CHAPTER ONE

INTRODUCTION

1.1 Origin of ITF

In 1973 the Industrial Research Fund (ITF) launched the Student Industrial Work

Experience Scheme (SIWES). This was to upgrade students' practical awareness in the

Universities, Polytechnics and Technology Schools. It sought to close the gap between

the theoretical knowledge gained in classes and the industry's technical knowledge by

giving students the opportunity to apply their educational knowledge in real work

situations. Over the years, SIWES has made an enormous contribution to building the

popular pool of technical and allied skills available in the Nigerian economy required

for the industrial development of the country. However, the position and importance of

SIWES is demonstrated by the fact that the scheme leads to the enhancement of the

standard of the technical skills commonly available in the pool through which the

employer's source of technical skills provides the student the opportunity to combine

the theoretical knowledge gained in the classroom with the practical implementation of

the information needed for the execution of the work. It also prepares students for

employment, and after graduation makes the transition from school to the world of work

easier.

I undertook my SIWES at Kubwa General Hospital, Abuja (Physiotherapy Department)

which is located at Kubwa, Abuja Nigeria.

1.2 Background of SIWES

The Student Work Experience Scheme (SIWES) is a skill compulsory training

programme established in 1973, designed to prepare and expose students of the tertiary
institution to the industrial work situation they are likely to meet after graduation. The

scheme affords students the opportunity of familiarizing and exposing themselves to

handling equipment and machinery thus enhancing how they engage and apply

themselves mentally, intellectually and physically in relation to the theoretical

knowledge acquired in the classroom in their respective institutions. Students’

Industrial Work Experience (SIWES) is a tripartite programme, involving the students,

universities and the industries (employer of labour).The programme is funded by the

Federal Government of Nigeria and jointly coordinated by the Industrial Training Fund

(ITF) and the National Universities Commission (NUC). In the race for excellence the

Department of Biochemistry, University of Ilorin sends her students on a mandatory

three months industrial training to equip them students with necessary practical skills

to be highly competitive, productive, competent and professional individuals in the

labour market. Consequently, this has benefited student in many ways. These includes;

a) Opportunity for students to blend theoretical knowledge acquired in the classroom

with practical hand-on application of the knowledge required to perform work in the

industry;

b) Exposes the students to the working environment, i.e to enable them see how

professions are organized in practice;

c) Prepare the students to contribute to the productivity of their employers and nations

economy;

d) Provision of an enabling environment where students can develop and enhance

personal attributes such as critical thinking, creativity, initiative, resourcefulness

leadership, time management, presentation of skills and interpersonal skills;

e) Enables students bridge the gap between acquired skills in the institutions and the

relevant production skills required to work in the organization;

f) Enhances students contact with potential employers while on training; and

g) Prepares student for employment and makes transition from school to the work

environment easier after graduation.

1.3 Aims and objectives of SIWES

The objective of the Students’ Industrial Work Experience Scheme (SIWES) include;

a) Provide an avenue for students in institutions of higher learning to acquire industrial

skills and experience relevant to their course of study;

b) Expose student to work methods and techniques in handling equipment and

machinery that may not be available in their institutions;

c) Make the transition from school to the world of work easier, and enhance students

contacts for later job placement;

d) Provide students with an opportunity to apply their knowledge in real work situation

thereby bridging the gap between the theory and practice; and

e) Enlist and strengthen employers involvement in the entire educational process and

prepare students for employment after graduation.

1.4 Scope of SIWES

The scope of this program varies from one department to department and also from

institution to institution. The Department of Medical Physiology, Faculty of Basic

Medical Sciences, University of Cross River. This Scheme is conducted by the

Industrial Training Fund (ITF), through their representative liaison units and offices

situated within the various institutions and in major cities or towns in Nigeria with the
necessary industrial rudiments needed to corroborate, practicalize and then actualize the

required technical knowledge. The Industrial Training experience not only puts them in

real life situations but also exposes their practical knowledge of the course of study,

consequently perfecting this knowledge thereby producing very competent and versatile

professionals.

1.5 Mission statement

To set and regulate standards and offer direct training intervention in industrial and

commercial skills training and development, using a corps of highly competent

professional staff, modern techniques and technology.

1.6 Vision statement

To be the foremost Skills Training Development Organization in Nigeria and one of the

best in the world.

