₦airaland Forum

drsteroid: kk...dats a benign tumor,it is really not a problem but it lacks cosmetic appeal, since it presses on your eyeball,it can lead to astigmatism in that eye.a minor surgery can be done to remove that.Thank you

sorry doc it sounds more like a chalazion than a benign eye tumour.

AbdH: I don't know why, nurses do not seem to have one voice in their demands for their rights. Could it be because they are mostly women?
PS: I'm not being sexist.

Read through the post again, all the officials of the two bodies are me,Nishi, Yusuf, Adeniyi and Egweonu. For several years now the president of the Nurses association have been men even when a nurse was made minister for state it was a man. It is actually since the advent of men into nusring that the nuses became more militant in Nigeria.

You need to be examined, nobody can make a diagnosis from the information in your post without examining you.

Yes

YourHealthlabs: Ultrasound Scan is about N3,000-N5000 depending on the human area of Study and equipment used. When you recommend it to patients in your private capacity. Some indigent ones will go elsewhere and ask for cheaper non-specific tests.
You forgot to give credit to Sonographer/Imaging Scientist that confirmed the Hernia.

Which so no graphed confirmed the diagnosis A general surgeon confirmed it. The diagnosis of a straight forward hernia is made entirely clinically, that makes it a very popular case for medical students examination and an ultrasound is only necessary when complications a suspected not to make a diagnosis.

jpphilips: I wont rule out wickedness completely, A black man is a black mind, Dr iyke's wife is a doctor too, now she already knew what killed her husband but gladly went to UPTH to deposit his corpse and failed to inform the mortician what killed her hubby.
I got info she is denying knowledge but ask me, between I and doctors, who should know the symptoms of Ebola?
If the doctors claim they don't know, then God help us in pH.

The wife had nothing to do with the corpse in UPTH mortuary, the body was evacuated from the hospital he died by men from the ministry of healt h(in full PPE) and for some reason instead of disposing of it put it in a mortuary. It was even the wife that alerted authorities that her husband may have ebola.

What many laboratory Scientist refuse to admit is they are not taught how to make clinical diagnosis, it is based on clinical diagnosis that the type of investigations is determine and there are diseases they dont dont even know about because there is no laboratory investigations directly related to those conditions.
My new house help complained to me of a stomach ache which she has had for several years. On further questioning she admitted having never gone to see a doctor but instead she had done several tests in different labs and was prescribed drugs in the pharmacies near her house based on the test results on several occasions. The pain would stop for a few days or weeks and then return. When I examined the abdomen, staring at me was an umbilical hernia and from her history it has obviously been incarcerated and released itself on and off. No lab tests would have diagnosed that so if she had continued on that path she would have stayed till it strangulated before she would have shown up in a hospital as an emergency. I see patients like this everyday and when they finally come to see the doctor they want miracles and quickly too.

Earlier on this year a young lady showed up in my department with a letter stating that she was to do a residency in pharmacy. No sweat, the question I asked was what does your programme entail, who is to supervise you and what postings are you here for. She had a blank look on her face. The reason being that for doctors residency is a well defined programme. First a department and hospital that want to run a residency programme must seek accreditation from the PL college in that field and must undergo assessment where every thing from the number of Fellows and consultants available to teach to the number of instruments available, to the laboratory facilities to the state of your library.This is repeated every 2 to 5 years depending on how the department/hospital performs.
Then the resident usually must pass an entry level exam called the primaries to actually be deemed to started residency.During the programme there are procedures you must watch, assist and then do yourself with increasing levels of expertise. You must present countless clinical presentations, take part in all sorts of academic activities all the while doing the same duties a medical officer not in residency does. You are also required to go and spend time in other departments outside your primary area of specialisation for periods ranging from 2 months to a year or 2. If these are not available in your centre or not accredited in your centre you have to find a centre to complete your postings. You then do your part 1 which typically has a pass rate of 30% in Nigeria. Then two to four years of intense training in your department till you get to a stage that you are deemed to be fit to be left alone in the management of patients without any supervision and that is when you take part 2 and become a Fellow.
Why this long grammar because obviously this young lady was planning to come and sit in the department running clinics and joining us for ward rounds and maybe theatre sessions. Since she is not a doctor and the department has no pharmacy there would be nothing for her to do and nobody to train her.Or would she like a doctor resident clerk and examine patients, admit them do investigations, prepare them for surgery, assist the surgeon , do post op monitoring, set lines and do rectal examinations when necessary. Or were Consultant surgeons now expected to train her to become a surgeon. She couldn't answer the questions that day and never came back this happened more than 6 months ago. I am still waiting for her to come and explain her programme to me.
It's obvious so many others in allied health fields believe residency is about coming to work and getting paid and that's all. They have absolutely no idea what the programme entails foe doctors they just want what they consider the Perks!

