TUESDAY, APRIL 03, 2007
Some things can start to be frustrating, I'm not patient enough to work here a lot of the time. You see nothing happens fast around here, no one runs, in fact no one walks quickly, its purely unconcerned sauntering. Often people don't answer questions, they will respond with a monotonic nnnnnnn. Not a
problem in most settings, but when I am assuming that that means yes when asking about sympyomology.... I was under the impression that means yes, Dr. D today gave the nurse a hard time for answering that way as he too needs confirmation of yes or no.
The nurse today wouldn't translate for me on rounds. I would ask how the patient was, she would say they are changing her dressing. I would eventually get exasperated and curtly ask, but how is the patient!, then I might get a vague answer. Forget doing a proper post-op bleeding, blues, baby, breastfeeding, bowels, bladder, pain history on every patient. Another frustration is purely mine, I'm not
sure how they go about changing dressings, when sutures come out etc. We do things rather differently, discharge sooner and have nurses follow up at home. They don't have home care, and they have a
horribly high incidence of wound dehissence (superficial usually) and infection. I think I've only seen one infected c-section wound before, today I saw about 10. So evn though I don't know their protocols I fear they might not be doing it right at some point, but I don't know enough of the litterature to really correct them. I don't even know if its a problem with technique in OR, with the sutures they use, or with the post-op wound care.
Then nothing is stocked enough. There's always a wait to get a pair of gloves, or a BP cuff as they search the ward for the one. There's never enough of the drugs we need on the anaesthetic cart for the day, sometimes cases are held up because we have to get drugs out of the storage locker, and they won't just bring 20 and then restock, they only bring a few. I don't know where things are so I rely on a nurse,
or student, to get things for me, which slows things up even more, and really cramps my independance on simple things like starting an IV. I still can't get a swab to clean the area on my own, and its expected
that I don't. That's the nurses job here and the Drs just don't do it, but I just want to do it to get the bloody job done. Especially in an urgent situation (there are no emergencies here) I get frustrated when slowed.
The OR today was a gong show for all that, and my usually ordered, smooth running anaesthetic routine was constantly interupted by supply shortages, and we need to start an IV but the nurses are all busy helping drape the patient etc etc. Frustrating...