1.7 Brief History of General Hospital, Kubwa

Brief overview of General Hospital, Kubwa: Kubwa General Hospital is a secondary

health care system developed by the Municipal Area Council, Abuja. This is a

secondary health facility since the health care services are operated by, for example,

medical practitioners, dental practitioners and other health professionals who do not

generally have direct contact with the patients: cardiologists, pharmacists in the

hospitals. It needs medical care: treatment is needed for a short period for a brief but

serious illness, injury or other health condition such as in a hospital emergency room.

It is a tertiary health institution that consists of many departments: Internal Medicine,

Psychiatry, Obstetrics and Gynecology, Dentistry, Pediatry, Oncology, Radiodiagnosis,

Surgery, Forensic Medicine and Allied Services (Medical Social Care, Nursing Care,

pharmacy, and Physiotherapy).

About the Ministry:

VISION: "To achieve excellence in the provision of healthcare services by applying

best practices at all levels of care"

MISSION: "To provide qualitative, accessible and sustainable healthcare services to

people using appropriate technology through highly motivated workers" HIM's Special

Advisor on Wellbeing and the Permanent Supports the Commissioner.

1.7.1 Physiotherapy Department

The Department of Physiotherapy is divided around General Hospital, Kubwa, Abuja

into several units. Alongside proper storage and distribution throughout the hospital, it

is primarily responsible for the ECG and physiotherapy services, Services Offered

includes:

 Physiotherapy

 ECG services

 Administrative Services

 Education and Training Services

 Accident and Emergency Services

 Out Patient Services

 In Patient Services
1.8 Organogram of General Hospital, Kubwa
 SECTION TWO

EXPERIENCE GAINED DURING THE SIX MONTHS INDUSTRIAL

TRAINING AT KUBWA GENERAL HOSPITAL

2.1 Introduction to laboratory

A laboratory is a facility that provides controlled conditions in which scientific or

technological research, experiments, and measurement may be performed. Laboratory

services are provided in a variety of settings: physicians' offices, clinics, hospitals, and

regional and national referral centres.

2.1.1 Safety Laboratory Rules and Practice

Know locations of laboratory safety showers, eyewash stations, and fire extinguishers,

because the safety equipment may be located in the hallway near the laboratory

entrance.

 Know emergency exit routes.

 Avoid skin and eye contact with all chemicals.

 Minimize all chemical exposures.

 No horseplay will be tolerated.

 Assume that all chemicals of unknown toxicity are highly toxic.

 Post warning signs when unusual hazards, hazardous materials, hazardous

equipment, or other special conditions are present.

 Avoid distracting or startling persons working in the laboratory.

 Use equipment only for its designated purpose.

 Combine reagents in their appropriate order, such as adding acid to water.

 Avoid adding solids to hot liquids.

  All laboratory personnel should place emphasis on safety and chemical hygiene

at all times.

 Never leave containers of chemicals open.

 All containers must have appropriate labels. Unlabelled chemicals should never

be used.

2.2 Physiotherapy department

Physiotherapy is offered to patients with a variety of medical respiratory conditions,

with the aim of breathlessness management and symptom control, mobility and function

improvement or maintenance, and airway clearance and cough enhancement or support.

Strategies and techniques used in these departments include:

 Rehabilitation

 Exercise testing (including for ambulatory oxygen assessment)

 Exercise prescription

 Airway clearance

 Positioning

 Breathing techniques

Physiotherapy may be helpful for postural and/or musculoskeletal dysfunction and pain,

and provide help in improving continence, especially during coughing and forced

expiratory manoeuvres. Physiotherapists are usually central to the delivery of

pulmonary rehabilitation and may be instrumental in the non-invasive ventilation

service

My services to the physiotherapy department at the General Hospital, Kubwa includes

  To be an integral member of the physiotherapy team to provide impeccable high

quality, safe, cost effective and evidence based treatments to all patients

requiring physiotherapy services within the catchment area of the hospital.

 To improve my clinical and hands on skills in physiotherapy management of

different conditions that I have learnt from my previous four years.

 To gain physiotherapy work experience in preparation to start future

employment.

 To continue developing my leadership and managerial skills through caseload

management, multidisplinary team work, self, patient and care taker

management.

 To engage in patient care delivery quality improvement projects within the

physiotherapy department and hospital at large.

 To share the knowledge and life experience I have had in life to the hospital staff,

practicing students, patients and communities of Kubwa.