theplanmaker: 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

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.

Do serious research and look for gynaecologist with experience in myomectomies for large multiple fibroids. Co-opt all your medical friends and relations to search for the best for you. Fibroids is a disease most common amongst black women and many gynaecologist in Europe and America do not see many of such cases with large fibroids except for places like South Africa where they have a large black population like ours. Before you go into theatre anywhere you sign a consent form, this permits the surgeon to increase the scope of the surgery. So a surgeon that does not do too many of these cases can tell you yes he will do a myomectomy but if he goes in and the situation is more than he can handle will do a hysterectomy instead. This is more likely with a doctor that has not done many and the doctors abroad are not used to seeing such large fibroids as doctors back home are and tend to resort to hysterectomy more readily.
You can also request your surgeon invites a second surgeon in for the case just be ready to pay.
My colleagues sister ended up with a hysterectomy in America for what would be regarded as medium sized fibroids back home, meanwhile my PA had a myomectomy in Abia state and the fibroids were so large that they had to use a bucket to carry them.
Good luck and my prayers are with you!

bibikalamie@yahoo.com

When there were residents, patients in my clinic were already getting 6 months appointment and that is because 4 doctors including house officers, residents and consultants were seeing about 140 to 200 patients in a clinic day. It used to be double that number but we cut down when we realised all we were doing was just surface consultation and quick examination nothing thorough. Even with the present number we are hardly able to fully examine every patient (it would take about 30 minutes to do a decent history taking and examination). The house officers can't do much being a specialist clinic and the consultant can only see a few patients because he or she has to review cases with the residents and teach medical students while the clinic is going on. So now what will happen is the number of patients we see a day will reduce even further, appointments will now be longer year to 18 months. Surgeries will be reduced because only the consultants can operate , senior residents especially used to do most of the minor to intermediate cases and some major cases under supervisiona, while the consultants do the major cases and supervise the residents that way one consultants surgery list could have up to 10 cases in a day because he had assistance. More patients will definitely be referred either to private clinics or abroad. Imagine a hospital that has 5 consultant anaesthetist and that is a large number for a teaching hospital oh. Everyday they have about 10 surgeons from different specialties operating, prior to the sack of the residents the residents would gas the straight forward cases while one consultant anaesthetist supervises like 5 or 6 of them and then personally handle complicated cases. So definitely the rate of surgery will fall and really major cases like those which take 8 to 12 hours will no more be done.At least me I won't dare, it's only a mad man that will start what he cannot handle.
Imagine the neurosurgeon or cardiac surgeons who are usually one or 2 in a hospital running clinic and they now have an emergency. Ghenghen clinic will be cancelled and if the same thing happens 2 or 3 times in a month the backlog will be unimaginable.
Let me be watching this cinema it's going to be bloody.
Or maybe we should just close down the teaching hospitals and send our medical students to Ukraine and India after all in India residency is done in private hospitals and they haven't died yet.

When is GET going to sack consultants

Na wah oh. Where I work patients were already getting 6 months appointments to be seen in our clinic and that was with 6 residents. So now one or two consultants alone maybe now it will take about 18 months to get an appointment. The surgical waiting list will now be even longer apart from emergencies the waiting list will maybe be as long as 2 years. Who knows if we are luv they may even sack the consultants and close down the teaching hospitals!

