Mar 24, 2009

response and responsibility

http://www.sg.af.mil/shared/media/photodb/photos/070705-F-2185F-082.jpg

real teamwork is simply too overrated


I wrote this blog entry in an extremely solemn mood, in total disappointment with how another mother and baby were mistreated in the first world operation theater surrounded by 3rd world mentality medical personnels.

1030pm. I was called upon that the mother planned for emergency C-Section had the sudden urge to push. I rushed to that mother and I saw the mother pushing madly with the baby’s head crowning on the perineum. The maternity staff nurse and me attended to the delivery. The baby popped up, covered with thick meconium stained liquor. As we called for help to call the Paed MO. No one answered. Everyone left us alone, as if, this is purely our O&G work, not theirs. Someone just passed me a few sterile scissors and left.

In summary, simple plain - calculative.

In reality,

“who care a damn if the baby die of meconium aspiration syndrome or the mother die of bleeding due to PPH, the O&G team should handle it, or they will be held responsible to it. She’s our patient only if she’s going for C-Section”
That, of course, was not said out loud. But that pretty much sums up their body language. Basically goes missing faster than the Great Houdini. I was thinking probably or perhaps the Great Houdini is their disciple.

I brought the baby to the warmer. She was moving vigorously, and crying well. Cord stained with meconium (oh god!). Unable to do much of direct suction, just proceed with oral nasal suction (moderate meconium stained – oh god!), warm and stimulate and rush to NICU for better observation and Pediatrics MO evaluation.

As the maternity staff nurse busy contacting Labor Room for the transport box for baby to NICU, I evaluated the mother and asked for help to take vital signs, give Pitocin and hand me a suture to stitch the oozing perineal tear. No one is around. Even if there is someone there, she pretended that she did not hear what I said, expecting her colleagues to come to help me. I can’t even assess the perineum properly. It was truly bad lighting at the observation bay and no one willing to bring in any extra lights. I took of my sterile gloves and timed the mother pulse – not tachycardic (thank god!)

It was hopeless to do anything for the mother in the OT. I called the Labor room for a trolley, applied a pad for temporary direct pressure on the perineum. The perineal tear was sutured well in the Labor Room, under good lighting.

I met the Sister (Head of Staff Nurses in a specific ward or department) on call incidentally and I told her about the appalling incident.

“It’s always happening. What can we do?”

Her reply truly irked me.

To them:

The patient is someone else.

The patient is someone else’s wife.

The baby is someone else’s baby.

I do my job. You do yours.

The patient is just another case. A job. A burden.

Dr. J (fr Unit Kualiti) once said,

“Life is always like that. Only when they lie in their death bed, only then, they realize people would have done more for them, if only they had done more for others when they can.”

I would not want my younger generation (yep, I’m old liao) to inherit such an horrendous tradition, but scolding them or explaining to them is like talking to pigs.

You know what they say about pigs.

Don’t fight with them.

They just wants you to get to their level – all dirty and smelly, without response or responsibility.

5 comments:

chenghiang said...

Yo... If you call me, very happy to be there. And the baby is my business. but can't help you with the mother.

Btw, mec liquor. If the baby come out screaming, and good respiratory effort, there is no need to visualize the cord and do any suction. Research show that suction in this cases make no difference in Mec Aspiration Syndrome

fibrate said...

2 words : INCIDENT REPORTING!

pilocarpine said...

CH: ya, i heard that once the baby started screaming, the meconium is 'in' - i was concerned with the baby desaturating...

f: btw, Dr. J is in charge of receiving the incident reporting. everything became just stats. attitude is not something incident reporting can change.

at least for now, I am glad both baby and mother doing well, unlike a maternal mortality in OT post vaginal delivery that happened some time ago - same thing apathetic support similar to this incident.

it is not only reported, it is discussed, investigated, and one of the conclusion is O&G side 'called for help late'.

like current incident, i called for help, no one listen, no one answered but God (or Gods, in buddhists' belief).

Product of the System said...

Friend,

No point incident reporting. Been there, done that, and only got my own ass kicked instead.

Whistle blower becomes the scapegoat.

That's how it is in our country. From politics to healthcare to education.

You can only whine and blog about it for your own mental and emotional health.

But do be careful cos the nation is teeming with people waiting to backstab you at the first opportunity.

The famous saying of 'all for one and one for all' doesn't gel in Malaysia, or in real life on the whole.

God bless.

Btw: This is a better blog than the one you had before this.

pilocarpine said...

POTS: everyone gotta be careful in this PM transition period.

thx, i also believe my old blog kinda lame and gay.