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The Epistle Of A Young Nigerian Doctor. by drgeorge1(m): 11:46pm On Aug 23, 2014 |
I met Ikenna Obieze last year when I just started my horsemanship. A tall, brilliant chap with a tired smile. He always wore that smile, he told me, to ward off the spirit of aggression that seemed to threaten his relationship with people especially, his patients."Excessive work in a suffocating working environment have a way of making people angry so, I have to smile away the anger,"he smiled. I had just started my obstetrics and gynecology posting when he was about to Start his neurosurgery posting. And that same day, in the common room, he received a text from his girlfriend saying goodbye to him, breaking up with him. He showed me that text with hot tears running down his cheeks. But, he did not cry for long; he was just starting the second of three ninety days, 24hours calls. And soon as he showed me the text, his phone started ringing; some new accident victims had just been brought into the hospital. There was no room for petty emotions or his work would be compromised. He would have to toss his life away, immediately, in order to save the sick. Yet, he too, was sick, only that he could not notice. But I saw it in his eyes. That was the day I swore never to become a surgeon. Or even to do residency in any clinical field at all. That singular encounter with Dr Ikenna completely discouraged me. I couldn't just imagine myself, after the hell of medical school, writing primaries - a hectic West African exam that qualifies one for the residency program, that then leads into years of more hell, like Ikenna was experiencing. The program is designed to train would-be specialist in the different areas of specialization in medical and surgical practices. It takes on the average of six years to complete the program. But, in reality, it takes a lot longer because, it is designed in such a way that ninety percent fails the exams, each time it is conducted."It's relatively, deliberate"an examiner once told me."It is to ensure that any would be consultant is properly trained, taken through the furnace, so that he would be able to handle a patient's life and the teaching hospital. It is a holistic training,"he concluded. That same day, I made up my mind to go for master in pharmacology instead of residency. And when I discussed it with my consultant, he gave me a stern warning."You'll never become a consultant,"he warned."You'll never be a CMD, and you will watch your mates leap frog you in the practice."I just sat there, nodding as he babbled. In the end I just said"no problem". My, mind was made up. I wasn't going to be a slave in the hospital, a prisoner for up to a decade like Ikenna had chosen. And I was right. Ikenna's life became more distorted as time went by. Not because his fiancé had left him because, as she lamented, he wasn't giving her enough attention. Not because he was often seen dosing off at almost every corner of the hospital because he never had time to sleep at night. Not because some people started doubting his sanity; lack of sleep actually affects our mental health and Ikenna had not slept adequately for two years now owing to excessive, overwhelming work load. It was rather because of what happened in the middle of his neurosurgery posting. It was on a cold December monday. We were watching a premier League match between Chelsea and liverpool when his phone rang for the millionth time. It was a patient calling. A patient that had been previously in coma and had just recovered. Ikenna, as usual, ran off for the millionth time. "It's that patient I told you about, let me go and empty his urine bag. The nurses won't go close to him, you know. He is violent and HIV Positive; they are afraid of getting smeared by his ever bleeding hand", he said to me in one breath, as he ran off. "But, you can't be doing your work and do the nurses work, too,"I countered. "Is that what you are considering; of what use is it to wait for the nurses? In this practice you, the doctor, is responsible for the patient's life and if you keep waiting for the non committed support staff, you'll lose a lot of patients."He replied in one breath, as usual, and ran off. The match was nearing the end, when he came back, so sad and sullen. He had a slight dressing on his forehead. I noticed it as he quietly came and sat beside me, dropping his head to cry. "That bastered just gave me a needle prick", he lamented. I was shocked. That was the first time I knew what risk faces me daily, in medical practice. "How did it happen,"I asked, a bit angry that he didn't take precautions. He shook his head at me."Of course I took precautions, Emeka, but as I bent to fix his catheter, he pulled out his Butterfly cannula and stuck it on my forehead." "You should go for Post exposure prophylaxis, you know,"I proffered. "I got it covered already"he feebly replied. But, he was shaken and really scared. "Who knows.... Just pray for me so I wouldn't just become infected doing this job."He resumed watching the match. "We have to pray for one another,"I said. I would later have my own encounter with that kind of hazard three times but, luckily for me, the patients were not infected. Each