₦airaland Forum

Fortisville:
Don't even know what to say anymore. Reading some post here makes me want to scream.

Having been opportune to manage 3 hospitals in Lagos Island, Ilupeju and Victoria Island respectively. I think am qualified to say that my experiences in those areas exposed me to the very poor, average class, rich and the super rich. Giving me full insight into how some hospitals operate in Nigeria and why staff are not motivated.

In all my experiences, I instruct staff....never to request money before treatment not even registration card. Meaning I will start treatment immediately, stabilize my patients after which we can discuss payment modalities. Often times patients don't even hesitate to pay any amount they are charged and fully. Appreciating the approach. "Life First"

I class my patients into very poor, average and rich.

Very poor: Pay full very reduced fees, Pay reduced part fees, Pay reduced fees by installment or Pay Nothing ( when it's obvious )....At my discretion ignoring hospital protocol.

Average: Pay full moderate fees, Pay part moderate fees, Pay by installment. At my discretion. Ignoring hospital protocol.

Rich/Super Rich: Pay full mandatory fees or Pay by Installment. No discretion. No reduced fees. (Accessible and Affordable For All).

All emergency kits are available and easily accessible. Staff...including myself are fully on ground. Mini theatre and delivery room in ready state. 24/7.

All patients are accessed as quickly as possible, those beyond our scope are stabilized if necessary and referred immediately.

In that way, fund is available to run daily activities and pay salary. Nobody dies in the hospital (Primary Goal)

Was not in anyway related to the owners of the 3 hospitals. Each hospital owed their staff minimum 2 months salary and those that supply them drugs etc. My decision is final because its my license that is at stake not theirs.

Bottom line is protocols have to be broken to save lives even if your job is on the line.

Save life before money.

Interestingly..I never lost my job. Neither did the owners sanction me for giving free service at times including free normal delivery or charging the super rich exorbitantly because that's what subsidize for the poor.

The 3 hospitals gained more patients from my approach and turn over was great. And they became the first point of call within the locality despite being previously written off as dead zone for anyone to come out there alive. Staff salary was increased for the first time over 6 -12 yrs. (Motivating Staff)

Hospital management needs to be flexible in their operations, motivate their staff paying salary and on time and equipping their establishments.

No life was lost in any of those hospitals during my stay. Not because we were the best, but for putting life first before money, making it affordable and accessible for all and attitudinal change patients and hospital staff.

It's easy to finger point, but patients and medical staff attitude needs to change. Only then can we reduce avoidable deaths.

Well said,motivating and worthy for references.

zed7:
Lame excuse. Do you know how many lives are saved in community centres in the rural areas? It's beyond using lanterns. Your attitude and passion for the job is very important.
Administer whatever first aid is available. Try to stabilize the patient, then you can refer the patient somewhere. The important thing is how you go about it.

Haven't you seen medical personnel attending to people in areas where disaster has occurred? Stability is the first step and key. Stabilize then move on. Come back and then try and alleviate the issue. We have seen 5 doctors attending to 500 people who are badly wounded and at the end of the day only a few usually end up dying.

Any hospital that doesn't have the most basic stuff like bandages, basic saline drips, painkillers should fold up. The medical personnel there should go and sell roasted yam.

Ok..let's agree not to disagree. Your points are clearer now.

LadyFiona:
Hmmmm, you've not seen anything.

I have been on night duty with two ward maids who doubles as my assistants, with three patients in active phase of labour.
I have delivered babies with Nokia torchlight strapped on my hairnet, sutured perineal tears with kerosene lanterns.

No wonder my professional colleagues are writing NCLEX-RN, GFNS, TOEFL and other exams with acronyms I can't remember just to get at of this hellhole.

@topic, nurses are always at the receiving end because they are at the forefront of health service delivery.

I can relate to this. The first time I heard that from my sister, I couldn't believe my ears.

HaneefahRN:
Normally, I don't argue with people who are obviously holding on to a stereotype, but ur points are full of fallacies. Pray tell how nurses are contributing more to the health sector in shambles than lack of equipment, adequate personnel, and an enabling environment to provide care?
Yes, there are bad eggs in nursing, someone being saucy and mean is a personality thing and not an attribute of the pple in a profession. If a nurse was rude to u or was negligent report to the appropriate quarters and don't paint everyone black.
The issue of BNSC and SON nurses is by the way, every nurse whether BNSC or diplomate has to write and pass the same licensure exam and have the basic RN which qualifies them to practice as nurses, and it isn't the certificate a nurse holds that determines if she is a good nurse, a nurse with masters might not have the compassion, empathy and good interpersonal relationship the diplomate nurse has although better in knowledge, and besides all nurses are striving for professional advancement everyday so no qualms there.
All nurses might be painted black by every1 becos of some bad eggs they meet, but it doesn't change the fact that there are nurses working their butts off every minute even with limited resources trying to save and improve lives of pple who do not appreciate the.
I'm curious, what's ur profession?

