I had looked forward to my house job experience. Now was the time to truly be a doctor, after shadowing doctors as a medical student for six years. When I received my placement letter, I was over the moon. I resumed, filled with enthusiasm, ready to apply myself and pick up as many skills as possible. The passion was there, palpable. I’m now in my third out of four internship postings, and that passion has been overcome by stress, exhaustion, abuse, and even mental fatigue. This is not the house job I expected.
I initially thought it was me being incompetent, that I probably did not learn enough in medical school, which is not true. I learned enough in medical school. I attended the classes, the clinics, the ward rounds, the theatre sessions. I did all I needed to do as a student, enough to qualify me to be here as a doctor, even if just as an average one. But house job showed that I needed more than medical knowledge and clinical skills.
One day, I had just ended a very chaotic call that deprived me of reasonable hours of sleep. Unfortunately, I had to show up the next day for clinical activities: pre-round visits, the ward rounds themselves, and post-round documentation. With my groggy eyes and tired soul, I freshened up begrudgingly and found my way to join in the unit’s activities for the day. It made me feel worse to know that there were quite a number of patients to be seen that day, and as it was consultant rounds, I already knew it was going to be a long day. It didn’t help matters that all I yearned to do was to collapse into the softness of my bed and lose myself in deep sleep. I shrugged my thoughts off and tried to focus on the mountain in front of me.
The ward round dragged on for hours, punctuated with a series of chit-chats between the consultant, residents and patients, till it eventually ended late in the afternoon. The round ended for everyone but house officers. We had to execute the plans instituted by the unit head. That meant sending consultation letters to other units where necessary, prescribing investigations, collecting samples, revising drug regimen, monitoring patients, and so on. Now, I would have done my part and executed the plans for my patients to the ‘T’, but my body had other plans. So, I decided to ‘hand over’ the tasks to the team on call for that day. I had to go home. Besides, it was past work hours.
The next day, I arrived at work and was met with trouble. The team on call did not follow through on any of the plans. My chief was livid. He oversees house officers in the unit and reports directly to the consultant. He raged at me for not implementing the plans after the round, not minding that my colleagues and other patients were there. And then he went on to accuse me of being lazy. Lazy: an interesting characterisation of someone who has attended to all the relevant patients in the previous days, set their lines, collected their samples, documented their care, and is now here for another round of care and management. All of that was now in the past, forgotten. It was awful, listening to those hurtful words as they rolled off his tongue.
I had to temper my hurt and focus on seeing out the remaining days in house job. It became clearer by the day that working in this environment comes with unique challenges that I needed to adjust to, not because the situation was ideal, but because it is what it is.
I have seen firsthand how a poor working environment adversely affects healthcare workers, their delivery of services and overall treatment outcome. I have seen two doctors doing the work of ten. I have run endless shifts with sleepy eyes. I have had to improvise when the ideal tools I needed for work were not available. I have had to bear the frustrations of colleagues, seniors, and patients alike. These impact negatively on how much I could offer. I needed to adjust. I must. At least, until this house job is over.
As narrated by: Dr Aruwa Hameedah (Abuja, Nigeria).
This snippet is published as part of the series, Surviving Medical School.
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