just back from ppd camp in neg sembilan at a btn camp area. the food was spicy aggravating my sorethroat, but much better than ppd camp 1 in 1st year. other than that, everything else was good.
i learnt thr's more to medical ethics than 1 side of the story.
i learnt thr isnt a clear cut yes no solution in being ethical.
i learnt to humble myself, even at times when i feel i'm not wrong.
and the importance of give and take bcz no one is perfect. i am not perfect. we gotta give space to ppl to make mistakes and look forward from thr.
its about getting through and around the system, while earning respect and respecting others.
I say this, because i am touched that a person forgave me for a huge mistake. to me it was a huge huge blunder. but there was no 'HARRR HOW can you do thisss??' or 'Crap.. now i have to do this / that bcz of ur mistake' or 'WHy din u realise earlier??' and not even an 'OH Noooooo....'.
just a simple reply of 'Its ok. no problem. dun worry bout it. it can be settled.'
This reply not only reassures me and takes away my guilt, but makes me feel a lot better knowing i hav not angered / troubled sum1 else bcz of my mistake.
i truly respect this person, and it was a solemn reminder to me to practise this sort of courtesy to others as well in future.
speaking of medical ethics, a few scenarios in the grp discussion session in the ppd camp spurred me to think further and look at both sides of things b4 making accusations or forming my opinion on 1 side.
When a doctor is charged or accused for negligence, ie. not attending to the patient properly/timely, patient getting contradicting explanations about the cause of a complication that arose in the ward, we need to consider both sides of the story. from the medical staff or system point of view, as well as that of the patient.
there are loopholes in the healthcare system. bcz no system is perfect, and in reality Msian gov hospitals still lack staff. the unfortunate thing is when the loophole compromises a patient's life, resulting in unneccessary deaths at times. its sad. but it happens. doctors missing out on significant vital signs of a post op patient such as severe hypotension, an alarm indicating a flaw (such as inserting a branula into an artery instead of a vein) that goes unnoticed, the exhausted houseman making a mistake in administering medicine in the middle of the night etc.
while the system constantly being improved in order to reduce mistakes by doctors or patch up loopholes in the system, the danger of being that victim plunging into that dark abyss is stil present. in certain countries, pharmacists accompany doctors in ward rounds to reduce mistakes done in the administration of drugs. it brings up the issue of credibility of doctors being questioned (which could injure some pride), conflict of interest, burden on healthcare system. but it's been proven to be successful.
another issue is about communication. its probably something that's still lacking in our healthcare system. patients feel uncared for bcz the doctor doesnt explain to him/her about his/her condition and management. the patient has actually been managed, but bcz he/she was not informed by medical staff about it and given adequate explanation, therefore they feel like they're neglected. communication is important. it prevents lawsuits. according to my Dr. facilitator. true. its a patient's right to noe what's happening to their body and what u're doing to their body.
another area is language barrier. they're lots of cases in gov hosps esp whr the patient has no idea what illness he has been diagnosed with and what or why he is taking this drug bcz the Chinese elderly cannot speak Malay or English and the doctor is unable to converse in Mandarin or Cantonese. i therefore, have to BUck up to improve my Mandarin. like seriously... ! gosh.
in the end its about every member of the healthcare team working TOgether to ensure the well being of patients.
i believe no doctor wants a patient to suffer. no normal person for that matter, wants anyone to suffer. but for now everyone has just got to play their part in trying their best to meet the needs of patients and learn to communicate effectively, in assuring him / her that he/she is in good hands.
4 comments:
good post, Vin. Being a scrupulous doctor is indeed tough. *click on the invisible "Like" button*
XuVin,I've jz spent whole morning wrote abt Adam the musical..kinda lazy to write anothr post abt PPD camp..haha..but..finally!!u've updated ur blog by sharing wat we've learnt frm the camp..indeed,i've learnt a lot as well,esp frm SGD & Dr's sharings..I even hv post-PPD camp syndrome..gosh!:)
cher-double likes cher's comment. hehe. for now, being a good student under the eyes of watchful scrupulous Dr.s is tough s well. wish me luck! :P
yu zhen-hahah yeah its high time both of us updated the blogs!! post ppd camp syndrome!! wow! hahaha its cz u miss ME right?? heheheh..
I agree with what you say. Communication is important but being in a multi ratial country with so many languages, it's kinda tough to communicate with EVERYONE.
You live in Kuching, you should know. Not only do we have to deal with the Chinese and Indian elderlies, but also those of the natives. Can't learn every single native language can you? I was at one of the clinics the other day and watched a houseman trying to communicate with an Iban grandmother. Poor houseman, since she didn't know Iban. So at times, it's also the patient responsibility to have someone, a family member to be there to translate. God knows, the hospital can't provide a translator, what more to say a clinic?
We all have our responsibilities, hospital staff and patients. And of course there is the problems in laymans medical terms. We say pneumonia the say something else... tough
Would be ideal to explain everything that's going on with the patient to the patient, but it takes time. Will we doctors have the time to sit down and talk to our patients, explaining everything and at the same time simplifying things down so that the patient can understand and at the same time be accurate? It ain't easy and it requires time. You've seen how overworked our houseman and doctors are, will we really have the time?
M'sian hospitals aren't like those of the UK, US or NZ. Or Russia. Russian patients seems rather well informed here, maybe it's because they have more doctors than they require here, so doctors aren't overworked. But at the same time, patients here actually inquire about their health, treatment and even medication.
Most patients I've observed SGH rarely even inquire about their treatment or meds. All they wanna know is if their prognosis is good or bad. Some don't even bother to know what the name of their medication is. To them, it's just the round, yellow pill, or the pink square pills. Patients also need to be proactive in their own health. Doctors are busy and sometimes we forget that patients don't understand all the medical junky. We ramble on and on with what textbook we've read from. If patients don't ask, we assume they understand. You get so used to having ppl around you that understand all these medical stuff that you forget sometimes you're with a non-medical personal.
It happened to me once and when the patient was asking what was tranesophageal echocardiogram, or a simple LP, I'm like 'huh?' I was momentarily confused, like 'what do you what is it?' But if the patient didn't ask me, I would have just went on with my medical explaination.
Legal and patients have to understand that. And of course doctors need to suck in their pride. Sure, we made it past 5/6 years of med school, stayed up countless nights studying, practicing like hell to get finally graduate and be a DOCTOR. But being stuck up just means that you're not able to learn more and medicine is always evolving. Need to humble ourselves in order to learn more.
What I hate most is how most houseman treat nurses. I've heard from my mother, I've even seen some. At the first few months of being a houseman, especially when still rotating from department to department, nurses are more skilled than the houseman, the senior nurses anyways. Instead of looking down on them, show some respect as they are better that you at your own job as they have years on experience on their side.
I think this is too long already. I'll stop here. :P
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