Posted by Danhale93 1 day ago
Yes, you can allow patients to go uncovered. This hero mentality is what leads the bosses to not properly staff and the politicians to not properly fund in the first place.
It is not an individual’s responsibility to correct a societal failure by hurting themselves.
Though probably not the direct cause - sleep is very important, so are periods where people can relax and decompress at the end of day. Most any job a person works hard in, they can unwittingly become overstretched, being the go to person to get it done right ... or just well enough finished by end of day / shift. Go a few weeks doing 15 hours a day without a break - even strong people can find themselves rattling a little with things that they'd normally consider totally insignificant.
The strange thing is in Australia, or Queensland at the very least, they stopped drivers for truck freight services working long periods [1] due to the danger they posed to other road users, even the more experienced drivers. Yet those that hold life and death based on their action or inaction for people already nearing that edge from living to down a path of departing ...
I suspect though what troubled the poor doctor more was dealing with failings within the immediate medical field, issues with after care, medications and treatments the ward doctor or nurses opted for. Sadly I've seen this first hand, people who should know better eg [2] - I'm not in the medical profession, just armed with a bit of common sense along with a dollop of experiencing a long term gut issue that should have been sorted out in a couple of months and not let drag into years.
An expected death I would suspect would not take as much as a toll as a patient that had a good prognosis but died shortly after. Also there's the nag if from a statistical stand point patient outcome had changed for the worse.
Some things should be no brainers, like do not give osmotic laxitives to someone who is dehydrated, and perhaps blood pressure is not the tell all for a dehydration event ... probably the inability to urinate is more telling. But I'm encountered some such that even over the top things are dismissed, for example if the patient in a hospital ward hasn't drunk much more than a cup (250ml) in a given day, (or additionally less than a cup for more than 14 days,) with little consideration the air is moisture sapping dry due to constant air conditioning, and the urine output is clearly a sign [3] of distress due to insufficient dehydration. No it is not mysterious why such a patient has rallied a little after being administered just a singular bag of IV fluid, nor is it that mysterious when they decline after it has been stopped. Citing blood pressure for the reason there is no dehydration is a sign to me that that medical person needs more training - I've met more than a few in my local hospital system [4] that make that mistake I'm sad to say. Then again, for a number of nurses, nursing comes down more to management rather than care, and they will dutifully carry out their prescribed job function but miss other common sense signs the patient has taken a turn for the worse and needs to be reaccessed by the attending doctor in a timely manner.
[1] https://www.legislation.qld.gov.au/view/whole/html/inforce/c...
[2] The manufactures of Targin have clear guidelines how their slow release tablets should be given, and when not not use them, these directions are not to be ignored, they are not mere suggestions. Subsequently not telling the principal doctor the patient was so out of it they chewed it up and resulting bad side effects were more probable a result of that - rather than leaving the principal doctor to conclude these were as per the origin of illness and treatment path ...
[3] Should not be brown, and volume is multiples of any fluid input for the day
[4] Yeah drop "queensland worst base hospital malpractice" into a good search engine and possibly it might point to the largest town / city south of me.
Medicine is ran by a bunch of creepy boards. "ACGME Review Committee for Dermatology." For example gets together and votes on how many Dermatologist we get, fun fact it doesn't go up much.
$They were so kind to add 400 more Dermatologist$ in the past decade to the student pipeline.$ What could the rea$son be?
What I would do if you are a doctor and don't hate humans - ask these boards to let more people in (hopefully Americans, but Americans have an uphill climb getting accepted with the flood of fraud applications from around the world).
Why? Do you think Americans make better doctors?
A suicidal feeling comes from persistent depression. Instead, if one immediately takes correct steps to revert one's unipolar depression, the suicidal feeling and unipolar depression both go away. In the case of this article, it stems from social factors, so maybe they should quit and find somewhere else to work with better hours.