Sista, ladyfiona,Ameenahz...I'm proud of you..yours truly. You really impress me as practitioners who knows their story and what the profession entails. You are no pushovers.

Here's a link I want you to join ....offers jaburata for there... www.nursetogether.com and u get to update on your present knowledge by relating with others from across the globe.... Ahem....likewise job offers.

When I read some responses here on nairaland to some issues I shake my head some more. I finally resigned from the public health sector 2 weeks ago. I got to work and met over 50 patients behaving like Nigerians and wasI alone was to see them. When I finally finished at about 5 PM I went home wrote my resignation letter and dropped it off the next morning. In some ways I feel bad because I know we are very short staffed and there is no obvious replacement for me. I even had to turn away new patients last week because if I start seeing them I don't know what will happen to them after I leave as my collegues are already overworked and I know they will end up with things like 6,7 months appointments. Unfortunately my area of specialization is rare so replacements are few and far between. Some people will curse me out but I am tiredof working under terrible conditions and that when I do make an inevitable mistake nobody will say sorry rather my whole tribe will be cursed for generations.

allycat:
When I read some responses here on nairaland to some issues I shake my head some more. I finally resigned from the public health sector 2 weeks ago. I got to work and met over 50 patients behaving like Nigerians and wasI alone was to see them. When I finally finished at about 5 PM I went home wrote my resignation letter and dropped it off the next morning. In some ways I feel bad because I know we are very short staffed and there is no obvious replacement for me. I even had to turn away new patients last week because if I start seeing them I don't know what will happen to them after I leave as my collegues are already overworked and I know they will end up with things like 6,7 months appointments. Unfortunately my area of specialization is rare so replacements are few and far between. Some people will curse me out but I am tiredof working under terrible conditions and that when I do make an inevitable mistake nobody will say sorry rather my whole tribe will be cursed for generations.

And the brain drain continues..........

What's the way forward? Which way Nigeria?
Our workers are jumping ship to where they will be valued, sending us back to the 50s.

IamforGod:
Nusre pls are u saying ur salary is more important than a life?

I believe u dnt av passion for ur job!

U dnt know what it means to be dead and gone for ever? Yh that's right U AV NEVER BEEN DEAD!

So u telling me a card and admission what
ever is more important than a man's life?


In situations like this, rather than have him die, i'll make him stable first, and tell them if they don't get the money he might die u'll see how they'll run and get the money!

But as a nurse ur first priority is saving a life.U SIGNED UP FOR IT!

I pray u will never be in an emergency situation and av people pushing u up and down.

You seem to have forgotten that the nurse in question was trying to deliver a baby at that moment , a baby in breech presentation. The lives of that baby and that of the mother who was in pain didn't matter, in your own judgement.
Brilliant.

Sanmel:
I'm a nurse too o.. JIC u av something special for Nairaland nurses..

its ok

Chinwem:
It's not so much about the facilities but the appalling attitude of staff and extreme lack of empathy to patients
We are talking jaundice and you re mentioning ECMO ??!? Even in the UK how many ECMO centers are there?
Simple things like taking a good history , keep baby under blue light/phototherapy , blood exchange
As for the bolded, jaundice from what .......that's for the doctors and nurses to find out and tell us.
You can study to the highest level and provide all the multi million equipment
But if your attitude stinks from a mile away......you re in the wrong vocation.
Medicine is not about bragging rights..... It's about human life

my dear, most neonatal cases are very complex. A baby with severe sepsis can develop jaundice with severe respiratory acidosis and deranged blood gases that may warrant ECMO. Hypoplastic lungs commonly occur with jaundice and many of them will need assisted ventilation including ECMO. neonatal cases requiring intensive care are usually complex and interwoven so your jundice may not occur in isolation. moreso this baby died within 4 days so that will tell you the severity of the case. in nigeria, how many hospitals can boast of conventional ventilators? so attitude will replace ventilators? The man just told you his baby died from jaundice and was blaming the hospital and i am telling you the mere fact they knew the baby was suffering from jaundice doesnt mean they must be able to help. i am telling you what could have happened to the baby and you already conclude i was bragging. Good history for neonatal jaundice....for christ sake these people delivered this baby in their hospital via cs so what history are you talking about? . so you think if it is just about bili lights the baby would die within four days and you assumed the hospital didnt know about bili light or exchange blood transfusion. As a doctor, you must read in between lines

allycat:
When I read some responses here on nairaland to some issues I shake my head some more. I finally resigned from the public health sector 2 weeks ago. I got to work and met over 50 patients behaving like Nigerians and wasI alone was to see them. When I finally finished at about 5 PM I went home wrote my resignation letter and dropped it off the next morning. In some ways I feel bad because I know we are very short staffed and there is no obvious replacement for me. I even had to turn away new patients last week because if I start seeing them I don't know what will happen to them after I leave as my collegues are already overworked and I know they will end up with things like 6,7 months appointments. Unfortunately my area of specialization is rare so replacements are few and far between. Some people will curse me out but I am tiredof working under terrible conditions and that when I do make an inevitable mistake nobody will say sorry rather my whole tribe will be cursed for generations.

