CHAPTER ONE

INTRODUCTION

1.1 Brief History of S.I.W.E.S

In October 1971, the federal government established the Industrial Training Fund (I.T.F). In its

policy statement no.1 published in 1973, a clause was inserted dealing with the issue of practical

skills among the locally trained professionals in the tertiary institutions especially the

Universities of Technology, Monotechnics, Polytechnics, Colleges of Education and Technical

Colleges. Section 15 of the policy statement states clearly that “Great emphasis will be placed on

assisting certain products of the post-secondary school system to adapt or orientate easily to their

possible post-graduation job environments”, subsequently leading to the launch of a scheme

known as the Student’s Industrial work Experience Scheme(SIWES).

The S.I.W.E.S. was launched in 1973 by the Industrial Training Fund (I.T.F) as a

programme designed to impart the undergraduate of the nation’s tertiary institutions studying

various professional courses with the practical methods of performing professional functions to

real life situations on site, in the office or even the factory and how they apply themselves

mentally, intellectually and physically in relation to what they have been taught in the classrooms

theoretically. It works with the following professional bodies to function effectively across the

tertiary institutions nationwide. These are the Nigeria University Commission (N.U.C), National

Board for Technical Education (N.B.T.E.) and the National Commission for Colleges of

Education (N.C.C.E.). Thus, equipping the students with the necessary skills and technical

knowledge to make them highly competitive and professional individuals in the labour Market

1.2 Scope of S.I.W.E.S

The scheme as conducted by the Industrial Training Fund (I.T.F) through their representative

liaison units and offices situated within the various institution 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 buts also exposes their practical knowledge of the course of study,

consequently perfecting this knowledge thereby producing very competent and versatile

professionals.

1.3 Aim and objectives of S.I.W.E.S

The aim of S.I.W.E.S is to bridge the gap between the level of knowledge acquired in tertiary

institutions and the practical application of such knowledge in the field of work.

The Objectives are:

 To provide an avenue for students in industries of higher learning to acquire industrial

skills and experience in their course of study.

 To prepare students for the work situations they are to meet after graduation.

 To expose students to work methods and techniques in handling equipment and

machinery that may not available in the educational institution.

 To make transition from school to the world of work easier and enhance students

contact for later job placements.

 To improve student’s interpersonal relationship with others in their field.

 To prove students an opportunity to apply his/her knowledge in real work situation,

thereby bridging the gap between college work and actual practice
 CHAPTER TWO

History and Background of Nigerian Navy Reference Hospital

2.1 History and Background of Nigerian Navy Reference Hospital, Calabar

Nigerian Navy Reference Hospital, Calabar, was established by NNO in 1982. It started as a

39 bed hospitals located on old secretariat road in Calabar. The hospital has catered for the

healthcare needs of officers and men within the Eastern Naval Command, their families as well

as civilians within the general calabar area. With increasing population as well as growth in the

number of service personnel in the area, the old hospital has struggled to meet the attendant

challenge, the Nigeria Navy embarked upon the task of completing the new edifice of the now

Nigeria Navy Reference Hospital, which is located at plot 1 Archbishop Archibong Archibong

avenue off Murtala Mohammed Highway Calabar, Cross River State.

It started as a health care centre and became a full operational Medical Hospital. Since

establishment it has delivered quality services to the residents of Cross River State, it goes with

the slogan ‘’Trusted Hands, Touching Lives’’

2.2 Organization vision

To be a world class human resource agency, ensuring the delivery of qualitative health care

services for the people

2.3 Organization mission

To provide highly skilled and motivated staff with the right attitude to deliver efficient and

effective health care to community

2.4 Core values

 Medical excellence based on knowledge, skills and first rate human relations

 Passions

 Knowledge based hard work

  Trust

 Persistence

 Imagination

 Timeliness

 Integrity

 Professionalism

2.5 Scope of service

Nigerian Navy Reference Hospital provides the following services to people:

 Dental

Known evaluation, diagnoses, prevention and treatment of diseases, disorders and

conditions of the soft and hard tissues of the jaw (mandible). The oral cavity,

maxillofacial area and the adjacent and associated structures and their impact on the

human body

 ENT (Ear, Nose, and Throat)

The branch of medicine that specializes in diagnosis and treatment or ear, nose, throat

and head and neck disorders.

