Hospital Bitten By Complaints (not snakes)

11:23 PM

I suppose everyone must have read this on their page this past few days. It's another complain from the public regarding services at public hospitals. Apparently someone wasn't pleased with how a snake bite case was managed in Hospital Kepala Batas Pulau Pinang.

FOUR HOURS went by and ONLY given analgesics



This prompted a reply from Dr Abdul Rahman Abdul Kadir regarding the management of snake bites. (The admin of Penang Kini should be given a pat on the back for highlighting both sides of the story). This was no ordinary reply. Dr Abdul Rahman Abdul Kadir IS an emergency physician of Malacca Hospital. His points are based on FACTS. NOT emotions.








As a summary, what was done was according to procedure. The picture posted on Penang Kini
also clearly shows that there were markings on the hand which corresponds to the fact that proper observations were made. Even the bite mark looks clean.

Do the public expect medical staff to be at the bedside at ALL TIMES?

In a remarkable twist of event, another comment was made online. It appears to be nitpicking on the whole issue.


Now, another issue arises;

Why was the patient NOT sent directly to the nearest hospital with an EMERGENCY PHYSICIAN?

Another reply was given out by Dr Abdul Rahman.










Lo and behold, it turned out the waiting time was only 2 1/2 hours. 90 minutes short of the FOUR hour duration. Dr Abdul Rahman made a good point of our policy to stabilize patients at the nearest medically equipped facilities before any decision is made to transfer a patient to a tertiary center.

I am sure the way Dr Abdul Rahman is encountering this issue head on won't go down so well with the public and the Ministry of Health. But I am glad there are doctors who are willing to face issues like this head on instead of just keeping quiet. Remember Dr Fatima from KJMC? She somehow managed to get a patient who shamed her online to issue a public apology.

To MOs in the Emergency Department of Hospital Malacca, you have a great boss here. Learn as much from him.

My personal take on this, is it might have been an issue of miscommunication. Sometimes, doctors didn't get enough time to explain the whole process. Please note that the emergency department is usually hectic with emergency cases. Sometimes, medical staff do miss out on informing anxious relatives on the whole plan of management.

Advice to doctors:
1. Try and take some time to explain on what are the procedures that was done and the next plan of management.
2. If a time frame can be given, tell the relatives and the patient.
3. However, NEVER EVER give false hopes or give high expectations.
4. NEVER promise anything. Just give the best effort.
5. DOCUMENT everything. When the patient arrived. When initial treatment was given. Which relative you spoke to. If they don't want any active management, get them to sign on the notes. We are heading to an age of DEFENSIVE MEDICINE.

Advice to relatives:
1. If you come in large numbers, try and get just ONE representative that can understand explanations easily to talk to the doctors. Doctors can't spend time explaining the same thing to Pak Long, Tok Ngah and the next door neighbor.
2. We can't let relatives come into the treatment room because there are OTHER PATIENTS. Doctor's are expected to protect their privacy as well. Other patients have rights too.
3. If you don't understand something, ask the doctor in charge. Ask straight away, don't go back to your other relatives and just say "Doktor tu nak buat apa benda entah. Takut dengaq baq hang!"

You help us, we help you. Sounds like a win-win situation right?


MOfrust


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10 comments

  1. Just want to add in. The only person that was there the whole time is the female patient and her daughter. Son and father wasn't there. The communication was made to those who were present at first and on repeat assessment. Nothing will change in Malaysian healthcare scene. Situation in districts and smaller areas is even worse. We should start a survey on violence against doctor and draft up a law to protect us. Most of the time we don't care because we don't have the time to care. This puts its limit. We are not stupid timid to be oppressed all the time as and when they like.

    ReplyDelete
  2. Just want to add in. The only person that was there the whole time is the female patient and her daughter. Son and father wasn't there. The communication was made to those who were present at first and on repeat assessment. Nothing will change in Malaysian healthcare scene. Situation in districts and smaller areas is even worse. We should start a survey on violence against doctor and draft up a law to protect us. Most of the time we don't care because we don't have the time to care. This puts its limit. We are not stupid timid to be oppressed all the time as and when they like.