I envy you. Finished school with so much enthusiasm but in the next couple of years, I will leave and not regret it. The situation is progressively getting worse

donodion:
Sista, ladyfiona,Ameenahz...I'm proud of you..yourself truly. You really impress me as practitioners who knows their story and what the profession entails. You are no pushovers.

Here's a link I want you to join ....offers jaburata for there... www.nursestogether.com and u get to update on your present knowledge by relating with others from across the globe.... Ahem....likewise job offers.

Thank u, sounds cool. I'll sure check it out.

LadyFiona:
And the brain drain continues..........
What's the way forward? Which way Nigeria?
Our workers are jumping ship to where they will be valued, sending us back to the 50s.

It is sad, when I graduated half my class left the country. None could understand why I stayed behind. Do I regret it ? No but I am done, I have given all I have left in me. Before the system turns me into a bitter, mean person frustrated with myself and life. I have since heard that 2 other collegues are leaving too, in fact as we speak one of the teaching hospitals has lost its only heart surgeon, another hospital has lost its only ENT surgeon who also resigned, they are still begginghim to reconsider, But not to worry I am sure Indian doctors are lining up struggling to come to Nigeria to take up from the useless Nigerian doctors and I guess they are soo good they will treat for free sef.

omoarole:
Dear Nurse,
You have done a most unpardonable thing. That's the only fault I have for you. Do yu know what your sin is? YOU BROUGHT THIS TO NAIRALAND!!!!! Haba! This kind topic on Nairaland? I'm so disappointed. You have no idea what you've done.
You think people are are any reasonable or can judge something with reason? I am sure you didn't come here to look for sympathy for yourself or the Healthcare workers. I am sure your intention was to shed some light on the difficulties of working in a hospital. But you have just come to the wrong place.
A herbalist doesn't take counsel from market women forum. A clergyman has no preaching to do in a beer parlor. When you bring such an issue to a forum of I'll informed people with no inkling about the sorry state of health care delivery in Naija, this is what you get. Exactly this.
Meanwhile, for everyone that has commented on this matter, good or bad, authoritatively or iill-informed, witnesses or hearsay, your comments have been seen. Before you leave this forum, ask yourself....what have you contributed in a way to make sure Healthcare delivery improves in Nigeria?
The answer to Healthcare delivery is Participatory and responsible UNIVERSAL HEALTH CARE. It's a huge and daunting task that may never see the light of day in Nigeria, because even the baseline infrastructure that will allow it to work are not available.
The strongest variable that correlates with greatest statistical significance with the standard of living in any nation is availability of Universal Healthcare coverage. Not GDP. Not population. Not democracy. Not even freedom of speech or any of the other fundamental things. Definitely not how religious the country is.
So, dear OP.....kindly let's take this conversation elsewhere....there is a better way to make Nigeria a better place than discussing such an issue here where the only responses you read are OVERWHELMINGLY negative.

Thank you for your comments, what an intelligent post!

I have been reading through several ignorant posts and shaking my head, so the poor nurse should use her salary to save your life because you, Mr Stranger, your life is more precious than the life of her child at home?
You are just number 101 of 1000 emergencies she will see that month, should she pay for all of them? dying or not just because life is precious?
Did you not know your life was precious when you were walking or driving around without emergency funds in case you had an accident?

Everyone feigns poverty in nigeria, nobody want to pay for anything, So tell me because it is human life it should be free? You should have access to free immediate emergency care and the poor nurse has to provide it? Is the Nurse your father? your Governor? your benefactor?

Does the Nurse live in a free house, get free food, free rides to work? Does the nurse demand free everything because she has the very important life of saving jobs?

Please get things into perspective. If you live in Nigeria and you don't make provision for healthcare emergencies you deserve what you get! Mediocre care or no care at all.