has happened owing to tiredness during my own surgery posting. After staying awake for three weeks at a stretch, it was inevitable that I would injure myself in the process of caring for my patients. Lack of sleep makes people less careful and shaky. It stems from over work which stems from the fact that very few doctors are left in the country because, majority have run away from the stifling working conditions in the country. And work has got heavier and heavier, as time went by. And again, more patients are coming in as economic hardship hit the populace harder and harder. And just like Ikenna, over sixteen thousand resident doctors sweat and bleed daily, spending every second of every day in the hospital, working to save patients'lives. Often times you could see it in their faces, the excessive suffering they go through. Tattered and hungry, these brave doctors keep the hospitals ticking and without them, there would be no teaching hospitals. They are bleeding to become capable consultants in the future, to create a better healthy future for the nation. The Hazzard allowance is five thousand naira. Greatly unfair. Even for hazards like the ones both Ikenna and I suffered. Even ones bigger than ours. But, that's not the major difficulty these days. Sadly, they too, are not immune to the difficulty facing every serious minded intellectual in the country. The same leadership problems pushing intellectuals, daily, out of this country to greener pastures, real greener pastures. Problems like poor renumeration, not in any way commiserate with the amount of effort invested in working for the government. 1 Like |
Re: The Epistle Of A Young Nigerian Doctor. by Lagusta(m): 12:25am On Aug 24, 2014 |
I read this post from the beginning to the end... And i have the following to say: 1) what you said concerning the residency training is nothing but the bloody truth... Neurosurgery is still better, come to pediatric surgery, where you'll see residents coming out of one theatre, going into another, like zombies, all for 90 days stretch: no rest, no sleep!!! And after how many years, failing and failing those bloody exams, you turn into a scrawny consultant!!! 2) i have also made up my mind NEVER to specialize in any clinical field!! Not because the work-load is much, but it isnt worth it al all... There is no single appreciation, either from the government, or even from the patient's relatives.... 3) our salaries are nothing compared to what our counterparts earn overseas... A GP can be paid p to $75000 per annum, hehehe, do the math... Well, na God go save us shaa... Nice post!!! 2 Likes |
Re: The Epistle Of A Young Nigerian Doctor. by Nobody: 12:35am On Aug 24, 2014 |
Welcome into the world of medical pratice in nigeria, you take a seat by the left. |
Re: The Epistle Of A Young Nigerian Doctor. by Nobody: 12:44am On Aug 24, 2014 |
Did they force u to go into dt profesion? Think of what life wil be like if all of us are to study medicine. As a biotechnologist, I was colecting 5k naira as stipend frm d state govt while medical docs were being paid 100k naira during my NYSC days. I dreamed of studying medicine bt i couldn't fulfil it cos i had to find a way to survive -- taking part-time jobs while studying a full-time course. Will u or ur govt nw tell me dt i'm inferior to u in term of academic capability? U seem to easily forget such things like tragic ironies -- especially those dt are divinely orchestrated. |
Re: The Epistle Of A Young Nigerian Doctor. by theplanmaker: 12:55am On Aug 24, 2014 |
A masterpiece of pure fiction, composed deceive those who do not have first hand knowledge of the hospital setting! let me tackle you head on. 1) you work and school at the same time, you are sponsored by the government, and remunerated accordingly ( how much is your call duty allowances compared to that of other health workers?) when you become consultants, you earn well. do you expect all to come on a platter of gold?. 2) No nurse will refuse to empty the urine bag of a patient because of fear. (this was a lame attempt to disregard nurses) if it actually happened, then it becomes a disciplinary issue, you should have taken it up with the hospital management, and the nurse will be dealth with accordingly. nurses are accustomed to doing the "dirty job" in the hospital....it is actually unbelievable that a doctor Droped his pride and ego to touch a urine bag! any nurse in the house would understand what I'm saying. 3) on the issue of hazard, we are all exposed! but the most exposed of all are the nurses! at least you have time to sit in your ARD lounge to watch soccer. the nurse is inside the ward, by the patients bed side all through her shift. she inhales, touches, and contacts everything the patient brings out! take a look at the ebola mortality statistics, who is worst hit? it had been 3 nurses and 1 doctor. I remember 2years ago, after attending to a badly wounded victim, and having his blood all over my body, his test results came out, he was HIV positive! I emptied a full bottle of jik on myself that day, and did HIV tests monthly for a whole year! ask any nurse you know, they have a story to tell. 5k is small for all the hazard, if it should be increased, it should be done across board. 