    ReplyDelete
  3. Some Malaysians are just screwed up. Let me retell a story of a case of higher severity. An 18 years old man was involved in an accident in Pahang few years back slightly past midnight(We all know how fast midnight drivers always go). The patient was losing a lot of blood from his right arm with brachial artery involvement. He was sent straight to nearest KK for fluid resuscitation as the nearest hospital was more than an hour away. Despite that and plus time for ambulance response from that KK, the patient was able to reach the nearest hospital in 2.5 hours from time of MVA.

    Reaching ED, the patient was resuscitated immediately as they have already received the phone call from the ambulance, as his BP was unrecordable and SBP hovering between 60-70 despite aggressive fluid and blood resuscitation. Assessment and imaging was done as well and GXM 4 pint while referral was made to UKMMC vascular team for brachial artery involvement, which is 2 hours away as HKL and Kuantan could not accomodate the patient as their hands were full. Patient was in this hospital for 90 minutes, and ambulance sent him to reach UKMMC at 6 hours post MVA(upper limb critical period is 6 hours). Despite that, his BP crashed again in ED there and fluid resuscitation was continued and finally went into OT at 8 hours post MVA and his arm had to be amputated.

    Well, it is a tragic story for MVA, but what was more tragic was the father blamed this hospital in Pahang who responded and referred promptly, with the news headline "Terbiar 6 jam di kecemasan hospital" and "Para doktor dan jururawat tidak berbuat apa-apa."

    Zzzzz...

    ReplyDelete
    Replies
    1. Please forgive the fathers stupidity..imagine 2000 years ago if someone were to tell you metal can fly in the sky and murderers can be the leader of a country, what would your reaction be?

      Delete
  4. I agreed with the aboved comments..as a doctor in a govt hospital..i found lately that we are easily abused by the public. It really freak us out in managing these patients. They think that they know things but they dont. I have a similar scenario in our hospital where relatives are kept yelling of our medical staffs for minor reasons. It really disturbed us so much. Hoping that we have the law that protects doctors' and nurses' right..

    ReplyDelete
  5. I agreed with the aboved comments..as a doctor in a govt hospital..i found lately that we are easily abused by the public. It really freak us out in managing these patients. They think that they know things but they dont. I have a similar scenario in our hospital where relatives are kept yelling of our medical staffs for minor reasons. It really disturbed us so much. Hoping that we have the law that protects doctors' and nurses' right..

    ReplyDelete
  6. I'm confused. Legally regarding management of patient we can only speak to the patient or in case patient deemed unable to make decisions, discussion include person in charge of patient.

    Basically, speaking to saudara mara, bau bacang, jiran, majikan are really as a matter of extending courtesy and can (and should, for sake of privacy & confidentiality) be waived aside.

    Ps: Now visitors in ward also sudah berani bukak medical files patient, even though dah tertera kt cover files 'private & confidential'. Where's the civil manners?

    ReplyDelete
  7. I'm confused. Legally regarding management of patient we can only speak to the patient or in case patient deemed unable to make decisions, discussion include person in charge of patient.

    Basically, speaking to saudara mara, bau bacang, jiran, majikan are really as a matter of extending courtesy and can (and should, for sake of privacy & confidentiality) be waived aside.

    Ps: Now visitors in ward also sudah berani bukak medical files patient, even though dah tertera kt cover files 'private & confidential'. Where's the civil manners?

    ReplyDelete
  8. why not go to the bomoh or ustaz for treatment??manala nak tau ular tu ade saka ke or hantu ke..lg satu..ubat2 MLM kan byk kat rumah..telan jela dgn air water filter "permata hati hijrah itu pengorbanan"..doktor2 hospital kerajaan ni memang tak guna..setakat 5 tahun je kot blajar kt universiti tu..ape la sgt..bomoh kt hutan tu lg pandai..bayar mahal2 RM1 layanan ntah pape..rugi je bayar RM1..membazir

    ReplyDelete
  9. I got so many compliments the first time I wore this top! It is so bright and cheerful. I got the XXL because I am about a size 18, and this scrub top fits really well. Love the pockets, seams.

    ReplyDelete

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