 Laboratory

This is where tests are done on clinical specimens in order to get information about the

health of a patient as pertaining to the diagnosis, treatment and prevention of disease.

 Obstetrics and gynecology

The entire scope of clinical pathology involving female reproductive organs and

provision of care for both pregnant and non-pregnant patients

 Ophthalmology

This branch of medicine deals with the diseases and surgery of the visual pathways

including the eyes, hair, and areas surrounding the eyes, such as lachrymal system and

eyelids

 Paediatrics

The branch of medicine that deals with the medical care of infants, children, and

adolescents

 Pharmacy

Charged with ensuring the safe and effective use of pharmaceutical drugs, the scope of

pharmacy practice includes more traditional roles such as compounding and dispensing

medications and it also includes more modern services related to health care including

clinical services reviewing medications for safety and efficacy and providing drug

information.

 Radiology

The branch or specialty of medicine that deals with the study and application of imaging

technology like X-ray and radiation to diagnosing and treating disease.

 Surgery

A medical specialty that uses operative manual and instrumental techniques on a patient to

investigate and/or treat a pathological condition such as disease or injury to help improve

bodily function or appearance or sometimes for some other reason.

 VCT

Voluntary Counseling and Testing (VCT) for HIV

2.7 Organizational Chart of Nigeria Navy Hospital Calabar

ORGANIZATIONAL CHART OF THE NIGERIA NAVY REFERENCE

HOSPITAL CALABAR

ORGANISATION’S CHART AND ORGANOGRAM

 CHAPTER THREE

INTRODUCTION TO THE LABORATORY

2.1 The laboratory

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

experiments, and measurements, may be performed. Hence the medical laboratory is a laboratory

where tests are carried out on clinical specimens in other to get information about a patient’s

health.

There are three sections in the laboratory, they are; Physiotherapy Unit, Clinical Microbiology

section, Hematology/Serology section, and Clinical Biochemistry section. The overall

significance of the laboratory diagnosis is that they guide towards the administration most

effective therapy so as to restore a proper health on the patient. Laboratory safety precautions

and ethics.

2.2 Safety rules in the laboratory

Every laboratory is expected to adopt a code of bio-safety principles and work practice which

should be enforced and adhere to strictly by workers and visitors. All specimens coming into and

from the laboratory are being assumed to be potentially infectious and harmful and that is why

the below precautions are ensured to be taken to avoid contamination and laboratory hazard.

 Avoid disrupting laboratory activities you must TURN OFF all cell phones and pagers: their

use is prohibited.

 All persons in laboratories, including students, staff, and visitors, shall wear safety glasses,

goggles, or face shields at all times where potential eye hazards exist

 Eating, drinking, chewing gum, and applying cosmetics are prohibited laboratory.

 Do not store food or beverages in the same refrigerators or freezers with chemicals,

biohazards, or radioactive materials.

 Never conduct unauthorized experiments or engage in horseplay in a laboratory. Please

immediately report any unsafe behaviour to the instructor.

 Wear appropriate clothing. In particular, you must wear closed-toed shoes (i.e., NO sandals

or flip-flops!) in the laboratory. If you have a long hair, tie it back. Avoid wearing dangling

jewellery.

 Wearing an iPod, Bluetooth, or any other device that interferes with hearing is not allowed.

 Never pipette anything by mouth.

 The work area must be kept clean and uncluttered. All chemicals should be labelled and

stored properly.

 The hazards of chemicals used should be known (e.g., corrosiveness, flammability,

reactivity, stability, and toxicity).

 Always pay attention to your surroundings and be aware of what others are doing. Always

be courteous.

 Remove contaminated gloves before touching common use devices (door knobs, faucets,

equipment); discard gloves before leaving the laboratory.

 Always wash hands and arms with antibacterial soap and water before leaving the laboratory.

In conclusion, maintaining safety in the laboratory largely rest on the shoulder of the laboratory

workers. Adequate safety and good laboratory practice can be avoided irrespective of the

location, staff strength and availability of sophisticated safety cabinets in the laboratory. What

are required are highly standards of hygiene by the laboratory workers to achieve good results in

their daily occupational practice.

2.3 Emergency in the laboratory

 Know where to find the nearest exit in case of fire or other emergency.

 Know the whereabouts of the nearest fire extinguisher, fire blanket, first aid kit, eye

wash equipment, shower and telephone.

