Hati2 dengan Doktor pelatih di hospital gomen
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 – Komen: Ne sepatutnya ko sebagai Medical Officer on call pun kena check sendiri, tak leh harap pada si housemen jer….Ne reflex ko sebagai MO yang tak bertanggungjawab. Housemen tu kalo keluar dari university yang kerek entahkan gred 4 aliran sastera jadi camni lah…
> 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 drug chart during
rounds. He did not trace results of blood tests taken two days ago. - Komen: Ne sepatutnya ko sebagai Medical Officer on call kena check sendiri, tak leh harap pada si housemen jer….Ne reflex ko sebagai MO yang tak bertanggungjawab. Housemen tu kalo keluar dari university yang kerek entahkan gred 4 aliran sastera jadi camni lah…
> 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). – ST elevation sepatutnya doctor tak miss le…. Ko sebagai doctor yg bertanggungjawab Kena ada high level of suspicion!! Kerja mulai doctor bukannye nak merabakkan duit orang jer…MMC kena buat sesuatu sebab doctor ne yg tahap pengetahuan nye ciput atau staff nurse dan Medical Assistant lagi pandai dari doctor kena la ambil Exam lagi sekali kat Malaysia!! Mungkin kolej perubatan luar negeri dia tu kerek sanagt la kot….
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. - Ne doctor tak bertanggungjawab la ni…. Kalo dah tau tahap pengetahuan ko tu ciput atau ko tu pemalas nak cari ilmu pengetahuan, jangan le ko jadi doctor. Tapi doctor cam ne dalam kepala nak cari duit jer…. Cukup 4 tahun compulsory service dengan gomen terus blah pi swasta dan siap prescribe sampai 10 jenis ubat walhal pesakit komplen demem jer…Masalahnya kaum pesakit susah nak kenal pasti spesis duktur yg macam ne…. Senangnya nak distinguish kalo duktur tu tak kenal tuhan, lulusan dari Ukraine, India, Pakistan Bangladesh, Indonesia, China, Taiwan dan yang seangkatan pelik pelik tu.. berhati-hati le korang sebagai pesakit sebab ada university cikai ne yang terima calon medical student yang kelulusan gred 3 atau gred 4 Aliran Sastera SPM masuk univerisiti mereka. Janji mak bapak budak tu sanggup bayar duit rasuah RM juta juta kepada pemilik kolej swata tersebut!!! Kalo para duktur lulusan IPTA Malaysia kemungkinan besar masalah sebegini tiada sebab duktur lulusan IPTA Malaysia biasanya academically very strong dan genuinely intelligent, lagipun ibu bapa mereka orang miskin yang tak mampu beri rasuah macam tu… atau orang yang berpegang teguh pada agama !! Kelulusan mereka masa nak enrol medical student pun rata rata 4 flat semua!!… jadi hati hati dengan spesis yang tak kenal atau tak hirau dosa pahala @ neraka… Bagi ubat main tibai je asal dapat duit untuk bayar instalment BMW dia…
> 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. - - - zaman dulu duktur Hoesemen mana ada masa nak mandi weh oi….. nak makan pun tak de masa!!!
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 take blood investigations on time for patients with
dengue fever and never bother to trace the results on time,
putting patients at risk. Dr camne memang tak layak jadi doctor…
There are also house officers who smoke in the doctor 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
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 we
meet and keep on making silly mistakes when treating patients.
I do not scold house officers for no reason. I don get paid for that. I dont 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 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 person 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 even handle
negative comments from your senior colleagues, how can you
survive when you face demanding patients and family members?
It 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 mind being
unpopular, because it not a popularity contest, and my conscience