Friday December 19, 2008

No room for ignorance in hospital wards

I AM a senior doctor who works in a government hospital with house officers. Having read letters and comments by these house officers and their parents regarding the harassment by their senior colleagues, let me share some of my experiences.

> A middle-aged man, admitted to ward for severe diarrhoea, died due to hypovolemic shock (life-threatening fluid loss). The reason: The house officer on call did not check the patient’s vital signs documented in the record chart.

> A house officer during his morning rounds continued serving potassium supplement even though the patient has hyperkalemia. The reason: He did not review the patient’s drug chart during rounds. He did not trace results of blood tests taken two days ago.

> A young man was transferred from a district hospital for chest pain. The doctor who first saw him had missed the ECG findings of acute myocardial infarction (severe heart attack).

As a result, the man received delayed treatment, and ended up with heart failure. The doctor was a house officer from my hospital, sent out to the district hospital after having completed two years of house officer training.

> A man who collapsed in the ward at 7am was left unattended. The house officer who was on call the night before had left the ward to take a bath, even though he had been informed that the patient was unstable. The patient died due to a delay in administration of CPR.

These are some of the scenarios where the house officers got a shelling from me, not only because of their severe deficiency in knowledge, but due to their attitude and half-hearted manner when dealing with patients.

Then there are house officers who habitually come late to work, even later than their senior colleagues. And there are house officers who don’t take blood investigations on time for patients with dengue fever and never bother to trace the results on time, putting patients at risk.

There are also house officers who smoke in the doctor’s room and house officers who go out drinking late into the night, and are unable to come in to work the next morning due to a severe hangover.

These are the house officers that I have scolded. They grew up, finished their two years’ training and became my colleagues.

Some of them became my good friends, and appreciated what I had taught them. Yet, some will not even look at me when me meet and keep on making silly mistakes when treating patients.

I do not scold house officers for no reason. I don’t get paid for that. I don’t expect them to be superb in knowledge, but the basic knowledge that was acquired from medical schools must be there when they start working.

How do you call yourself a doctor when you do not even know how to perform CPR? Most importantly, one must work with a conscience. Yes, they are allowed to make mistakes, but never at the expense of the patient’s life due to their lousy attitude or severe deficiency in knowledge.

To the parents of these young doctors, have you heard the other side of the story before defending your children? Did they tell you why they got scolded at work?

And if you find out that your child caused a patient’s death, simply due to his poor knowledge and lousy working attitude, will you be able to sleep well at night?

To the house officers who complain a lot, if you can’t even handle negative comments from your senior colleagues, how can you survive when you face demanding patients and family members?

It’s disheartening to see that the public is trying to sensationalise this issue without hearing the other side of the story.

As for myself, I will still scold them if I need to. Of course, I will praise my house officers if they have done well. I don’t mind being unpopular, because it’s not a popularity contest, and my conscience is clear.

A DOCTOR,

Seremban.

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