  In case of fire, clear out of the laboratory first, and then call an emergency number.

2.4 Hazardous materials

 Both liquid and dry chemicals can be flammable, poisonous, carcinogenic, etc. Pay

attention to special instructions, such as to; work with a substance only in a fume hood.

 Biological hazards include bacteria and body fluids, such as blood. Handle with

appropriate care, and dispose of biological hazards as instructed.

 Dispose of hazardous materials as instructed. Never put anything down the sink without

checking with an instructor.

 Clean up spills and broken glass. Don't handle broken glass with your bare hands. Use

a broom and dustpan, and throw away all broken glass and disposable glass pipettes,

coverslips, and other sharp or easily breakable glass in a container for glass disposal

only. Notify the instructor immediately of all incidents.

2.5 Hazardous equipments

 If appropriate, turn off equipment that isn't being used.

 Do not use a Bunsen burner unless instructed to do so.

 Keep liquids and chemicals, especially flammable materials, well away from any heat

source or electrical equipment.

 If any electrical equipment is malfunctioning, making strange noises, sparking,

smoking, or smells "funny," do not attempt to shut it off or unplug it. Get an instructor

immediately. It is imperative that the instructor know of any equipment problems.

2.6 Laboratory equipments and their uses

 Microscope: Is used to examine samples and to analyze their contents that are not

visible to the naked eye. It is used to count pathogen and other cells and to view under

x10, x40, and x100 objectives.

 Autoclave: For Sterilization

 Centrifuge: Is used for spinning specimen e.g. urine to enable separation into

constituents or components e.g. blood into serum and plasma.

 Refrigerator: Provides suitable temperature for storage and preservation of

reagents, unused media, blood samples etc.

 Bunsen burner: Serves as the source of heat for sterilizing wire loop, surgical

forceps and other metal instruments to be used for analysis.

 Weighing Balance: Use for measurement.

 Wire loop: It is used for streaking specimen on culture plates and it can also be used

for making smear of samples on slides.

 Lancet: It is a sterile needle used to prick the thumb for the collection of blood

samples.

 Capillary tube: It is used for the collection of blood samples to determine the packed

cell volume.

 Universal bottle: used for sample collection e.g. urine, stool, semen

 Glass slide: It is used for the preparation of samples to be viewed directly under the

microscope.

 Sterile swab stick: Is used for the collection of samples to directly from the sight of

infection e.g. Ear, nose, vagina, cervix, etc.

 Sampling bottles: They are bottles used for the collection of blood samples e.g.

universal bottle, fluoride oxalate bottle, Ethylene-Di-amine-Tetra acetic Acid bottle

(EDTA), Lithium Heparin bottle, plain bottle.

 Incubator: used for culturing or drying of microorganism.

 Micro heamatocrit centrifuge machine: it is used to spin sample for the analysis

of packed cell volume of blood sample.

 Water bath: Use as heating apparatus

 Micro haematocrit reader: used to read the packed cell volume in percentage.

 Tourniquet: it is tightened on patient hand in the collection of blood sample in order

to get a prominent vein before incision.

 Needle and Syringe: It is used for the collection of blood samples.

 Macro centrifuge machine: It is used for the separation of blood samples in order

to get the plasma and also used for the separation of urine sample so as to get the

supernatant and the specimen

 Glucometer: used to check for the sugar level in the body with the aid of its strip.

 Hematology analyzer: Is used for the analysis of Full Blood Count (FBC).
 CHAPTER FOUR

WORK EXPERIENCE LEARNT DURING SIWES

4.1 High frequency heat therapy

Heat is used in physiotherapy Two types: simple heat radiation or by the application of high
frequency energy obtained from special generators. High frequency energy in thermotherapy
has better penetration compared to 'simple' heat application, it can penetrate deeper lying
tissues, e.g. muscles, bones, internal organs. High frequency energy for heating is obtained by
shortwave therapy unit making use of either the condenser field or the inductor field method.
Microwaves and ultrasonic waves are also used for heating purposes in special cases.
4.2 Short-wave diathermy machine
Diathermy' means 'through heating' or producing deep heating directly in the tissues of the
body. In the diathermy technique, the subject's body becomes a part of the electrical circuit &
the heat is produced within the body & not transferred through the skin.