2.2.3 Physiotherapy Case encountered

Some of the Cases I encountered during my industrial training at the physiotherapy

department at the General Hospital, Kubwa includes

Cases seen Physiotherapy Case management

Mechanical Low back pain Heat therapy, Spinal Mobs, McKenzie

Back stretching exercises, back soft

tissue massage, Back care advice.

Mechanical back pain Back care education and ergonomics,

Heat therapy, Spinal mobs, McKenzie

 therapy, low back soft tissue mob,

Aerobic Exs, lower limb stretches, and

general body fitness Exercise to minimize

falls.

Pulmonary tuberculosis & general body Chest Physio, general body strengthening

weakness Exercise, Patient and care takers

education about condition and care

Male with sciatica Heat therapy, sciatic nerve and stretching

Exercise, back care advise, stretching

Exercise for lower

Lumbar spondylosis Passive treatment (back deep tissue

massage, heat therapy). Active

treatments(Exercise to improve

flexibility, strength, core stability and

R.O.M.), Home exercises and Education

Lumbar Spondylo-Disc Degenerative Manual therapy, spinal traction, heat

Disease therapy, back strengthening exercises,

core stability strengthening, taught better

postures and ergonomics.

Empyema with chest drain Lung expansion exercises, positioning to

clear secretions and reduce work of

breathing, preventing secondary

complication caused by immmobility,

 ambulating, simple cardio-pulmonary

endurance training.

Sacral Iliac Joint Dysfunction Pain management with heat therapy,

Back care education and ergonomics,

accessory glides to SCI joints, spinal

mobs, back and core stability

strengthening Exs, lower limb muscle

stretches and strengthening

Lung malignancy and mild malnutrition Chest Physio, strengthening exercise,

cardio-pulmonary endurance training,

aerobics

Severe malaria with generalized body Passive to active R.O.M Exs to all joints.

weakness Strengthening Exs to all muscles, balance

and stability training , core stability

strengthening

Acute low back pain Heat therapy, STM, gentle stretches

Advanced rheumatoid arthritis in all Passive R.O.M Exs isometric

joints strengthening Exercise, pain

management, general fitness Exercise

General body aches & migraine General body fitness Exercise &

Relaxation Exercise

Shoulder girdle pain Shoulder and scapular mobs

 SECTION THREE

ECG SECTION

3.1 Introduction

The electrocardiogram (ECG) department handles the quick bedside investigation that

assesses the electrical activity of the heart using the electrocardiogram equipment. It

involves a non-invasive, cheap technique that provides critical information about heart

rate and rhythm, and helps assess for cardiac disease. ECG monitoring is was often

during my industrial training at General hospital Kubwa in many settings, which

includes acute care, cardiac care and pre-operative assessment.

3.2 Components of an electrocardiogram

It is waveform components that consist of the electrical events during one heartbeat and

the waveforms are labeled as P, Q, R, S, T and U.

3.3 Lead positioning of the electrocardiogram

There are several configurations of electrode positioning; continuous ECG monitoring

uses a 3-lead configuration but the standard 12-lead ECG comprises:

i. Six chest (precordial) leads, which are referred to as leads V1, V2, V3, V4, V5

and V6.

ii. Six limb leads, referred to as leads I, II, III, aVR, aVL, and aVF.

 To position the chest electrodes accurately, it is important to first identify the

sternal angle (angle of Louis); this is done by feeling the bony prominence at the

top of the sternum, which articulates with the second rib above the second

intercostal space. By moving the fingers downwards, the fourth intercostal space

can be felt: here,

 The electrodes for V1 and V2 should be placed to the right and left of the sternum

respectively.

 By feeling the fifth intercostal space and moving the fingers to the middle of the

clavicle, V4 can be placed on the midclavicular line.

 V3 should then be placed midway between V2 and V4.

 V5 is placed in the fifth intercostal space, more lateral to the anterior axillary

line, and V6 is placed in the fifth intercostal space in the midaxillary line.

 To record the limb leads, four electrodes are placed on the body.

 In the upper limbs, an electrode pad is placed below the right clavicle (arm)

 The next electrode pad is placed below the left clavicle (arm);

 In the lower limbs, a cable is connected to an electrode pad placed on the left

hip/ankle (LL) and on the right hip/ ankle (RL).

Note: It is important to follow local policy. All of the limb electrodes are placed on

bony areas, rather than muscle, to avoid motion artifact caused by muscle oscillation.