4) saying that the resident doctor is usually the first to make contact with a patient is a direct misinformation! what about the medical record officer that issues cards? or the OPD nurses that registers the client and take vital signs? when a patient is rushed to the a&e unit, who gets to the patient first? when a patient is admitted to the ward, who receives him? THE NURSE! 5) Registras do everybody's work? doctors are overwhelmed? well it is partly so because you made it so. when you prevent a midwife from examining a pregnant woman, delivering a baby, the gyneacologist is bound to overwork himself! when you refuse to allow a registered nurse do physical examination, or pass iv line, she ll wake you at 2 a.m to do it. when you refuse to allow the lab scientist to do his work, you are bound to outdo yourselves. when you reduced a pharmacist to a dispenser, you thought you were doing yourself a favour! 6) appointing other healthworkers as consultants in their own fields does not affect the chain of command in any way! A consultant pharmacist is restricted to "pharmacy" that's his specialty, he ll work within his scope of knowledge and experience. he has no right to alter a doctors prescription. if he does, then it is a disciplinary issue period! He should offer suggestion to the medical consultant, who makes the final decision. please get that right. 7) if you think a nurse is going to arrange instruments for you to do your wound dressing, then please go back to your private hospitals and order your auxiliaries around. if you were taught asepsis, then you should know how you ought to get your instruments. refering to core members of the health team as "suport staff" and paramedics, is the height of your pride and ignorance. please Google the term "para medics" and "hospital suport staff " 9) other members of the health team are not jealous, they are just fed up with the oppression and prejudice in the system. 10) please identify any of the 24 demands of NMA that has anything to do with improving healthcare delivery in nigeria 3 Likes |
Re: The Epistle Of A Young Nigerian Doctor. by mamarika: 12:58am On Aug 24, 2014 |
Rubbish!!! |
Re: The Epistle Of A Young Nigerian Doctor. by Lagusta(m): 10:55am On Aug 24, 2014 |
@theplanmaker... Please stop spreading lies!!! Residents are not sponsored by the government... Its the house officers that come in contact with patients first, not nurses imagine a surgeon exposed to all sorts of hazards, and you're telling me nurses are exposed to hazards... If doctors watch soccer in the common rooms, then nurses also watch african magic in the wards!!! How many times will i say this: being a consultantin any medical field is not an appointment... You have to write exams, and even fail them in nigeria!!! Come on, its even all over the world!!! If you hate doctors, please travel out and establish your nursing home... He even said pharmacists are hospital dispensers... Your mates are working in evans, gsk, NGC... You are here blabbing!!! Abbbegggiii!!! 2 Likes |
Re: The Epistle Of A Young Nigerian Doctor. by Azijo: 11:29am On Aug 24, 2014 |
This epistle is making me have a re-think... God help us! |
Re: The Epistle Of A Young Nigerian Doctor. by allycat: 12:46pm On Aug 24, 2014 |
theplanmaker: A masterpiece of pure fiction, composed deceive I embolden the statement because it just confirmed what the op wrote. When a nurse thinks it is beneath him or her to arrange an instrument tray it speaks volumes. I had an expirience when we had a visiting consultant from the UK, I was assisting him gown and glove and our nurses took offense that it was their job and I was making them look bad. That was amusing to me because for the last 7 years I worked with them they never knew it was their job but now because it was a white surgeon they suddenly remembered. Presently I don't care if nurses come with me for a ward round or not, what 10 years ago nurses did for me, my residents now do including removing stitches and wound dressings because the nurses nowadays are too big for such jobs. I send my residents to give IV drugs because nurses are too big to do that even when there is a line already. The residents and house officers now do the jobs of records staff( holding on to case notes so they don't dissapear), laboratory scientists (doing investigations in side labs because results from the lab may take days to come out even when you say it is an emergency) porter (personally wheeling patients to theatre, taking blood samples to labs and collectting results even collecting blood for transfusion from the labs themselves) nurses, setting instrument trays, wound dressings, taking vital signs, monitoring urine input and output. Fortunately for me I have passed that stage and I tell my residents to do anything it takes to get the patient better, it also pays them because when they open their own clinics in future they have a better understanding of how each person on their team does his job. 2 Likes |
Re: The Epistle Of A Young Nigerian Doctor. by Nobody: 3:15pm On Aug 24, 2014 |
Please someone should government to recall residents oooooo. I can't imagine myself surviving with the paltry sum idola hospital pay me ooooo. |
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