Sunday, May 20, 2007

Of being courteous and good manners

After a tiring day yesterday in CHilling , I am back to work today. I'm the "crash"-man today - doing the elusive referral and "saviour" doctor for the whole of UMMC. Practically my job during on call today is to resuscitate collapsed patient in the ward as well as the emergency department if they have any problems securing the airway.In our KKM hospitals , usually the Anaesthetist MO in charge of ICU will have the extra burden to complete this task despite having a busy ICU. In UK or US - the actually have a team dedicated to resuscitation per day - consists of doctors from all discipline. We don't have this yet in our hospitals - except maybe the RED ALERT team in MAternity hospital , Kuala Lumpur. My Head of Department is very keen on providing Acute Care at its best and optimum type of care - not the ASAL BOLEH resuscitation. Therefore , this single man "superhero" call is a start in implying the acute care concept in the future.

In the morning , I will have to do rounds with patients ventilated in the wards. Basically , it is quite easy as all we have to do is check the ventilator setting - see how the patient is improving or not - and then review the arterial blood gas taken earlier. But then , it is difficult NOT to get involved with the overall management of the patient ; I suppose being anaesthetists we tend to see patient as a whole and everyday , ended up looking for the ward doctor to offer our opinion. I just cannot isolate ventilation as one partition and others differently. At the end of the day , you get a bit stressed out with the suboptimal management .

One thing that pisses me off a lot these days is when the closest relatives asking me about the condition of their loved ones. Not that I'm angry at them asking me ; they deserve to know !! but more to the primary carers who tend TO NEGLECT THEM and keep them in the limbo. I've always tried my best to explain to the relatives during my house officer days ; as we are the ones who slugs it out really bad in the wards. Unfortunately , I see this matter to be taken lightly and often enough ; they'll come and ask about their loved ones after I've changed my ventilator setting.

It is quite sad to know - the level of information they know about the patient ; eventhough they've been staying up day and night to accompany them in the ward. I do pity the family members who are left in such a state and as doctors we should be courteous and as informative as possible in updating them about latest developments. Coping with critical illness is not easy - and it is important for us as doctors to play our part to help them to calm down. Imagine if we are in their shoes ; how would we cope with that ? True enough , sometimes there are those who are difficult to handle ; but as doctors we should be calm in attending them and settle them . That is what we are trained to do- Multi-lateral human resource management ; not just to manage the medical illness but people who the patient brings in with them.

SO to aspiring doctors as well as house officers out there ; Be courteous and kind. It helps a lot ; and trust me - you'll feel very satisfied with your job.. ( and not complain about the low pay.. torturing working hours... etc... )

Blipppp...bliiippp.... My pager dah bunyi lagi dahh.....


Stupe said...

if only mroe Docs are like you. some really have bad bedside manners!

mz ayam said...

My father was in the govt. hospital for few months & I became a permanent fixture there, the MOs are a bunch of over-worked personnel but super nice. :)

I jush wish you guys could speak clearly & slowly with the least amount of medical jargons / terms Too much of medical jargon will create a barrier between a doc & a patient.
My two sens' worth.


Dr.M said...

Stupe : Few of my previous superiors still have bad bedside manner !! Old school lor..

MZ : true enuff jargon confuses patients.. We'd try our best to reduce the info gap !! :)