WHERE IS THE STUPID NURSE?: ANOTHER LESSON FROM INSIDE MY CONSULTING ROOM

I was on call overnight. It was one of those days that patients were trooping in. Eventually I was able to rest at midnight since 2 pm I started the call after the day work. I slept for the few hours left but my sleep was intermittently interrupted by one or two cases of patients. I sorted them out and finally the following morning was here. I had to rise very early so that I could do my work for that day which was to register the new pregnant women for antenatal care before going home once and for all to rest for the rest of the day. I woke up around 5 am and said my prayers. I had my bath inside the call room bathroom and changed my clothe for the business of the day, the booking of the new pregnant women. I had not eaten. That had practically become my habit since I started practising medicine and surgery. I prioritized my patients to the detriment of my health that I had developed peptic ulcer disease. My wife is fed up with this aspect of me. I had apologised many times to her that I would change my habit of not taking breakfast but have i changed? Well that is a story for another day. Now back to the story I was telling you from inside my consulting room. I was ready for the new pregnant women booking with empty stomach. The booking usually took like 6-7 hours sometimes so I might likely be going home around 1 pm in the afternoon. Dont forget this was continuity of my yesterday work and call in the hospital .I had been in the hospital working and saving lives,this would be 48 hours going now. The protocol of the hospital was that new pregnant women should come very early and the policy of first come first served had been the order of the day because they were always many and the hospital had done their calculation, we could only book 20 new pregnant women weekly every friday. Some doctors had complained bitterly that they were overwhelmed and overworked with the new 20 pregnant women weekly to add to the pool of thousands of old ones already on ground but the hospital craved their indulgence and appealed for their sacrifice. This is always the habit of our medical elders that usually puts the junior medical personnel lives at risk of BURN OUT and DEATH. This too is another topic for another day. So how did we come about the topic of today " WHERE IS THE STUPID NURSE?". Like I said earlier, if you would book in our hospital you must come very early if possible by 6 am latest but many of the new pregnant women arrived even much earlier to get slot,some slept over in the hospital because many of them had come severally missing the slot. As usual, nurses in the antenatal clinic for the booking applied the rule of first come first served as instructed by the hospital. After I had been ready for the nurses to start bringing them one by one after they had painstakingly taken all their vital signs,gave them health talk,did urinalysis for them,collected all their results and filed them appropriately, alerting the booking doctor to any alarming high blood pressure and any other abnormal vital signs,some of them would still come, out of passion and commitment to these patients they do not know from anywhere,to beg the already overwhelmed booking doctor to please still increase the 20 patients because many new pregnant women were stranded. Still on the sacrifices of these antenatal nurses,some of them would still be used as interpreters for patients that had barrier language, these are just few out of the great sacrifices our antenatal nurses made from time to time. God bless your labour of love,our ever hard working and caring nurses. So,as we were in the midst of all these preparations for the day,I was sitting inside my consulting room and awaiting the cleared folders from the nurses in the reception to start the booking,I suddenly heard the loud noise " WHERE IS THE STUPID NURSE?". I heard this statement like 3 times within seconds. It was a man's voice and it sounded as if he was ready to slap the nurse he was asking for her whereabouts. I stood up promptly and rushed out of my consulting room where I was waiting. I saw the man feasibly angry and in fighting mode. I stepped in " I am dr...and you ? I introduced myself. He brushed me aside and said " where is the stupid nurse that said my wife will not be registered today again after coming here very early every friday in a row for the past 4 weeks?". He was walking towards our matron booking the new pregnant women like getting charged to attack her. I moved faster and blocked him. I stood between him and the matron. I stared him in the face as if I was furious too. I shouted and said mr man " dont dare try raise your hand on the matron or else I will get you locked up" I said "calm down,I am the doctor in charge of the clinic doing the booking I am asking you what happened tell me and I will sort you out" Then at this point I got his attention and his anger came down. I invited him and his wife to my office. I implored him to calm down to explain his reason for this frustration and explosion to me. He managed to calm down a little and explained to me how they had been frustrated because today was the fourth time they would be coming in 4 weeks and the matron promised them last week that his wife would be booked today but by the time they came around 6 am, the wife was told the number of new pregnant women was complete again. He was afraid something could go wrong with the wife or unborn baby or both of them while waiting too long to be registered. I called in matron who confirmed the truth of his story but said there was nothing she could do by the time they arrived today again,the number was complete again. More people came early. I understood perfectly the frustration and the explosion but matron was not responsible for this bottleneck failure of our health system. I told him I appreciated his passion for the safety of his wife and unborn child and I would sacrifice and add his wife as number 21 for that day but on one condition he would openly apologise to our matron for the insult and assault. He said it was not his fault he was frustrated. I stood my ground that that was the only condition I would book his pregnant wife because other patients who had witnessed this insult and assault on our matron would do worse tomorrow. I further educated him in what many people seemed not to know including himself,about health workers' rights. Most patients believed that doctors, nurses and other health workers are option less irrespective of what they do to them ,they must treat them. They are in humanitarian work. Yes health workers are in humanitarian workers but they have rights too. Health workers have rights not to attend to you if you insult,assault,threaten or attack them as far as you are not in an emergency condition. After thoroughly educating him, he lowered his pride with understanding that truly matron was not the cause of his frustration that it was systemic failure of our health system. He accepted to public apology to matron in front of other pregnant women in the reception. We went out together to the reception and he apologised publicly to matron and equally educated other people in the reception about the rights of health workers,the cause of frustration in the health sector and how we should show understanding and treat our life savers ( health workers ) with respect and dignity. I fulfilled my part of the pact. I booked his newly pregnant wife that day. As I was going back home finally that day in the evening,many lessons engulfed my troubled mind. Firstly, would that man had beaten our innocent matron just like that?,what of if the matron died from the assault or attack? It would be called occupational hazard?. Secondly, people should know that health workers have rights not to treat them if their lives are in danger. Your own life first, that is what the HIPPOCRATIC oath we took told us. Thirdly, our health care system needs urgent over hauling. Forty thousand medical doctors to 200 million people's health. This is grossly inadequate. We had to wake up urgently and rise to this health challenge of the nation. Fourthly and lastly,pending the time that this change will come ,I am appealing to the people, to stop insulting,threatening, assaulting or attacking your life savers ( the health workers). If you know how much of their lives they sacrifice daily to make sure your life and your family members' lives are safe and saved,you will appreciate every health worker you come across every day.

Expect another intriguing write up from me soon. Follow my page on Facebook "FROM INSIDE MY CONSULTING ROOM ". Thank you.

*The writer is Dr Adesida Adewumi,he works in the department of Family Medicine,Aminu Kano Teaching Hospital,AKTH,Kano,Nigeria*

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