The reason for their stability/apparent discovery is that they started supportive therapy early, unlike most patients who reported to hospital when the symptoms were obvious, these were being monitored and supportive therapy began immediately they showed any signs of fever.Again these medics had short term exposure and were relatively unstressed unlike the medics that died in Sierra Leone and Liberia that had been on the frontline treating Ebola patients for weeks and some even months, having repeated exposure to Ebola patients and were badly stressed. Early detection and early intervention is the key to improved outcomes.

I had an appointment in LASUTH today and when I was leaving I saw so many people milling around the BT children's ward in groups. This was about 4pm . It caught my attention because it reminded me of the scene at a bus stop after they catch a theif.

coogar: it's pretty simple.....
we cannot continue to discuss autism without looking at the causes. women older than 40 years of age should stop giving birth.
if any woman feels her career is going to delay childbirth, she should remove & freeze her eggs till when she's ready. the older a mother is when she gives birth, the higher her child's risk of autism.
this is the kind of awareness the NGOs in nigeria should be dishing out, but they would rather organise a street dance with the shepopotamus @ aso rock! autism should be as
much awareness as the sickle-cell especially in a judgemental society like nigeria.
@tbaba,
tell your dad's colleague to take his autistic child to the bar beach. the child should be put on a horse. it's not a cure, but it improves the condition of the child.t

All the autistic children I have come across were born to young women all below the age of 35. It's Down's syndrome that is age related but actually occurs quite frequently in younger mothers in this part of the world.

I am a doctor in Lagos and actually have quite a number of autistic patients. The ones I see however are all from middle and upper class homes which I guess is due to awareness. I believe ignorance and our cultural beliefs keep the less educated from seeking help when confronted with an autistic child.

You guys should make sure you keep all batteries away from this child. One of the worst things for a child to swallow by mistake is a battery. The battery inside the food passages will leak and cause severe chemical burns and at 2 the oesophagus is narrow so they end up stuck and cause a lot of damage. The same goes for watch and toy batteries.

Thank you

gbodimowo: Naturally I would have worked passed this place but the uniport story has an element of truth in it but of course you have to be in the system to know what the story should have said is a particular doctor not the whole lot of them as alleging that all the doctors took away the case notes is falsehood
When a doctor comes to work on clinic day with all his patients case notes and goes home with them and you as a patient become a slave to that doctor
It's a shame that this actually happens but it's like dropping water on the desert that's why it's not noticed
Like I said it's happening so don't be naive to say such can't but the percentage of people involved is so insignificant you may hardly notice unless it happens to you
For all those who know not you can attack me but I have made my point

That sounds strange, is there no records department in the hospital? Anyway this is what I say about doctors carrying responsibility for patients care, when a patient goes to hospital and his case note is missing nobody remembers the records department it's still the doctors that get the blame. I know how many times I have had to see a patient with a temporary folder because they can't locate his fille but when you ask a house officer to go and search in the records department he invariably finds it in one corner. We know that if we refuse to see the patient they will go home and say the doctors lost my file, never the records department.

She died a MARTYR, in which country. One the person that died is a nurse not a doctor, the doctor is still hanging in there for now. But someone said she died a martyr, in which country? Will Nigerians feed her children or give them free housing or education. Do people know her name or even care who she is. Nigeria does not have a reputation for valuing human life and I bet you in 6 months time we would have forgotten she existed and gone on to a new topic or jis, .its only her family that will bear the brunt. Martyr my ...........

prettyprettywow: What we have is chief nursing officer and that is just a rank. It is not gotten through education but job progression Consultant is a job description thanks for letting me know that. So why are Nigerian Drs claiming ownership of the word? Until they start paying others specialist /matron allowance. This is just a case of monkey dey work, Baboon dey chop.

Now CNO is just a rank, why then can't the ward maid become a CNO if it is not through education but just job progression. Even in UK and USA the Cheif Nursing officer or executive position is the highest ranking nurse in the hospital even higher than a nurse consultant. Dont in a bid to prove your point denigrate your own profession. My mum retired as an ADNS/ Chief matron of a teaching hospital and she was not less than any consultant, she was as respected if not more than some consultants. Same for many good nurses I have worked with, they were proud to be nurses and respected the fact that they were not called Consultant did not take away anything from them. The fact is that if you google the term hospital consultant what pops up is physicians or doctors because that is the norm in hospitals in UK and the commonwealth which our practice is modeled after.