Positioning electrodes in this formation allows the heart to be electrically mapped in

three dimensions

3.4 Interpreting the waves and results

3.4.1 P wave

P wave is the first short upward movement of the ECG tracing. It indicates that the atria

are contracting, pumping blood into the ventricles.

Amplitude: 2-3 mm high The P-wave should be 2–3 small squares in duration Duration:

0.06 - 0.12 sec.

3.4.2 QRS complex

The QRS complex, normally beginning with a downward deflection, Q; a larger

upwards deflection, a peak (R); and then a downwards S wave. The QRS complex

represents ventricular depolarization and contraction.

Amplitude: 5-30 mm high The QRS complex should be 1.5–2.5 small squares in

duration

Duration: 0.06 - 0.10 sec.

3.4.3 PR interval

The PR interval indicates the transit time for the electrical signal to travel from the sinus

node to the ventricles.

Duration: 0.012 - 0.20 sec

The PR interval should be 3–5 squares in duration

3.4.4 QT interval

The QT interval should be 9–11 small squares

3.4.5 T wave

T wave is normally a modest upwards waveform representing ventricular repolarization

Amplitude: 0.5 mm in limb leads Duration: 0.1 - 0.25 sec

3.4.6 Normal Adult heart rates

Normal = 60 – 100 bpm

Tachycardia > 100 bpm

Bradycardia < 60 bpm

3.5 How to calculate the ECG

To calculate the rate of a regular ECG, simply divide 300 by the number of large squares

between two complexes.

For irregular rhythms, count the number of complexes between 30 large squares and

multiply by 10 (30 large squares = 6 seconds, assuming standard paper speed of 25

mm/s)
 SECTION FIVE

SUMMARY, CHALLENGES ENCOUNTERED, AND CONCLUSION

RECOMMENDATION

5.1 SUMMARY OF ATTACHMENT ACTIVITIES

During my period at the Kubwa General Hospital, Abuja, at the physiotherapy

department as a Pharmacy Student was a big success and a wonderful opportunity to

learn knowledge and skills. It introduced a more realistic approach to physiology

awareness and was a look into the world of hospital physiology & physiotherapy

practice including their positions, primarily obligation in the health care system.

Through my research, I was able to appreciate my chosen study course (Medical

Physiology) even more because I had the opportunity to combine the theoretical

knowledge acquired from school with the practical application of the knowledge

learned here to engage in patient-related clinical problems that contributed to my

organizational effectiveness in a way. My training here has given me a broader

understanding of the importance and relevance of physiology in the local community

and hospital, as I look forward now to joining my future colleagues in improving the

physiology profession positively after graduation.

I was also able to improve my communication and presentation skills and developed a

good relationship with physiologist and interns in the workplace and with patients in

particular. I was also able to appreciate the link between my course of study and other

health-related disciplines in achieving a common goal of interest for the patient.

5.2 CHALLENGES ENCOUNTERED

The main problems encountered were getting placement and transportation. It was quite

challenging for me that live in far place to get to the organisation every working day. I

was not given any remuneration or allowance, other problems encountered during the

training was attending to different people with different personalities at the reception.

5.3 CONCLUSION

My six months industrial attachment with Kubwa General Hospital has been one of the

most interesting , productive, instructive and educative experience in my life. Through

this training, I have gained new insight and more comprehensive understanding about

the real industrial working condition and practice and also improved my soft and

functional skills. All these valuable experiences and knowledge that I have gained were

not only acquired through the direct involvement in task but also through other aspects

of the training such as: work observation, supervision, interaction with colleagues,

supervisors, superior and other people l related to the field. It also exposed me to some

certain things about medical environment. And from what I have undergone,I am sure

that the industrial training programme has achieved its primary objective.

5.4 RECOMMENDATION

I recommend that all institutions or bodies involve in Student Industrial Working

Experience Scheme, should provide places of placement for industrial attachment for

Student Industrial Training Fund and also pay some allowances to students and the

company should provide more safety equipments to prevent further environmental and

health hazards. Also, to students that are to undergo the training, I recommend that they

should take it very seriously, because it is one of the most important parts of their studies
which will help them build a very significant and effective meaning in their career

pursuit.
 References

• Students industrial work experience scheme guide to successful participation in

SIWES by Olusegun A.T. Mafe.

• EMDEX; The complete drug formulary for Nigeria’s Health Professionals. 2018-2019

edition

• BNF for Children: British National Formulary 2018-2019 editio