The advantage of diathermy -the treatment can be controlled precisely where electrodes
placement permits localization of the heat to the region that has to be treated. The amount of
heat can be closely adjusted by means of circuit parameters. The heating originates from high
frequency alternating current which has a frequency of 27.12 MHz & a wavelength of 11 m.
Currents of this high frequencies do not stimulate motor or sensory nerves, nor produce muscle
contraction.

The current being alternating, will pass through the tissues currents with greater intensity to
produce direct heating in the tissues similar to any other electrical conductor. The method
consists in applying the output of a radio frequency (RF) oscillator to a pair of electrodes which
are positioned on the body over the region to be treated. Thus, promotes healing of injured
tissues and inflammations.

Precautions in Automatic Tuning in Short-wave Diathermy Machine

Any short-wave therapy unit would give out the desired energy to the patient only if & as long
as, the unit is correctly tuned to the electrical values of the part of the body. Therefore, tuning
must be carefully carried out at the beginning of the treatment & continuously monitored during
the treatment. There is a possibility of the tuning getting affected due to unavoidable but
involuntary movements of the patients & the resultant fall of dosage. In order to overcome the
problem of making tuning adjustments during the course of treatment, an additional circuit is
fitted in the machine.

Fig 4.1: Short-

wave diathermy machine: Shortwave diathermy (with capacitive electrodes/coplanar
method) in use

4.3 Electrotherapy

Electrotherapy, employing low-volt, low-frequency impulse currents, has become an accepted

practice in the physiotherapy departments. The biological reactions produced by low-volt
currents have resulted in the adoption of this therapy in the management of many diseases
affecting muscles & nerves. The technique is used for the treatment of paralysis with totally or
partially degenerated muscles, for the treatment of pain, muscular spasm & peripheral
circulatory disturbances, & for several other applications.

4.3.1 Galvanic Current Electrotherapy

When a steady flow of direct current is passed through a tissue, its effect is primarily chemical.
It causes the movement of ions & their collection at the skin areas lying immediately beneath
the electrodes. The effect is manifested most clearly in a bright red coloration which is an
expression of hyperaemia (increased blood flow). The duration of the treatment is generally
10–20 minutes. Galvanic current may be used for the preliminary treatment of atonic paralysis
and for the treatment of disturbance in the blood flow. It is also used for iontophoresis, which
means the introduction of drugs into the body through the skin by electrolytic means. In
general, the intensity of the current passed through any part of the body does not exceed 0.3 to
0.5 ma/sq cm of electrode surface.

4.4 Spinal Cord Stimulator

Spinal cord stimulation is a term relating to the use of electrical stimulation of the human spinal
cord for the relief of pain. This is accomplished through the surgical placement of electrodes
close to the spinal cord, either with leads extending through the skin, or chronically, with the
leads connected to an implanted source of electrical current. The applied electrical impulses
develop an electrical field in & around the spinal cord, which then causes depolarization or
activation of a portion of the neural system resulting in physiological changes. The stimulus
source provides stimulation pulses at frequencies ranging from 10 - 1500 Hz, with pulse widths
from 100 - 600 μs & controllable amplitude from 1 to 15 mA delivered into a load from 300 to
1500 Ω. These parameters can be controlled when one is using an implant that derives power
& control through RF coupling from an externally power unit.
 Fig 4.2: Spinal cord stimulation system with programmer (Transmitter).

4.5 Deep brain stimulation (DBS)

The deep brain stimulation (DBS) therapy is a new treatment technique for a number of
neurologic disorders such as Parkinson's disease. The system consists of three components: the
implanted pulse generator (neurostimulator), the electrode & the extension The electrode or
lead is a thin, insulated wire which is inserted through a small opening in the skull & implanted
in the brain. The tip of the electrode is positioned within the targeted brain area. The extension
is an insulated wire that is passed under the skin of the head, neck, & shoulder, connecting the
lead to the neurostimulator which is usually implanted under the skin near the collarbone. The
stimulator delivers a constant fast-frequency stimulus which interrupts a specific circuit in the
brain that is overactive in the disease state. This interruption of the diseased overactive circuit
can significantly improve the symptoms of the disease.
4.6 Treadmill Exercise
Four Exercise advices and Policy
Warm-up: Take warm-up exercise for 5 to 10 minutes before using this machine each time.
Breathing: When exercising, you can’t hold your breath, usually inhale with nose when
intending to release actions, and exhale with mouth. Inhaling should becoordinated with exha
ling. If breathing too fast, you should stop exercising immediately.
Frequency: After the exercise of the same parts of the muscles, this part should have 48
hours’ rest. That is to say, it only can be exercised every other day.
Load: Decide the training volume based on the training state of everyone’s physical
fitness, and then exercise according to the progressive overload principle. At the
first exercising stage, muscles soreness is normal and can be eliminated by keep exercising.
Diet: To protect digestive system, exercise should be taken one hour after a meal.
Eating should be done at least half an hour after exercising. When exercising,
drink less water, and especially avoid drinking much so as not to increase the
burden of heart and kidney.