I really believe they should privatize health care in Nigeria, we would suffer for a while but in time a lot of the malaise of the health sector will cool down. That way if a hospital requires the services of a consultant nurse or doctor or pharmacist or whatever they will advertise for one and employ whomever they wish. Doctors will also learn that in order to get along you must specialize if not you remain redundant.

The designation consultant is not a title it is a job description. The terms Matron, Sister or Staff are not medical terms, but anybody coming to the hospital and hearing those terms automatically knew they were referring to a Nurse. Before the recent change in nomenclature a Matron was the most senior nurse in a hospital while a Consultant was a senior doctor leading a team of doctors and responsible for patients under his care. Now nurses in Nigeria no longer want to be Matrons or CNO's but would rather be consultants. Maybe doctors should stop answering consultant and use the American appellation Attending Physicians. I am sure in 10 years time nurses will now say Attending is the peak of a nurses career. Or we will now have pharmacist and physiotherapist now saying they want to be Attending pharmacists and Attending Physiotherapist.

Google the words Hospital Consultant and then educate me on how many times it refers to any other person but a physician ie medical doctor. Yes there are Consultant Pharmacists, Consultant Nurses, Consultant Physiotherapists, Consultant Laboratory Scientists all over the world but international best practice is that when the word consultant is mentioned in relation to a hospital it means a particular cadre of doctors.

Not all patients require admission and nursing care, not every patient requires physiotherapy or laboratory tests or X-rays or drugs. It is the doctor that determines what they need and when they need it. In secondary and tertiary health care settings the patient is under the care of a Consultant who is responsible for everything concerning the patient. Who gets the blame if something goes wrong and is patted on the back when the patient does well. That's why we say we own the patient! This is world standard. In America the equivalent is Attending Physician.
Also in Nigeria the role of Hospital consultant remains the same wether in government or private practice. Has anyone stopped pharmacists or nurses or laboratory scientist from bearing consultant outside the government hospitals. The truth is it's just the title and allowances people are interested in nothing more.

They should let anyone who wants become a consultant in the hospital. But on one condition he has the same responsibilities as every other consultant. Run his own clinics,make diagnosis, treatment plan and monitor his patients till they are discharged. Presently once a patient is registered to a consultant he takes responsibility for treatment outcome for that patient. If he is a surgeon and the patient requires a cardiologist, no cardiologist can just walk up to that patient unless he recognizes the need and invites one, if he invites a cardiologist and does not agree with the cardiologist on a treatment plan it is his decision and he takes responsibility for it. Likewise he decides which investigations to do for his patient, nobody can just walk in and start investigating his patient and expect him to work with those results. If unfortunately the patient dies it is on his record. Now if the new consultants come into the system they should be ready to work like that not expect a doctor consultant to see patients make a diagnosis and hand over to him for him to "consult" then back to the doctor to monitor and continue management when he has finished what he considers his work. Let the hospital have nurses clinics, pharmacy clinics, laboratory clinics, physiotherapy clinics and let the patients choose whom they want to see.

Jimmychoo: our useless doctors. na only strike them sabi go. one research dem no dey do. very arrogant and proud set of doctors. shame on them all.

Oahray: because our doctors are always on strike. Na useless things like title we sabi fight for. Doctors fighting pharmacists... Which time dem go get take do anything?

Wetin concern Agbero with overload. Shebi now it is doctors that will do research and produce vaccines, what are all the pharmacists and medical laboratory scientists supposed to be doing? Shebi you heard that in America it's doctors that are doing the research. This is what doctors have been saying when the shit hits the fan doctors get the blame for everything concerning patient management, but when it's time to receive the reward everybody remembers how the doctor did nothing,

Remember Pfizer in Kano? If the drug was used on Africans and the result was not good we would be shouting that they used us as guinea pigs and sue them. The Americans were prepared to take the risk and signed consent forms and they were lucky it worked now we say it's a conspiracy.

the Americans have not forgotten the Pfizer scandal. If they use it on Africans and there is any side effects we will say they came to use us as guinea pigs. So they are using themselves as guinea pigs and now it's working for them we are shouting.