₦airaland Forum

Nice @OP
I've followed the story from day 1 and quite frankly it was a self prescription and the pharmacist can and should advise the patient on the meds he or she self prescribed. The only thing the pharmacist did wrong is not telling him the side effects of the medication.
However I read some comments by some pharmacists who in a bid to defend the profession passed some wrong information. THOUGH NOT APPLICABLE IN THE INDEX CASE, it's wrong for you to change a doctor's prescription without informing the doctor. I work with an experienced pharmacist in our medical centre who is older than me and more experienced, but has never changed my prescription. Sometimes he could walk down to my consulting room with the prescription sheet and tell me " doc I don't think this woman can take this in first trimester ", or just call over the phone over the phone for clarification. Because in this era of medicolegal wahala everybody is playing safe, doctors, consultants, nurses, pharmacists, lab guys. When the lawyers come they scan the patients folders and look for who to seize their practicing license be you doctor or pharmacist.
So don't, in a bid to show you know more than the doctor, get yourself into trouble.

I hope the kaduna state government and other state governments should make it a law and more importantly PROTECT the doctors from police harassment for treating gunshot wounds without a police report. Because it was the police ab initio that made it the rule. Because I've heard of a few colleagues that slept in the cell for days after accusations of being involved in armed robbery because they treated gunshot victims who are presumed to be armed robbers. So till I get assurance from the state government where I work from protection from police harassment I'm afraid if you come with a gunshot injury I'm not touching you without a police report I don't want to be paraded on TV with boxers as a suspect.

I also read someone say a doctor can't make a diagnosis without a lab test which is untrue. In fact in the laboratory form you send to a laboratory you are required to write your provisional diagnosis. In standard centres your lab request will be returned if you don't have a working diagnosis. What the lab does is to confirm your diagnosis. Now nobody is saying doing labs is not important, it's an essential part of medical practice but in most cases treatment is commenced based on your provisional diagnosis before your labs come out. that is standard worldwide practice. Nigeria has its own peculiarities. If you work in a general Hospital for example labs that should take fifteen minutes may take up to a day either due to workload or lack of reagents or no light etc. Some assays take weeks to get results. Some tests are expensive and patients can't afford them. Some tests can't be done in our locality. So what happens is that the doctors tend to work longer with their provisional diagnosis in this part of the world which with good clinical skills is fairly accurate.

nonix22:
Gbam! I have seen personally as well. A young female Doctor in well known hospital in Abuja. I was just stunned. Perhaps, after she must have crammed to scale thru medical school.

wow you guys it's no longer funny. There is nothing wrong in crosschecking a prescription dosage for crying out loud. In every consulting room there is a drug formulary for doctor's use because there are thousands of medications and different dosages for different age groups, contra indications, side effects etc. it is a safe doctor that crosschecks his prescription and you should be happy. Over years of practice older doctors tend to remember more dosages, but the key thing is that the doctor is giving you the right medication and has made the right diagnosis

The way people bash doctors on nairaland sha. I wonder if it is the same Nigerian doctors that are excelling in other countries. In case people don't know the Saudi ministry of health alone recruited over a 100 doctors last year and just employed about 200 in March. Also mopping up B.sc nurses aggressively. The doctors are tired of the system too, and are leaving never to return. We can continue the blame game here.

Tinyemeka:
ABSU produces the worst set of doctors I know about.

The good consultants at FMC Umuahia attest to that.

l could take you through our alumni page and show you a lot of absu trained doctors excelling all over the world, but then your comment wasn't an attempt to be reasonable but purely ignorant and malicious so I will allow you to continue saying nonsense.

Just came back from church and reading through comments. Now I would be practical and say what an ideal house officer would have done, having been onr
1.triage and start resuscitation. Actually apart from securing an iv access, commencing iv fluid, and commencing oxygen, he wouldn't be able to do more. Urgent transfusion might require blood from lab which is quite cumbersome unless you have friends in the lab who can loan you blood. Now the opportunity said he called 2 other house officers obviously older ones cos he is a novice. It's not likely that the other 2 house officers just stood there without even trying to get a line.
2. Actually at this point he should inform the registrar on call. Though when I trained we had experienced casualty doctors so as a house officer you collect blood samples etc. Now this is where I fault that hospital. You should never leave the emergency for a house officer. Have an experienced casualty officer at least.
3. Obviously the senior doctor was wrong by not being there for his house officers when they needed him. He was probably sleeping and didn't want to come out. But as a house officer once you hv informed your registrar and he tells you to refer you have to refer anybody telling you otherwise is not a doctor and wants to get you into trouble. Sometimes ill-equipped hospitals may not have oxygen, no blood and keeping that patient makes you more culpable than being superman. If that patient dies in your hand you will be severely punished. As far as you hv evidence that you hv informed your senior you will not be held liable.
Thanks (please this is for the doctors here who know how things work nobody should insult me and call me half baked lol)

Wagasigiungu:
Touching story indeed. Took my time to read some of the comments. The facts therein:
1. The O. P. is a greenhorn in the medical profession. However this is not an excuse for any form of incompetence on his part. Why so? As the 1st H. O. on call, he should hv at least done something irrespective of any orders from above. Basic resuscitation would hv probably made a world of difference between life and death. Moreover the training of a H. O. is targeted at equipping him with the requisite knowledge & skills to keep a patient alive before the arrival of a senior colleague.
2. From what he wrote I could deduce that there were 3 Drs who ground (2 other H. O. joined him), that's more than enough temporary manpower. The O. P probably had the time to take picx of the accident victims while they were writhing in pain & @ the brink of death. He probably planned on sharing the story on NL anyways (my speculation but I maybe wrong). My point is this: during all this time they could hv simply resuscitated by checking the patients vital signs and administering some fluid resuscitation. If he was afraid of flaunting orders from above there are other steps he could hv taken below.
3. Note that some bad eggs among your senior Dr colleagues will always shy away from responsibility. They do this by always hiding under the referral system. All in an effort to avoid taking on the burden of emergency surgeries or having to closely monitor a critical patient. Will you always give in to them? It's inevitable, you will hv to act against orders from above in this profession.
4. You could hv helped in facilitating the patients referral. Some Drs don't want to take the initial step. You could hv taken a very brief history and written a referral note including the victims vitals. This would hv helped in ways you may not imagine.
At the referral hospital if they are u lucky to meet a Healthcare worker who is lazy or unwilling to examine d check fr vital signs, ur referral note would then go demand an indication of the urgency of the condition & the need for immediate intervention. Moreover it then becomes legally professionally binding on them.

read your analysis and I concur. But I still insist the senior doctor is culpable and infact in a review he would be punished. House officers towards end of their training year can handle emergencies but don't expect a HO in his first week who can't even secure an IV access properly to handle multiple trauma. The medical officer should have barked orders from the phone, come down to the ER before referral. He must have been a lazy type. Anyway I hope they have a review in the hospital about their emergency protocol.

I've been reading all the comments and this is what I hv to say. First It's not right for a training hospital to leave a house officer alone in an ER. See its easy to read all the emergency protocol in medical school but when faced with mass casualty like the op you tend to panic. I remember my first day as a house officer in the children emergency when they brought a child fitting and paper white pale with the parents screaming I panicked and ran to call my senior. But that's the point. The registrar was there promptly acted and I watched. The right thing was for the op to commence resuscitation yeah. Do this do that sure. But I can say that cos I now know better with years of practice. The Op is feeling bad it's probably his first ER case, but as for me the senior doctor should never have left that emergency room for a house officer that is not experience. As for the Op, I will say wat the registrar told me that day " next time start setting a line first then be thinking of the next step"