I am unsure whether it is a total lack of insight or just plain laziness which is the doctrine of state sector hospital employees. My concerns are with those occupying the other very important positions in health care delivery who avoid responsibility. A telephone is the wicked accomplice to those in question.
Here ensues three stories to illustrate my point.
Switchboard Operator & Nurses
I receive a call from a very flustered colleague. She has her hands full with a patient who has complicated intra-operatively and needs an urgent ICU bed. She is working in another hospital nearby, which only has a high care facility without ventilators. So she has been trying to arrange for a bed in the hospital where I am on call. She is calling from her personal cellphone to mine. Apparently, she can't get through to our ICU or find out who the doctor on duty is because switchboard is not answering the phone.
"Not a problem", I reassure her. "Just sit tight, I'll get this sorted out from my side"
This shouldn't be a problem since I have the advantage of the internal short dial for ICU & will arrange the bed on her behalf.
4121 - engaged
4122 - rings, rings, rings
4123 - engaged
4122 again - engaged
(the nurses are making private phone calls)
9 - rings, rings, rings
(switchboard operator still sleeping/on tea/away)
After retrying for 10 minutes or so I finally get through to ICU.
I tell the sister I am trying to urgently arrange for a bed et cetera. She abruptly tells me to phone the doctor on 4137 & puts the phone down in my ear.
4137 - rings, rings, rings
Phone back to ICU. Engaged or ringing again. Persist & finally get through. I tell the sister the doctor is unavailable on 4133. I ask her who the doctor on call is, but she doesn't know!
"Ask one of the others, please"
"We don't know, we are the new shift." (so much for handover rounds, which was 2 hours ago mind you)
"Please could you look on the roster for me, Sister."
"Where is the roster?"
"I don't know, I don't work there - you do"
"Find out from switchboard" and she puts the phone down in my ear again before I can tell her nobody is answering at switchboard.
By now I am breaking out in a sweat from fury. I am about to sprint to ICU in person to wring a few necks & vent my frustrations. Lucky for them, I have a case on table.
We eventually solved the problem by phoning a random ICU doctor & asked who was on call. All was sorted out in 2 minutes.
This is the reason why I pay for a business cellular phone contract, privately. Many of my calls are for the state, which gives me no phone allowance and pays me peanuts in thanks.
We had a patient on table the other day - very ill, very urgent. I was unwilling this time (with the patient's best interests at heart) to blindly start the procedure in good faith that the blood results would be available "soon".
We knew the specimens were at the laboratory because an Intern had kindly made the two kilometre round trip to deliver them in person (you see, the messengers don't respond to sentences containing the word "urgently").
- nobody answers the phone at the laboratory - it just rings & rings & rings
- when it rings too much, it is irritating to the lab tech's, so they take it off the hook
- then the phone stays engaged
- there is no computer system for us to personally check results
- it is far to run to the laboratory each time
- smoke signals would contravene certain laws (besides, they would be too stupid to understand it, or be too busy sleeping to notice)
The techies didn't even notice us standing at the counter. Music was blaring. One was sleeping in the laboratory & two were having an animated conversation in the corner near the phone which was ringing because I had dialed it on my cellphone.
We were only noticed after my earsplitting whistle. I thought the two of us standing there, in theatre attire, would perhaps draw at least an apology for the inconvenience caused or mild embarrassment at such poor service rendering. In fact, they didn't even flinch when I asked them if they weren't going to answer the phone whilst waving my cell in the air.
Blood Bank Technician
I'll spare you the details. We called for 4 packed cells, 6 fresh frozen plasmas & 1 mega unit of platelets.
The blood bank technician felt our order was overkill and only dispensed 1 unit of packed cells and a message via the porter that we can ask for the remainder as we need it.
After struggling with the phones and eventually, much explaining to the insightless but frugal-due-to-low-blood-stocks tech, the rest of the products finally arrived just as the sisters were preparing the corpse for the mortuary.
I KNOW she would have made it, but we missed the window of opportunity.
And the struggle continues because blood bank doesn't have to break the news to families, therefore no culture of responsibility.
I wish I could enlighten those who hide behind the telephone :
You may enjoy the anonymity and use it as a scapegoat for sloth and ducking responsibility....People die everyday because of phones, lack of responsibility & lazyness.
You may enjoy ignoring the phone because you know it brings more work...
You may enjoy removing the phone off the hook because your sleep is then uninterrupted...
How corny, but what if that phone call is your life hanging in the balance?