Tuesday, November 03, 2009

known case of

my first encounter with seremban hospital hospital tuanku ja'afar was a little more than 3 years ago during the hilarity (on hindsight) that was nursing week. it was a bit of a shock for me at the time because the only other hospitals i've been in were either private hospitals or nuh or the-hospital-formerly-known-as-universiti-hospital and they are 5-star venues compared to seremban hospital hospital tuanku ja'afar.

as a first-year freshie, i was horrified by the colour-coding system and the manner in which labels were stuck onto patients for convenience sake. halfway into my final year as a student, those labels are second nature to me and i appreciate every little thing that makes life as a healthcare provider just that little easier.

during my paediatrics posting this semester, one of my professors insisted that none of us present our cases with the words "known case of" preceding a patient's list of concurrent illnesses. she made it clear that we should say "the patient was previously diagnosed with..." instead because slapping a label like "k/c/o" on a patient, as is the common practice in htj, clouds our ability to identify and treat our patient's problems.

it left a deep impression on me because it alerted me to the carelessness and apathy with which i sometimes treat the patients i see due to the little abbreviation i see right at the beginning of a clerking sheet. i judge them based on the diseases they have already been diagnosed with instead of viewing them as problems that may still have to be reconsidered, reinvestigated, and have their treatment reevaluated. when i clerk around their past medical/surgical history, i become lackadaisical when asking about their "k/c/o"s because well...they're known, hence they are dealt with already. yay?

of course, a good doctor wouldn't let three simple words get in the way of coming up with a comprehensive problem list and doling out an effective management plan and achieving the good outcomes he/she have set to achieve from the very start.

but not every doctor is a good doctor and if my professor - who is absolutely awesome at her job, imho - finds that little bit of wisdom important enough to pass on to us n00bs, it must surely have a significant impact on the way she has practiced medicine...and it should have an equally significant impact on ours.

the insane patient load in government hospitals makes it impossible for things to run smoothly without labeled cubicles and colour-coded files and what-not. however, it is the mental labeling going on in a doctor's mind that may prove detrimental towards the care of a patient.

a patient isn't a "known case of". he/she has a (usually) valid reason for hospitalisation and just had the misfortune of being "previously diagnosed with" some other illness(es). i hope i remember that my whole life.

lishun at 7:52 PM