Medicine in different shoes

Medicine in different shoes

A doctor does not work alone. This is especially true at the Emergency Department where a good team is needed to ensure all aspects of patient care are met.

Apart from doctors, the backbone of the team primarily comprises assistant medical officers (AMOs), nurses and hospital attendants (HA). Behind every service that a doctor renders to each patient, a lot of work is done "behind the scenes" by these groups of people.

For example, before a doctor sees a patient for consultation at the Emergency Department, "triaging" - the process of systematically sorting patients according to severity of illness, in which initial evaluation of patients' syndromes include the assessment of vital signs such as blood pressure, heart rate, respiratory rate and temperature - is done by the triage officer who is either an AMO or a nurse.

Apart from triaging, AMOs and nurses also perform a wide range of jobs for patient care, from setting up intravenous lines to resuscitation of critically-ill patients, and subsequent care.

During resuscitation, a doctor may, among other things, order certain drugs to be prepared or given by a nurse and even direct AMOs or other staff to take turns doing chest compression or other procedures. And hospital attendants would be assisting doctors by sending specimens to the lab, cleaning and sterilising equipment, or pushing patients on wheelchairs or trolleys to the wards after admission has been decided by doctors.

I have been working as a doctor for almost 15 years, with eight of those years as a specialist in Emergency Medicine (Emergency Physician). In all those years, I have only observed and given remarks about their jobs but never performed their duties myself.

It struck me that I wanted to understand their work by experience, and so I asked my head of department at Hospital Kuala Lumpur, Professor Datuk Seri Dr Abu Hassan Asaari Abdullah, to allow me to perform their duties at my department.

After getting my roster as specialist arranged, and permission to "step into the others' shoes" for two days, I informed the relevant supervisors and borrowed their uniforms, which I would wear on my duties.

In the Hospital Attendant's shoes

I started off by making coffee for staff in the pantry. Having simple but tasteful coffee served in the pantry is among the little things in my department that keep our staff motivated. Or at least, it demonstrates that we care about our staff.

My coffee may not have been as good as Kak Noraini Hasan's, who can whip up government-supplied coffee into tasty "San Francisco Coffee-like" brews, but I stirred a jug that passed as "all right" among the morning staff. Perhaps the secret ingredient is the passion and sincerity in making one.

I then moved on to the resuscitation area and began by cleaning used resuscitation equipment. With Pakcik Rashid (who has been with us for almost 30 years), I cleaned used oxygen masks, tubings and nebulizer containers. We washed and scrubbed them with soap and sponges before rinsing each one thoroughly. As I worked, I saw the passion Pakcik Rashid has in ensuring that each used equipment was cleaned and restored to as good as new. The equipment were subsequently autoclaved, sterilised and repacked before storing in hygienic conditions for future use. It was sheer hard work as each had to be scrubbed rigorously under running water with a specified cleaning solution.

Watching Pakcik Rashid cleaning them as thoroughly as he has been doing over the past 30 years, I realised what a gem we had in our attendants. Before this, all I knew was just ordering the equipment when I needed them. I never had the slightest idea of who cleaned up after me or who packed things up for me.

We owe it to them in ensuring our equipment are clean so that new patients who need them do not get infected.

After completing the cleaning, I moved to the consultation room to assist the doctors. My medical officer could not help smiling as I, his specialist, took orders from him. But in that green uniform, I was an attendant taking his every order diligently, in full character as his willing and ready staff. I assisted him in calling patients in or sending investigation specimens to the lab. Intermittently, I would send patients who needed admission to the wards.

A few members of staff in the ward recognised me in my attendant's uniform and they could not help wondering what I was doing. When asked, I just smiled and continued with my work. I had to get my job done without any distraction.

Upon experiencing their work sending patients to the wards, I thought our hospital attendants were important "ambassadors" for our hospital. The way they handled and communicated with our patients on the way to the ward would shape patients' perception of us.

The attendants had the opportunity to create a good impression of hospital services if they could provide comfort to patients as they are wheeled to the wards.

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