Tell the market woman to give you free garri to save your life, afterall hunger can lead to death

allycat:
It is sad, when I graduated half my class left the country. None could understand why I stayed behind. Do I regret it ? No but I am done, I have given all I have left in me. Before the system turns me into a bitter, mean person frustrated with myself and life. I have since heard that 2 other collegues are leaving too, in fact as we speak one of the teaching hospitals has lost its only heart surgeon, another hospital has lost its only ENT surgeon who also resigned, they are still begginghim to reconsider, But not to worry I am sure Indian doctors are lining up struggling to come to Nigeria to take up from the useless Nigerian doctors and I guess they are soo good they will treat for free sef.

You're right on point. I know about the cases you've listed above. There was even one recent one about a surgeon that resigned and left the country last August from a state hospital in Ogun. I heard he was the only one in his field in the busy general hospital. Understaffed and underequiped. The physicians and surgeons who came back to Lagos from the diaspora on the promise of Fashola in 2007 have mostly returned shamefacedly back to their adoptive countries....they cannot stomach the decadence in the health sector.
The way forward is Participatory and responsible UNIVERSAL HEALTH CARE. I will keep saying it. And the forum for that is not Nairaland. We need to take the battle up with our leaders. If we do, we can make a difference.

Obamedo:
Thank you for your comments, what an intelligent post!

I have been reading through several ignorant posts and shaking my head, so the poor nurse should use her salary to save your life because you, Mr Stranger, your life is more precious than the life of her child at home?
You are just number 101 of 1000 emergencies she will see that month, should she pay for all of them? dying or not. everyone feigns poverty in nigeria, nobody want to pay for anything so because it is human life it should be free?
Does the Nurse live in a free house, get free food, free rides to work?

If you live in Nigeria and you don't make provision for health emergencies you deserve what you get!
Tell the market woman to give you free garri to save your life, afterall hunger can lead to death

Thank you jare. Most people here really don't know what's going on. They don't even know what to ask for.

Wen its tym for u to die u ll just die cos no one can save u from death wen its tym. So there's no nid for all d accusations. I've seen patients who luk lyk in d next few minutes dey will die if nothing is done to dem. but to my surprise dis patients live longer dan expected....
Can't just escape it eg. President Yar addua

horlus:
I appreciate your write up but in some cases it's also negligence and carelessness from doctors. I lost my son few weeks ago after being born 4days later to jaundice. Despite the fact my wife kept alerting them that she has an history with jaundice from the theater where she had a casseran procedure. It's a story I don't want to start writing about right now but the child should not be dead if not for carelessness from the hospital doctors. Everyone keeps telling me to sue the hospital I v just decided to let go.

it is because the hospital and drs and nurses are always not being allowed to face the music that their negligence becomes heightened and they go ahead and repeat it with further patients,nigeri must learn to sue and no matter how long it take,get justice against the negligent.the trauma of attending court every now and then will ensure the health care worker avoids being sued.

josite:
it is because the hospital and drs and nurses are always not being allowed to face the music that their negligence becomes heightened and they go ahead and repeat it with further patients,nigeri must learn to sue and no matter how long it take,get justice against the negligent.the trauma of attending court every now and then will ensure the health care worker avoids being sued.

You're looking at the story from just one angle. It's not only about suing that will solve the problem. I agree with you that there is some negligence in the sector. People are not suing might improve on negligence, but I tell you, it will make things much worse.
The upsurge on litigation in the USA is what has made it possible for doctors to practise defensive medicine, and I bet my neck in a guillotine that you will not want that to happen in Nigeria. Because if it does, healthcare delivery will practically shutdown.
Because before your doctor prescribes an analgesic for your headache, you will need to take an MRI to rule out brain rumours. And with litigation will also come communal responsibility. Don't think that doctors will take that lying down. Your access to over the counter controlled medications will cease. You will need a tightly controlled prescription for everything.
Also, doctors fees will go up as a result of insurance premiums going up due to the rise in litigation. The poor populace will suffer it.
The government hospitals will practically shut down due to lack of equipment and manpower, since the associations and insurance companies will prescribe stricter working rules and the limit to effect of fatigue on performance and errors.....
The list goes on and on......
The answer to the mess we are in is a Participatory and responsible UNIVERSAL HEALTH CARE system. It's the only way things can work out . Your idea of litigation working can only be in motion if there is a system that protects everyone. Provider, user and regulator inclusive.

josite:
it is because the hospital and drs and nurses are always not being allowed to face the music that their negligence becomes heightened and they go ahead and repeat it with further patients,nigeri must learn to sue and no matter how long it take,get justice against the negligent.the trauma of attending court every now and then will ensure the health care worker avoids being sued.

Despite my belief that healthcare could and should be better once you start suing there would be he'll to pay by the masses.


Modified..


The poster above me said it all.

dicefrost:
I signed up for war, so give me a gun, a bullet proof vest and i ll fight to death. But you cannot give me sticks and stones and tie my hands behind my back and expect me to fight! I ll run away

Ridiculous