Monday, January 11, 2010

the math

the math is pretty simple.

each operating theater has, at minimum, an anaesthesiologist, a surgeon, his/her assistant, and a scrub nurse. however, in my hospital, there will usually be another medical officer, a house officer, a student nurse, a medical assistant/student medical assistant, plus minus 2 or 3 medical students. that comes up at least 10 people at any one time in an operating room.

at least. i personally have never been in a surgery where there were only 10 people present. the average number comes up to about 15.

if ideal conditions govern that less than 10 people should be there, who should leave? hierarchy states that the dispensable ones should go first, which means bye bye medical students.

is it any wonder then that when there was found to be a rising number of surgical site infections (which must have been confirmed through an audit or something...surely those figures aren't baseless), the fingers would immediately be pointed at us? is it any wonder then that the OT sisters, who rule the sterile floors, are displeased at our presence and want us to either take turns or just bugger off altogether?

so we slink off away from the OT, tails between our legs, and when our lecturers question our lack of initiative in finding out what goes on in surgeries, we timidly answer that the women in pink caps have informed us that we have contributed to our patients' suffering. who can argue with that?

but no. our lecturers want us to be there anyway. they scold us for being lazy/timid. some of them chatise the sisters for making us leave, therefore further straining the already strained relationship the university has with the hospital.

and there we are, medical students, soon-to-be doctors, caught in the middle of the crossfire - not learning anything and getting scolded for it, wanting to learn something and getting scolded for it too.

i feel terribly childish for ranting about this. after all, we're 20-somethings who should be mature enough to come to a compromise...and we have! we go to the OT as early as we can and inform our friends to come for the next surgery so we wouldn't anger the sisters but will still be able to observe some procedures. we take turns. we patiently endure whatever scoldings we receive. we act as mood rings, sensitive to the temperament of the women in pink caps and our lecturers too, sounding the alarm when necessary.

we do whatever we can to ease the situation. to make the math work out. to ease the tension between hospital and university staff. not more than 2 of us in any one room, but always someone there.

but it still isn't enough.

i felt terrible today. the first thing to greet my friend and i this morning as we entered the recovery room was the cloudy face of a pink-capped sister who spent some time reminding us of our contribution to wound contamination. she had perfectly valid points and we tried frantically to come up with a compromise so that we'd still be able to see anaesthesia being administered to patients. we told our friends that there were 3 of us here already and that the sisters aren't too happy this morning, so maybe we should take turns and they should come a little later in the morning.

who knew that our lecturer came and swept through the rooms, looking for us, and expressed her displeasure that only half of us were present this morning?

so everyone else came and as a few of us joined in to see how an emergency surgery is dealt with, we got a second dose of the surgical site infection talk, this time coupled with a hurt look that accompanied a short comment on how we complain to our lecturers about not being allowed into the OT.

my friends and i decided that enough was enough and we left once the patient's legs went numb and the surgeon made the first incision. we've done what we could. we've attended one-and-a-half surgeries from induction to recovery. we've seen our daily quota. no one should say we weren't considerate towards the patients, the sisters' feelings, that we didn't respect the workings of an operating theatre or that we didn't take our posting seriously.

no one should...but i'd bet on my life that someone will.

lishun at 11:15 AM