my experience of doing supervised fieldwork

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++ +