Indexing Title:  HABalucating 06-02

MAR Title: On Being A Clerk

Date of Medical Observation: March 2006 

Narration:               

            I was on my 24-hour duty at the Emergency Room when I received a phone call.  I looked at my watch and it was already 3-o-clock AM. I answered the call and it was the ward nurse-on-duty informing me that one of the patient wanted her colostomy bag to be replaced because it was already full.  I was both tired and sleepy then but I have to go up check on the patient.

                I was in no hurry to go up the ward so I leisurely walked into the hallway and used the elevator to conserve my energy.

                As I stepped out of the elevator, I heard a lady shouting at the top of her voice.  At first, I couldn’t make of anything from what she was saying, but as I approach the Surgery ward, I saw the lady in front of our Surgical ICU (Rm 307).  “Isusumbong kita sa director nyo! Ganyan pala kayo mag-trato ng pasyente dito!” I hurriedly walked into her and asked her what was going on. “Yung nurse nyo kasi eh, pinapatingnan ko lang sa kaniya yung swero ng asawa ko, bigla na lang ako sinigawan!” The lady was combatant.  I looked inside the SICU to check on the nurse the lady was talking about.  To no surprise, the nurse she was talking about was one of our medical clerk-on-duty (junior intern) acting apathetic to what was happening while monitoring our SICU patient. I went back  to the lady and tried to calm her.

 “Relax lang po kayo ‘nay, hindi po sya nurse, doktora po natin siya dito.” Hoping my statement would put some senses into her, but it did not. 

“Porke ba mahirap lang kami, ganyan niya kami tatratuhin?”

Realizing that I could not calm her down anymore, I gently dragged her back to her room and volunteered to check on the IV line myself.  Again, to no surprise, there was a stain of blood in the IV tubing of her husband.  It was not unusual for us to encounter some of the patient or their relatives making a big a deal out of the blood seen at the IV tubing.  Trying to control myself from being sarcastic, I explained to the lady and her husband that there’s nothing to worry about as long as the IV line is patent and the IV infiltration site is not swollen.  During that time, the lady was already calmed down and apologetic. I told her to approach the clerk-on-duty and apologize. She thanked me and said she will apologize to the clerk-on-duty later.

After that, I looked for the clerk and saw her at their quarters crying. I just sat beside her and her cry.  As soon as she is finished, I told that she doesn’t have to explain anything because I know she is not the type of person who would ignore a patient’s grievance much more shout at their relatives.  I started telling my own experiences as a clerk in an effort to make her feel better.  We talked for almost an hour exchanging stories about our clerkship..sad, funny, frustrating and inspiring stories.

It was then I remembered the very reason I went up to the ward…the colostomy bag.

Insights (Stimulus, Discovery, Reinforcement) (Physical, Psychosocial, Ethical)

             Clerk, to most lay people, is synonymous to a secretary doing a desk job.  In the medical field, however, clerkship is one of the toughest phases of their life as a medical student.  It is a grueling one-year of adjustment to every rotation in clinics.  Witnessing in an actual patient what they only read in the medical books.  Together with it are carrying-out doctor’s orders; monitoring patient every 1-hour or even 15 minutes; preparing medical abstracts, 24-hour histories and discharge summaries, taking history and physical examination at the ER and OPD, and presenting their patients during rounds.

                Unfortunately, they are being tagged as the ‘lowest form of … in the hospital’.

                I was a medical clerk once, and I still could vividly remember the good, the bad, the inspiring and frustrating memories of my medical clerkship at OMMC.

                Now, as a resident of OMMC, I realized how much the hospital, myself included, depended on the clerks to make sure that the care for the patient is provided.  I am really amazed and thankful on the discipline showed by the medical clerks of OMMC.

                As a resident, I feel its part of my responsibility to make sure that their efforts will not go into waste.  I should read on the cases we encounter everyday at the ward, ER or OPD and discuss it with them.  That way, it would encourage them to do the same so that they could make the most out of their Surgery rotation.

                Secondly, I should try to listen to their problem and provide assistance to them whenever they need one.