team WKP & WKL Compulsory clinical activity among
team of Psychiatrist It started at 8.00 a.m. until 10.00 a.m
except for Tuesday and Friday (because the need to attend CME and present in clinical meeting)
The purposes of Ward-Round is the same as other doctors in general hospital did
To review the clinical record of the patients, to discuss any medication complication, needs to refer to any department of mental healthcare, consideration to change to in-patient ward or anti-psychotic drugs
(no photo taking is allowed)
Continuous Medical Education (CME)
Conducted at every Tuesday morning, 8.00 am
Lecture-based session comprises of presentation in a form of LCD display and Q&A session at the end of CME
Chances for the staffs to improves knowledge especially about mental health care
Week Topic Speaker Date
1.
2.
Jaundice Dr. Mohd Hafiz bin Mohamad 10th February, 2015
3.
Love Dr. Fabian Sunil Dass 17th February, 2015
4.
Disorders Of The Ear 24th February, 2015
5.
6.
Hepatitis Dr. See Bon Hwa 10th March, 20157.
Health Promotion in Community Pn. Nasuha bt Jais 17th March, 2015
8.
Adult Life Support Dr Nurul Nadiah bt Zakaria 24th March, 2015
9.
Food & Treatment Dietician & Food Services Unit 31st March, 2015
10.
Stigma in Mental Health Dr. Natasha Subhas 7th April, 2015
11.
Clinical Pratice Guidelines : Management of Schizophrenia in Adults
Dr. Sharmaein 14th April, 2015
12.
13.
14.
15.
Fluid Management & Electrolytes Dr. Lau 12nd May, 2015
16.
Electro-Convulsive Therapy
Conducted at every Monday, Wednesday, and Friday morning 8.00 a.m. until 9.30 a.m.
In average,10 patients per day having ECT Example, chronic schizophrenia, severe
Major Depression, acute mania, catatonia, Not all the patients can be treated through
ECT such as, The patients are having hypertension,
pregnant women Team : ETC Psychiatrist, Anesthesia Provider,
ECT nurse or assistant, recovery nurse
Trip to Jabatan Pendaftaran Negara (JPN)
Under Social Work unit Handling patient charity such as IC,
BR1M, salary, document loss, etc.*no need Degree qualification in Psychology to become SWO, BUT it is an advantage if you are psychology student especially when dealing with patients/clients or patient’s family who traumatized/illegal mother/else
Psycho-Education
For in-patient Schizophrenia patient who are referred from doctors (in process to discharge)
5 modules (Monday to Friday)
Day Module SpeakerMonday Module 1 : Mengenali Penyakit Anda Nursing unitTuesday Module 2 : Memahami Rawatan
AndaPharmacy unit
Wednesday
Module 3 : Mencegah Penyakit Berulang atau Relapse
Occupational Therapy unit
Thursday Module 4 : Mengelak dan Mencegah Krisis
Medical Assistance unit
Friday Module 5 : Cara Hidup Sihat Dietetic & Serving unit
Course/ Workshop/ Activities
Attended course : Introduction to Psychiatry PFA course Gaya Hidup Organ Donation Pra-Persaraan (committee)
8 hours attended course = 1 time Must complete 7 times course/yearAlmost course is held in HBUK
Dewan Bahagia Dewan Anggerik Dewan Forensik Akut
Social Visit to Industrial Training Workshop
Patients are recommended by doctors, which is okay to do work
One of efforts to divert attention away from hallucinating and so forth
Patients work from 8 am until 2pm Punch card same as other working system They take their meals 6 times same as other
in-patients Their work will repay with amount of
incentives(how much they did settle the tasks)
Recommendation
1) NEVER RESIST WHEN ASKED TO DO ROLE PLAY (**As Mr. Mujeeb frequently assigned us in class) It Trains Us When Dealing With Patient Some Courses Such As Introduction To Psychiatry And Psychosocial Training
And Psychological First Aid Emphasize On Role Play Activities
2) DO FOLLOW UP BEFORE AND AFTER SUBMIT THE APPLICATION LETTER
Don’t Assume They Will Read Your Email! Alert Them!
3) REVIEW AND UNDERSTAND ABOUT PSYCHIATRIC DIAGNOSIS Schizophrenia (Hallucination & Delusion) Bipolar Mood Disorder Major Depression Drug-Induced Psychosis
And…… Stress Management Anger Management Relaxation Technique Deep Breathing Technique++ +