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This is a question Doctors, Nurses, Dentists and Hospitals

Tingtwatter asks: Ever been on the receiving end of some quality health care? Tell us about it

(, Thu 11 Mar 2010, 11:49)
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Right - my turn . . .
I’ve read 8 or so pages of comments from those who love/loathe the public health system, and now it’s my turn to tell you all what gives me the shits . . . and some people will get a serve here – apologies if I offend.

I have been a doctor for 10 years, all of which have been in the public system. I chose a specialty that has taken a great deal of my life to complete, and thank God, I’m almost there.

Not all doctors are great people; not all nurses care about their patients; not all of us are shiny happy individuals after 10 hours’ sleep in 3 days, or no chance to stop for a meal in almost 16 hours (and no, that’s not bullshit – that’s my last week of work). You will have the dedicated, the incompetent, the apathetic – and they all work in the same place.

What I do daily is in a sense self-inflicted (I chose to follow this career path), but some things are not very helpful:

1. Rudeness – the few incidents I can remember being rude to a patient have all been when they are being unreasonable, dangerous, or when someone else tries to die and I have to leave the conversation about your dogs to fix it . . . now. I really don’t deal well with the following subgroups:
a) I’ve had problems with hospitals before and if you don’t treat me properly, I’m going to sue your ass (actual conversation). Lovely start to the consult – may result in you being seen last by my boss because we will document everything we say to you – twice, and refer you endlessly for further advice.
b) The “I know exactly what treatment I need and you will give it to me.” Feel free to show me case reports, but be ready for me to debunk them if I can show you a randomized study to contradict it; I don’t endorse homeopathy, chiropractic or naturopathy but feel free to discuss with me a trial of it if its what you want – I will disagree with you, but you’re mostly grown-ups, so you can decide some of your treatment for yourselves. Also, would you tell your hairdresser how to hold her scissors or a builder how to lay bricks? Probably not. The training for most of these jobs is long and borders on soul-destroying, and we’re not let loose on any of you unless we are safe.
c) Drunk and disorderly. Someone posted earlier about a metacarpal fracture not being treated because the doctor thought he was an idiot: let me give you some perspective: I call this particular fracture (base of 5th metacarpal) an “idiot fracture” because it usually comes from punching something hard, like a wall. To fix it requires surgery, and not fixing it removes the risks of open wounds and anaesthetics. The other upside to not fixing it means if the idiot does it again, I don’t have to fish out broken metal, as well as fix the fracture again. Drunk drivers and those who don’t know what a seatbelt is really, really, REALLY give me the shits. You damage yourselves and others, all without good reason. Many nights and Emergency lists are spent on you, because you think you’re invincible. Many families have received the “I’m sorry he passed away on the table” talk because that plastic strap you idiots have next to your seat wasn’t fastened firmly around you.
d) The “you sit around and do nothing” patients. I have been told (?7 years ago) by a rather angry young man that doctors sit around and drink coffee all day. The other variation on this is the “you guys are loaded” tune (usually trundled out by some of my family) and "your job is easy". I leave the house at about 5:30 am and return about 7:00 pm, provided I’m not on-call (on-call means no sleep at all for the night, and a theatre list the next morning). I have a mobile permanently turned on to receive calls from my bosses, juniors, and patients. Time not spent at work or sleeping is usually dedicated to studying. My last timesheet says (*quick glance*) I was rostered for work for 130 hours last fortnight (not including some extra hours where we come in early or leave late, but don’t claim it, because admin. didn’t think it was necessary). My job is not "easy".
I’m not bitter about my workload, but I am pissed when someone thinks it all a walk in the park. Oh – and a senior surgical registrar makes less an hour than the theatre technicians I work with.
e) “I won’t do what you tell me” – stop smoking because I have an open fracture and it will heal twice as fast without the fags? No – won’t stop smoking. Fast for an operation in six hours – nope, don’t feel like it . . . patient seen eating crisps 1 hour before start time. Please take this antibiotic for your infection – I didn’t finish my course – I forgot/got better/didn’t think it mattered. Keep this plaster on for six weeks then I’ll take it off when you’re back – patient hacks it off with an angle grinder at week 2. Arrghhhhh!!!!!! Some of the treatments we suggest for you are useful; some of the things we say will really happen if you don’t listen. Please, please follow advice, or tell me early if you plan to ignore it (there may be an alternative, or I might just read you the riot act and insist you do as I say).

2. Bastardisation from within the medical fraternity (notice the reference to the brotherhood of medicine, not sorority – God forbid women could form a group in surgery). We are our own worst enemies – we criticize, we pressure and openly humiliate our colleagues. We tell them it’s “character building” and to “toughen up.” We assess them for training by forcing them to do that “little extra time” (unpaid) ie: stand out from the crowd by staying behind hours to complete work someone else could/should do. Those that suck it up and don’t complain get the references. We have the gall to tell our colleagues that workplace laws state they have to go home after 86 hours in a fortnight, but we expect the dedicated ones will sign off their timesheets for the time, but stay at work – that’s dedication you see. If someone fucks up, we don’t always stick up for them – better to let them burn and save our own behinds (I’m glad to say this no longer happens much, but did when I started training).