Figure 4,3: A treadmill machine

Exercise for Stretching:
Whatever your running speed is, you’d better do stretching exercise first. Warn
muscles are easier to stretch, so walk for 5 to 10 minutes to warn up. Next, stop
to do stretching exercise for five times according to the following methods, 10
seconds or more for each leg, and do again after exercising.
Head muscles stretching
Put the right hand on the wall or desk, then stretch the left
hand backward, hold the left ankle and pull it upward to the hip until you feel
the front muscles of the upper leg is tense, pull for about 10~15 seconds and
then relax. Repeat for three times for each leg.
Sartorius (inner side muscles of leg) stretching
Sit down with leg bottom against each other and knees outward, hold feet with
hands, pull toward to abdominal groove, keep for 10~15 seconds and then relax.
Repeat for three times.
Precautions on the treadmill
For people who are undertaking medical treatment or the following patients, please discuss
with special doctors before use:
 People who are suffering back pain or who suffered leg, waist, neck injuries. People
who suffer leg, waist, neck and hand numbness (people who have inveterate diseases
such as slipped disc, spine slipped disease, cervical protruding, etc.)
 People who have deformed arthritis, rheumatism, gout..
 People who have osteoporosis abnormality.
 People who have circulation system troubles (heart disease, dysfunction of blood
vessel, high blood pressure, etc)
 People who have troubles in breathing organs.
 People who are using artificial pacemaker to implant medical electrical instruments into
the body.
People who have malignance.
 People who suffer disturbance of blood circulation like thrombosis or serious dynamic
fatty tumor, acute still fatty tumor etc., or all kinds of skin infections.
 People who have perceived barriers caused by highly peripheral circulation obstacles
that are caused by diabetes, etc.
 People who have skin injuries.
 People who have a high fever (less than 38°) caused by illness, etc.
  People who have spine abnormalities or spine bending.
 People who are in pregnancy or may be in pregnancy or who are in their period.
 People who have abnormalities in the body and need rest.
4.7 Sand Bag Physiotherapy
This is a kind of therapy used for patients positioning, Sandbags are bags filled with sand and
are sewn to be leak-proof & tear-proof it used mainly by patients for positioning, providing
rehabilitation, support and positioning. Sandbags provides weighted support, which gives the
physiotherapist a third hand to keep the trunk or limbs in a preferred position. Sandbags also
provides weighted resistance that can wrap around curved wrists and ankles.

Figure 4.4: A sandbag

4.8 Parallel Bell Therapy
This is an equipment used in the physiotherapy unit for patiemts to regain their strength,
balance, range of motion and independence.Patients also who are recovering from injuries,
illness and other debilitating conditions makes uses of this equipment too.

Figure 4.6: A parallel Bar

 CHAPTER FIVE

SUMMARY, CHALLENGES ENCOUNTERED, AND CONCLUSION

RECOMMENDATION

5.1 Summary of attachment activities

During my period at the Nigeria Navy Reference Hospital Calabar as a SIWES student,

cataloguing some information materials for the laboratory and I also did some activities at the

reception such as: attending to patients, confirming and examining their request forms, entering

their details into the register, detailing them concerning the test they are to undergo and

directing them to where is to be carried out. I was later transferred to the physiotherapy

department and was introduced to the departments, safety precautions and tests carried out in

each department.

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 Nigeria Navy Reference Hospital Calabar 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 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.

As a result of the programme, I am now more confident to build my future career which I have

already started with Nigeria Navy Reference Hospital Calabar.

5.4 Recommendation

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

Scheme, should provide places 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.