The shift!

Yup, finally HSB is going to implement the shift system.

My dream finally comes true.

Of course the senior doctors detest the shift system….it causes more trouble for them to organize the departmental schedule. But over all, I welcome the system wholeheartedly.

I don’t mind the fact that there will be fewer house officers working in each shift and thus more work for us. I don’t mind working hard for 8 hours straight. I’d rather work hard for 8 hours rather than work less but for 36 hours (which is never the case. Most of the time when we are on-call, it means working hard for 36 hours or more. How is that not slavery…I have no idea)

Some were saying that “On calls are necessary part of learning. Housemen need to see as much cases as possible so that they will be competent.”

RUBBISH!!! Double Rubbish!

William Osler himself said “He who studies medicine without books sails an uncharted sea, but he who studies medicine without patients, does not go to sea at all.”

We need balance, folks!

I can’t remember the number of patients I have treated after having done OnG and surgical. Most of the time, I am just following what is usually ordered for a particular situation. For example, patient who sustained cerebral concussion….you always ordered CT-brain, keep nil by mouth, observed for 24 hours, IVD 4 pints NS, start GCS chart and pupillary chart, maybe give him Tab Papase if you noticed he got some swelling somewhere.

But really, how does Tab Papase work? What class of medication is that? I don’t know.

I deal with blood transfusion every day! Not just whole blood but the components as well….packed cells, platelets, fresh frozen plasma, cryoprecipitate. But I don’t know things like how fast should they run? How long after being taken from blood bank can we still transfuse them into patients? In cases where the patients developed fever during transfusion, what is the absolute indication to stop  the transfusion?

Why does in some patients with high sugar you straight away start insulin sliding scale….why in some others you just order subcutaneous actrapid stat? There’s a clinical practice guidelines….but I haven’t had the time to read it.

And don’t get me started on antibiotics! Which antibiotic to choose for clean/contaminated/semi contaminated procedures? I just roughly know that in perforated appendix….you straightaway cover with cefobid and flagyl.

 

I have heard so many times about bacterias who are ESBL producer. Until now, I have to pause to remember what does ESBL stands for!

I have so many things I wanted to know and look up once I have finished working. But these things never got done because I often finished working so late….by the time I got home, I just want to sleep. I have no more interest in medicine when I started working.

So I end up treating patients the way I know things are commonly done. Not that I can medically explain or understand them.

Not that some of the specialist are keen to teach all that much either!

So, yes…I hate the current system!

***

I admit, that I am by nature, not a medical lover.

I admit that I am not that interested in medicine.

Having said that, I was also not a keen student when I was a child. But that has never stopped me from trying to excel in UPSR, PMR, SPM, IB and Med School. You have to do what you have to do.

Same here. I hate housemanship working hours. But I never once absconded. In surgical, I have never yet taken even 1 day of….and in HSB, you don’t even get weekends! I worked everyday for the past 3 months with NOT EVEN ONE DAY OFF!

What if I fall sick? Sure, I can take Emergency Leave. But then people will ‘pening’ trying to find someone else to cover my job. And I don’t want to trouble people that way. Because I know how HATEFUL it must be. I, myself, was asked to be on-call because the person who was supposed to do the on-call had taken sudden emergency leave. And it was very annoying!

Sure, I can apply for off days! But they make it so difficult for us to apply for off days. They say “You need to find one houseman who is willing to sign your ‘borang cuti’ and willing to cover for you. Then I allow you to take off days”

What the hell? Who will want to sign, then? WHo will volunteer to say “Ok, you can cuti. I will sign your borang cuti and cover your work”

Kalau I report kat Jabatan Buruh, dah lama HSB kena! Cuti adalah HAK semua pegawai kerajaan…tak kisah laa ada orang nak ganti kerja dia atau tak. Cuti adalah hak!  But they make it difficult for us. Nak kena cari borang cuti! Nak kena cari pengganti! Nak kena minta sign kapten dan sign specialist!

Off days are not automatically scheduled or given! You have to apply for, what is by right, yours!

HSB has been very lackadaisical in housemanship welfare. In other hospitals, they have implemented the circular that states “All doctors are entitled to 1 day off clinical days per week!” Automatic entitlement to 1 day off per week!  And it’s been done in many hospitals. But not HSB! Even our 8days/posting off days pun nak kena apply….punyalah susah nak dapat macam nak minta sedekah! “Tolong sign borang cuti aku, please? Nanti bila hang nak cuti, aku pula sign borang cuti hang.” G..God! I hate begging!

It comes to the point that I have stopped caring about how much money I make! It doesn’t matter to me anymore! I don’t need the money! You can offfer me a thousand more in salary….I still say no! No and no!

I have never cared about money. I live within my means. If I have only 100 to spend per week, then I will make sure I spend only RM100.  Somehow. So, my salary is not important.

I want quality of life.

I want the time to understand what I have been doing in the hospital. In other words, I want the time and the interest to read up after seeing patients! (When I am too tired already in the hospital, I completely lost the interest!)

I want the time with my family and my cat.

I want the time for myself and my books and my writings!

 

LIke I said, I hate studying when I was a student. But I went through it with minimal stress because at that time, I still had the time to do what I like to do. I got re-charged after reading a novel or two; and then I can start reading anatomy and physiology again.

But when I started working….I have been doing what I have come to hate (thanks to the grueling working hours) continuously with no breaks for my own hobbies! I got fed up to the point of tears!

****

It comes to the point that I become envious of the Faber cleaner in HSB. I become jealous of the cashier at the hospital cafeteria too.

It comes to the point that I said “I can leave this life with no regrets at all. At anytime, I can just quit and just be at home and become self-employed. ”

Money is important…but so does quality of life.

Some doctors have lost the plot! They only think of themselves as doctors. They think if they excel at being a good doctor who only think about patients 24/7, then they are this good saintly being.

I can’t be like that. I don’t think of myself ONLY as a doctor. To me, you are not a good person if you are just a good doctor.

You have to be a good slave of Allah. That means, not rushing to pray in between work. It means investing the time in learning and revising your deen.

You have to be a good daughter who will be there for your parents if they are elderly and sick. You also have to be a good wife and a good mother, if you are married.

If you are just a good doctor but a bad daughter, a mediocre mother and a lousy wife….you are not a good person! You are just a good doctor. You shouldn’t have married, you shouldn’t have kids if only to abandon them to fend for themselves.

Some people somehow manage! But with difficulties and a lot of EMERGENCY LEAVES…for us single houseman to cover all their sudden disappearance! Not fair for us, but not fair for them too!

 

So I wholly welcome the shift system. To whoever said that the shift system will only make us incompetent…let me ask you, how competent has the current system been in creating a knowledgeable houseman? Hmm?

Shall we do a study comparing the old system and the new system? Someone should embark on it! Would be interesting to analyze the result.