I have worked in approximately 18 or so hospitals (at last count) in this time. We get rotated every 3-6 months (and it’s great fun to pack up your life in the boot of the car to move to the next place, usually in the weekend changeover between jobs). None as a whole has been particularly shonky, dangerous or guilty of providing bad service – but there are places where the attitudes stink, and I won’t work there again. I have seen bad doctors, nurses, pharmacists, social workers, admin. staff. I have also seen some great people doing wonderful work, quite often without being obliged to do so, and with little thanks.

Would I do this again, if I knew what I was signing up for 10 years ago? Probably. Would I suggest my children do this for a living? Maybe – depends on whether they have thick enough skin, and an endless capacity for punishment.

I always told myself I should choose a specialty where I wake up in the morning, and 99% of the time I’m glad to go to work. I’m quite lucky I still have that feeling (most) mornings.
(, Sat 13 Mar 2010, 10:52, 17 replies)
Actually, I'm curious now.
Based on my post below regarding being handcuffed, is that normal procedure in Oz (or even the UK?).
Monty says it's barbaric, but I understand why they do it. Agreed?
(, Sat 13 Mar 2010, 11:17, closed)
Not normal procedure . . .
unless you are endangering yourself, or others.

I was surprised at your post - I've not seen anyone non-dangerous brought in in cuffs (except for the guys going to the prison ward, and I've been ?lucky enough to work on one of those too).
(, Sat 13 Mar 2010, 11:38, closed)
Do I know you?
Ha, Ha, You sound so much like my sister it's not true! She's an over worked, under appreciated doctor who works countless hours a week plus "on call" hours where she averages two hours sleep a night then goes back to work. Consider the huge hugs and mountains of admiration I give her at part for all you guys x
(, Sat 13 Mar 2010, 11:18, closed)
I love your username!
And also...what you said. I can't imagine working those kind of hours under that kind of stress!
(, Sat 13 Mar 2010, 11:21, closed)
Bows . . .
thank you - most of my patients are actually great people, and a small thanks is often enough to cancel out a handful of gits.
(, Sat 13 Mar 2010, 11:47, closed)
I can't say I would like your job
I can understand being angry at those who cause grief to others,physically, mentally and otherwise, but I cannot bring myself to be angry at anyone who causes their own demise. A lot like that line in "top Gun", the one about "dear Mrs ???, your sons died because they were stupid". I really don't have the empathy to work with and/or around sick and injured people or the surviving relatives of natural selection candidates.
(, Sat 13 Mar 2010, 11:34, closed)
My way to deal with those who refuse to follow treatment . . .
is to give them the "you're a grown-up talk." They get given the information they need to decide if they'd like to be treated, but ultimately they are adults and can decide for themselves. They can refuse medical treatment, but they are also warned I *will* make them sign forms that say they refused medical advice, and will need to fid their own doctor for follow-up. I can handle disagreement, in fact, it usually means they are listening, and not just nodding and smiling at my plan. I don't appreciate the same patient coming back, telling me they're now stuffed because I wasn't clear enough when I told them they *must have* this treatment, and it's all my fault.
(, Sat 13 Mar 2010, 11:44, closed)
Last time I was in, they tried to make me take a Xanax (I wasn't even being unruly or anything, was just pissed off at being there when I didn't want to be). I refused as I only take Xanax when I fly long distance and don't use it as a calm down method.
They made me sign a form saying I refused medical treatment......and still refused to move me even though I said the corridor would be fine and there were plenty of other open beds. I so did not need to be next to the man puking in the bed next door (who, incidentally, was also on a mental health hold, had tried to kill himself and was puking the pills and alcohol out of his system, strapped down with full restraints - they just turned his head so he could puke).

And because I'd signed the form, they wouldn't give me my arthritis pills.
(, Sat 13 Mar 2010, 11:57, closed)
Funnily enough , here
once the forms are signed, you don't *have* to continue treating the patient - and some of them walk out - but if they stay, we still do everything for them they need: it's the right thing to do. Most of the time I'll even find someone else they can see if they want to swap hospitals.
(, Sat 13 Mar 2010, 12:00, closed)
Well, on behalf of most I hope,
Thanks for the work you do. I hope I never need it, but if treatment is neccesary then may it be with you!
(, Sat 13 Mar 2010, 12:09, closed)
Keep up the good work ;) I think it's wonderful people such as yourself that make the NHS actually work.
(, Sat 13 Mar 2010, 13:41, closed)
Please Mrs legless,
Can you explain why doctors have to work such shitty long hours?
Could we not train more and treat you like real human beings?

Thank you for what you do. My orthopaedic surgeon is some kind of arcane magician. He fixed my wrist.
(, Sat 13 Mar 2010, 13:44, closed)

(, Sun 14 Mar 2010, 0:29, closed)
Funnily enough,
the government has asked the same question of the training colleges - and is making moves to address this . . . though not in a way anyone with sense would like. The whole fiasco deserves a post of its own . . .
(, Sun 14 Mar 2010, 1:40, closed)
That begs the question
of how much theatre technicians make.
(, Sat 13 Mar 2010, 14:29, closed)

You get a +1 as my mrs is a dr too and she earns about as much as me / hour doing a shitty IT while I finish my studies. The money and the crap you guys get is NOTHING compared to what you have to put up with.
(, Sun 14 Mar 2010, 10:22, closed)
+1 click just for being able to do that! I don't think I could. Damn and I thought my job was hard....
(, Tue 16 Mar 2010, 11:55, closed)

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