Working at a KKM hospital is satisfaction 5% and heartache 95%. It’s not because we got no satisfaction treating the patients, but from up top to down bottom, rotten apples are everywhere. In government service, everything is about seniority. Everything is about hierarchy. Everything goes by what the boss says.
This system of hierarchy actually serves to protect the main KKM clients – the patients. A specialist with 15 years of experience certainly would give much more accurate and decisive treatment than a one-month old houseman. But the system also opens up another door – bullying. Bullying has been a culture of KKM doctors since forever. The main reason for this bullying – for YOU to learn. Whether it’s really the best teaching method, nobody can say.
A houseman does not outrank the nurses. The nurses rule the ward, they know how the works are being done all this time while the houseman keep changing every few months. They determine whether we had done things correctly or not, whether this form and that form are filled in correctly, whether our work is complete or incomplete, whether we can have meals or breaks during our shifts. I certainly don’t remember myself outranking the PPK because last I heard, I was told to “Jangan kacau saya boleh tak? Kalau doktor nak urgent, pegi hantar ABG ke lab sendiri lah! Saya banyak kerja ni!”
A houseman is at the bottom of the food chain. It’s so easy to bully a houseman with the reason “so that you can learn”. Me, I cannot tolerate bullies. I don’t stand up to every bullies in my workplace, but when I do, I make life messier for them.
When I was in medical posting, there was a discharged patient who is ex-IVDU with Hepatitis C positive, supposedly in radiology for a CT-scan, but was sent to our stable ward without any notice whatsoever for a venofix. The reason being; they couldn’t fix it down there. At that time there were only 2 houseman taking care of 30 patients. Medical being medical, with so many transfer-ins, discharges, bloods, referrals, charting, procedures, summaries etc, we just do as asked without asking questions, sometimes without knowing the cases. So my colleague at that time saw this patient and tried to insert branula for him. She was really in a rush as she has loads of other referrals to settle.
She attempted few times, but couldn’t get any because the patient’s venous architecture is no good. Frustrated and rushed, she made another try, and poked her own finger! She was crying after she got the needleprick injury. She was so stressed up. But she hasn’t known the case yet. Only after few minutes she got that needleprick, she discovered that the patient is ex-IVDU and Hepatitis C positive! And then she was even more panicked than ever.
I did feel pity for her and feel angry at the radiology MO who sent the patient up for us to fix in a branula. So I sent a memo back to the radiology MO saying that we couldn’t fix a branula and in the process of trying, a houseman got a needleprick injury, so please do your own job without pushing the work to us busy housemans. And I went straight to see one of the hospital administrator in director’s office to talk about this incident. I brought up the issue “Why should radiology push a patient to medical for venofix?”. Yes, radiology pushing venofixes to houseman is not a new thing. I was called down to radiology several times for venofixing. But I was so pissed off that day because one of us houseman got needleprick for helping out radiology.
And the said MO got a good yelling. But one of the radiology consultants wasn’t happy that I stood up. He wasn’t happy that I spoke to the administrator and wasn’t happy on how I wrote the memo. So he came to my ward and gave me a big yelling. You houseman with attitude, when I was a houseman blabla, needleprick injury no big deal, I will tell your consultant to extend you in medical etc etc etc.
I was happy I stood up for that. I heard that there was no more unnecessary bullying like that happening again across departments (radiology bullying medical houseman). The medical consultant actually backed me up and praised my courage for standing up like that. And I was NOT extended in medical. But I got a very big stare every time I walk down radiology department, arranging for ultrasound, CT and MRI for my patients. Damn, I made lots of enemies already…
You can see how miserable most KKM staffs across the board, one blaming another, save your ass first before someone else’s. That’s because they do not speak up. So they can just complain at the back. And this includes specialists that complain too many houseman and taking the frustration to the poor housemans. Houseman cannot do anything about our numbers, they also can’t do anything about it but they don’t want to speak with higher ups in fear of retribution, so they take out on the houseman.
So, if you don’t like how you are being treated, firstly, DO NOT EVER ACT LIKE THEM. Seriously. Secondly, speak up, but choose your battles well. You cannot want to win every time.
Remember, the bad things in the world happen because good people don’t speak up.