If I remember correctly, this government-owned charity institution I was in had more than 10 wards distributed in 3 buildings. A gamut of tropical & other infectious disease cases can be found here with pulmonary tuberculosis giving the most admissions. Because of this, the tuberculosis ward had a separate building of its own. From here, let's focus on the tuberculosis ward. It had 2 floors with the second floor for the male patients while the first floor was shared by both sexes. There were 10 rooms on each floor and each room had 10 beds which seldom get vacant. The staff on one floor consists of less than 10 nurses, a resident doctor, 2 nursing assistants, a janitor, and a trainee...me. I wasn't really sure of the number, but it seemed like that because the next staff I can see at the time aside from me was way across the corridor. I thought it couldn't get worse. Being the new trainee, I was often considered the lowest in the hierarchy. I'm the all-around-errand-boy kind of nurse trainee. Even the janitor tried to boss me around. Nevertheless, the circumstances won't be enough to make my head spin...that's what I thought. The early morning rounds... I took pride in putting the patient's neatly organized charts on bedside on time, 50 of them, especially when the resident doctor appreciated it. That's nursing art over there...yeah right. With almost a hundred patients, the rounds took forever. In the end, I couldn't understand half of the endorsement notes I've taken down. Fortunately, when it was time for the morning care, I was only required to supervise the patients' companion. Imagine if there weren't companions, 50 patients would've taken me the whole day...probably longer. In the first room that we entered, I was asked to auscultate a patient's chest and assess the adventitious breath sounds. Full of confidence, I grabbed my stethoscope and placed my patient in an upright position. After exposing and seeing the patient's chest, I was boggled. I wondered if the stethoscope can be of any use on a chest like that... the intercostal retractions were profound. The patient was really emaciated, and so were the others most likely. Still, I tried using the stethoscope even if there was a big space between the stethoscope's diaphragm and the skin over the intercostals. Rales & Rhonchi seemed audible enough just by listening closely with the naked ear anyway, but proper technique with a stethoscope should be observed at all times according to my grouchy instructor back in nursing school. It worked. At that point, I realized it was possible because from what I've read before, that was what the stethoscope's diaphragm is good for. Compared to the stethoscope's bell, it doesn't always need an even surface. Cool function. I just had to experience that to help me remember. After the morning rounds, I started gathering the patient's charts from the bedside. The beds were arranged against the four walls of the room next to each other in such a way that they surrounded me when I stood in the middle. When I went into this room, it seemed like I was in a gas chamber. What happened was after I asked one patient how he was feeling, he tried to reply but instead coughed incessantly followed by the patient next to him, then the next and so on and so forth in a chain reaction until everyone in the room was coughing...and there I was caught in the middle of the room carrying 20 charts. Aerosol droplets from diseased lungs were coughed at me in all directions. They were like a choir and I'm their conductor. I can't even cover my nose because my hands were full carrying the charts. I hurriedly went out of the room worried about the performance's finale. Since then, I made it a habit to put on double masks even if it felt uncomfortably hot. I should've done that in the first place. A choir is not a bad idea, though...I could've taught them to hit the right notes with the proper rhythm when coughing so that there would've been harmony. At least the chorus wouldn't have to sound so bad. -Finding humor in everything that happens to me makes the hardships easier to deal with.-