Friday, November 20, 2009

Bureaucrat in-the-making

I am so physically tired today after a PM shift, followed by a double shift (AM and PM), followed by an AM shift for these 3 consecutive days. An EN from the day shift has been re-deployed temporary to cover the night staff shortfall due to a staff resignation. As the ward staffing is very tight, some day staff has to do double shifts to cover the shortfall.

There was an elderly post-op patient with a surgical wound and some broken blisters on his right leg. As he was impatient to recover quickly, he tends to over-exert himself during the physiotherapy. His surgical Tegaderm with pad had haemoserous stains daily and his broken blisters weep fairly-to-badly. I had to change dressing twice for him yesterday (am and evening). While planning for CM (coming morning) discharge yesterday evening, his daughter asked if we could provide him with 10 sets of dressing items (dressing kits, various Tegaderm, gloves, Normal Saline in 20ml tubes, etc). They were happy to pay the hospital mark-up for the items in-exchange for the convenience.

In the past, I would be happy to get such a request. It brings profit for the company with minimal work involved. However, the ward stock was low and not enough to meet their request. I wasn't sure if the in-charge the next morning would be willing to put in the special order on their behalf. Thus, I advised them that I would prepare 1 set for their discharge and gave them a list of items to be purchased from any pharmacy instead.

This morning, another daughter of the patient spoke directly to the in-charge to ask for 10 sets of dressing items for home, using the list which I wrote for them the previous night. Fortunately SSN R (the morning SSN, not the permanent-night one that quit) was willing to call the store to put in this special order together with topping up of ward stock. When the store items came, I re-packed the items for this patient into a box for home and SSN R instructed SEN M to bill the items.

After work, I reflected on the matter and it occurred to me that I was behaving like a bureaucrat. To reduce my own workload and to avoid piling work to my colleagues, I had put the patient's wishes in a secondary position. I am not proud of this incipient change in my work attitude.

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