2017年4月8日星期六

Be grateful to what we've got - Government hospital

One more week and it will be done! One year of PRP life, it has been sour, mixed with sweet. Nevertheless, it was the year that I learned most ever! Yes, I was forced to learn fast, but, no regret, it worths. It is true that I have sacrificed a lot of playing, relaxing and travelling moments, and was even studying during Christmas time and Chinese New Year (although I have already submitted my logbooks by then), but everything would be worth, I truly believe.

So, let’s go back to one year ago, when I just entered this, the busiest and oldest hospital in Johor, Hospital Sultanah Aminah. Everything was so new to me, including the environment and the people. That was the first time I entered a government hospital, some more it is an old one, which means, kind of creepy especially when you are walking at a dark alleys.


From someone who always complained about the government service, which we all know it is slow and sometimes kind of irresponsible, to now I am really grateful that my government does provide free healthcare service to the citizens, some do have to pay, at least it is not expensive. 


And if you are observant enough, you would realize the doctors here in HSA, if not all then most of them, try their best to deliver the best service to the patients. They would talk to patients to understand their healthcare and social problems and try to solve it medically and help it if social worker is to be involved. 

We pharmacists, also play our role with full responsibility. I am truly impressed by many of the ward pharmacists in HSA. Some of them came to their wards to understand the patients’ medical case before their working hour (8am) and went home late. They were not paid of working over-time. They wouldn’t be blamed if they went back home on time, but that’s not what they care, because, they (at least the one I observed) truly hope they can give the best service to the patients and hope for the best for patients to get well and get discharged soon. Who says government hospital staffs do not care for the patients at all? Afterall we are human and not cold-blooded. We care for patients.

Then you would ask, if we do really care, then why we are slow. Why do patients need to wait for hours to have their turn to consult the doctor or get their medications? Actually, this is merely a simple mathematics question.

If it is in ward, there are around 35 beds in a ward, which means 35 patients, if there’s no extended beds added in the ward. But there are only one or two clinical specialists, one pharmacist and maybe 6 nurses in a ward. Then maybe, the team needs to spend about 5 minutes for each patient. Then, an 175 minutes would be needed for the team to review all patients, which is 3 hours. And, sometimes 5 minutes are simply not enough to review a more complicated case. If the team can get the daily review done in 3 hours, then what are you complaining?

Now let’s talk about Out-Patient Department. There are around 1200 patients per day. If there are three counters opening to prepare and dispense the medicines to the patients, and 5 staffs for each counter (to screen, prepare, intervene if any, label, dispense), that means 400 patients per counter. From screening to filling then labeling then dispensing, it takes about 5 minutes (if the medications on that prescription are not that many, some may go up to 9 medications in a prescription). If there are 25 patients before you, this means you would have to wait for about 2 hours to get your medications, provided that none of them goes to restroom. Somemore, we are trying our best to keep the waiting time to less than 30 minutes (though sometimes we failed and the waiting time goes up to 45 minutes). 

Okay, maybe this is a bit complicated to include all the steps from screening, filling, labeling and dispensing. So let’s talk only dispensing. If we need 2 minutes to dispense to each patient, and you are the 26th, that means you would have to wait for 50 minutes. And sometimes it is impossible to get dispensing done in only 2 minutes, especially when:
  • Patient: can you repeat it? (What were you doing when I was explaining (twice) to you just now?)
  • Patient: why you didn’t give me xxx? (I have, it is already in your bag.)
  • Patient: you must give me a plastic bag, I can’t carry all these medications. (Yeah yeah, we are like Tesco. Welcome back to shop again.)
  • Patient: you didn’t give my prescription back to me. (helping to look for it then found out it is already in patient’s wallet.)
  • Patient: this medication is not helping. (but still he/she wants to have it.)
  • Patient: wait wait wait, did you write on it. (yes, I do write on it, I don’t expect you to memorise it).
  • Patient: I can't read this. Can you write again, write big BIG? Write in chinese as well. (yea, I can write in tamil as well. Can I write three languages for u?)
  • Patient: can you give me some panadol ah?
  • Patient: Sweetie, can I be your friend? (rolling my eyes)
  • Patient: I don’t like government service. (Then why are you here?)
  • Patient: I do not want to wait anymore, you better go and find my medications for me right now? (who told you that you can cut the queue and order me to do you a favor?

So? Why are we still complaining?
Yes, our service really needs to be improved, but, is government service really that bad?
Or is it that we are easily affected by our old perception or other people’s perception? Are we complaining too much?

May be it is time for us to ponder.


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