the change ....
Making
referral and receiving referral were 2 different things.
Making
referral was a sign of showing weakness and receiving referral were a
declaration that we are capable.
Well,
some of those at the tertiary center would be too authoritative and would treat
referral doctor as junior or incompetent one.
I
had met rude surgeon who had asked detailed questions that made the referral look
like a resident reporting to the tutor. I hated that and I sworn that not to present
such stupid/arrogant attitude toward my comrade while receiving any referral.
But
yet sometimes, you would get some referral which was…..
I
received a call sometimes back in which an elderly male was referred for chest
pain and elevated cardiac enzyme. Routinely, we would ask the relevant unit to upload
the EKG12L to our LINE chat. The EKG uploaded later had however shown prominent
STT elevation over the inferior leads and the patient should be diagnosed as
STEMI undisputedly. I quickly called them up and asked them to prep the patient
and PCI would be performed as soon as the patient arrived. Never bite on your
colleagues no matter how incompetent they were, however you do feel odd when receiving some referral….the southern tip of this island
is a very secluded area; manpower drain was the norm and even surgeon who is
not well train in medicine had to take the stand in ED.
We
were facing similar situation since few months ago.
The
management had decided to split the roster arrangement into 2 parts. The ED roster
would be done by the HOD and the ward roster would be done by the admin head.
The
previous roster was actually manipulated solely by K. He would try anything to
filled up every hole on both the roster. However, there were always rules to
follow. No continual shift of more than 12 hours, no overlap shift covering
both ED and ward. Our shift was a mess as we need compromised our shift to enable
K to covered most of the shift upstairs. No kidding, K was doing 15 shifts in
ED and 12-13 shifts upstairs. Severe violation of working restriction however we
are not considered as labor and nothing to shout about.
The
reshuffling of roster making was a great news to us. Our shift was prioritized
and our roster looked nicer. We were getting streak of off days and night shifts
instead of getting intermittent off shift which burnt off half of our vacation.
The
impact was striking as the ward roster had left many blank spot and boss and
some surgeons who did not do calls had to fill in. K was unable to continue his
fill out all the spot plan and sought to find other locum elsewhere.
The
management had however tried to barred him to do extra locum which frustrated
K. K had complaint to me on a few occasions. I had sensed that his intention to
leave and finally talk to the management. I told him that the south would gladly
take over capable big gun like K and we would lose him in very soon should the
barring measurement continue. The plead was heard and K was happily ever after.
The
first and second month was chaotic for the ward roster. Last minutes call and overlapping
had started to emerged as it was the only solution to the situation. By the
third month, the management had totally given up and over lapping and continual
shift (aka alternative unit nonstop shift for indefinite hours) started to
exist.
The
gate to Hxll had finally opened; now, more than 30 shifts are applicable to a single person as arrangement of back to back calls which continued stay for 72 hours in the hospital had started to exist.
Over relaying on a single person to make up the ward
roster would be a disaster when the person quit, as for me…none of my business…
The
roster was pretty sweet for most of us and I had lots of streak vacation to plan
for activity….
Source:
the change ....
