Friday 8 October 2010

The Australian Health Service has devised interesting ways of trying to ease the burden on the nations Emergency Departments. One solution is to provide free telephonic medical advice to people that have non-emergency medical issues that would otherwise end up sitting in an emergency department waiting room with something that could easily what for a GP appointment in the morning.

This brilliant system named HealthDirect is a taxpayer funded six million dollar per annum telephone call centre where burnt-out nurses can google your medical questions on your behalf between checking their facebook.

This fantastic idea has actually increased the number of presentations to the emergency department and here is a lovely example of how……

While working in our local working class town ED, stitching up drunks and managing overdose patients, a lady came to triage with a splinter in her finger.

I really thought the triage nurse was joking with me but the “medical emergency” that required a trip to the local hospital at midnight was indeed a splinter in the finger.

At around 2am I was able to see this impaled appendage and it looked exactly as the nurse described: “a splinter in the finger”.

I thought there must be some trick or joke going on but this rather embarrassed and tired lady explained that she thought she would recoup some of her tax dollars and ring HealthDirect for a little telephonic advice. (She obviously had no friends or even google to turn to.) This government sanctioned initiative whose sole role is to unburden the Emergency Departments of this country instructed her to head straight to the nearest emergency department and get her splinter professionally removed. Fearing blood poisoning or sudden death, she obliged. As did I, and I professionally removed a tiny splinter from a healthy finger and thought, “ this one is for the blog”.

Monday 15 February 2010

I got frostbite in the Pilbara

Let it never be said that I don’t deeply care about medical education in my adopted land. I was supposedly supervising a junior doctor who was in turn supposedly supervising a medical student who was about to use cryotherapy to burn a few nasty skin lesions off some bloke's arms.

As the junior doctor was giving the medical student simple step by step instructions on how to use the cryotherapy, I could see the prospective patient's eyes growing larger and more anxious as he realized that this student had never even seen cryotherapy before.

“It sucks being the guinea pig patient, having some student experimenting on you.” I said to him to try and lighten the atmosphere and put him at ease.

I then added, “It's not too bad if the student has already practiced on some other sucker and you’re number 2 in the queue.”

He smiled and agreed. I then decided to offer my own little skin lesion for the medical student to “practice” on before doing a medical procedure on a real live patient.

I did my best to maintain a stern, content expression, denying the searing pain in my hand as the student poured the cryotherapy liquid onto my hand, instantly freezing the tissue and crystallizing the cytosol in my hand.

I couldn’t scream out as this whole charade was to build the patient's confidence in the future doctors of this great country and simultaneously allow the student the opportunity to learn a medical procedure in a calm, non-threatening environment. I’m pleased to say I remained as non-threatening and calm as I could.

Fortunately it was the patient who then stepped in and said, “I think you’ve put too much on, you’re supposed to use a nozzle.”

This gave me the opportunity to run to the next room to cry alone while I pretended to look for a “nozzle”.

My hand is still very tender and seriously discoloured from the literal frostbite.

It seems the best educator for eager medical students is not direct supervision by helpful experienced doctors but anxious patients vocal enough to speak up when they see incorrect procedure being performed!