Dilemma

1 week into ortho SIP; its been a reasonable week so far. got to know the system (if u can call it that) here, the people (super nice!) and the pateints quite well. System here is ward based; so HO and i have 3 cubicles (15 beds) under us, all under a variety of consultants. Every morning, the respective cons will come down at their own time to see the patient,and we run ard like headless chickens trying to follow whichever con is there at present. If more than 1, too bad just gotta pick 1 to listen to, and try to decipher the writing of the other later.

I could complain abt any of a hundred things here; the stuffy wards, the awful computer system that makes doing anything at all a nightmare n hangs exactly when u need it to work, the fact that the MOs are never around so everyone jsut muddles along making mistakes, the permanently sour faced and pms-ing ward clerk, the fact that most of the teams don't bother writing clearly or even completely their instructions.

And one thing i will certainly complain abt is this idiotic ward based system as opposed to a team based system. Its a little confusing, but basically this system means that the HO is left all alone (cos the MOs are never around). The patience of surgeons in general is paper thin, so any calls made for clarification carry a high risk of pain. Nurses are v helpful, but they can't help with everything. Its impossible to follow any given pateint's plan of management unless u already know it, cos u don't get to hear their decision making process most of the time. Compared to the team based system (back in SGH renal esp), it is miles behind.

But what really really galls me is the attitude of the surgeons towards the patients. The only doctors some of these pateitns have seen are the HOs, simply cos the consultants simply can't be bothered to even speak to them. Today really took the cake; if you aren't aware that ur patient had a stroke cos u didn't bother to read yday's notes and didn't wait for us to reach you, then why call urself her doctor?? Somewhere along the line they have forgotten that the reason they have a job is these patients, and not the other way round. Who owes who?

This then is my dilemma. For more than a year now (probably long before that also) i have made clear my desire for orthopaedic surgery, and i still find the subject fascinating and easy to understand. I also love the OT, and working in the OT, seeing patients improve immediately. But i absolutely cannot tolerate this kind of attitude (its more than 1 or 2 consultants, its the prevalent attitude here in this hospital). The one thing keeping me from ditching the profession altogether is the hope that in other hospitals things are not run this way. And from my time in CGH, i think it is true.

As we spend more time here, I guess some of these complaints will recede and i will grow to like this place more. I am already liking the HOs n nurses a lot. But i absolutely cannot see myself working here, and in fact I am seriously reconsidering my future in such a department. I would even rather work in a medical team where at least the doctors know their patients reasonably well, and the HOs are trained effectively to one day take over their seniors. Even if it means no more OT for me.

How? Any knowledgable help would be welcome.

"We need to be willing to let our intuition guide us, and then be willing to follow that guidance directly and fearlessly."

-Shakti Gawain