How trainee medicos (mis)handle critical cases at Lal Ded Hospital

How trainee medicos (mis)handle critical cases at Lal Ded Hospital

SRINAGAR: At Lal Ded Hospital, the emergency services are left in the evenings to inexperienced interns and postgraduate medicos who are unable to handle critical cases in absence of senior doctors.
Ambreen Khan is a case in point.
The 33-year-old woman was brought to the hospital in the third month of her pregnancy. Bleeding profusely, she sat in the examination room and cried before a postgraduate medico, who doesn’t know what to do with her.
“You sit here. I will call a registrar,” the doctor told her, and tried to telephone the registrar. But she didn’t answer the call.
Ambreen went on crying, fearing that the unstoppable bleeding may be the sign of a dead foetus.
She showed her medical reports to the doctor, revealing that she has diabetes.
“Why didn’t you tell me before? Do you know you are at a risk of miscarriage?” the medico said, and again tried to contact the registrar. She didn’t respond, yet again.
“Wait,” he said. “The doctor will come, and she will help you. I am new here.”
An hour passed, but the doctor didn’t arrive.
“For how long will you keep me waiting here? Do you even realise what bleeding during pregnancy means?” she shouted at the doctor.
Seeing no help coming from the novice, she made a call to her private gynaecologist, who happened to be head of a unit at the Lal Ded Hospital.
The doctor rushed to the hospital and began by scolding the postgraduate medico for not asking Ambreen to go for an ultrasound.
“Further delay could have resulted in her miscarriage,” she said, and started examining the patient.
“You are having a low-lying placenta, medically known as placenta praevia. Your sugar level is also uncontrolled. You need to be admitted to the hospital. You should thank God for saving the baby,” she told Ambreen.
The postgraduate doctor admitted Ambreen to the casualty ward, put a catheter, connected to a plastic pouch, in her uterus, and asked her to rest. But he didn’t fix the catheter properly, and was scolded by a senior who noticed it.
The senior sets it right, and Ambreen was finally able to relax on the hospital bed.
She is, however, not the only one who was mishandled at Lal Ded Hospital in the late hours.  A resident medical officer at the hospital said it was a routine.
“This is not the first time that a patient has suffered here. It is a routine. During the evening hours, only two postgraduate doctors attend patients in the casualty section where mostly emergency patients visit,” shared the officer, pleading anonymity.
“A patient being treated by a private gynaecologist can still manage, but those who come from far-off places suffer the worst,” he said.
The officer said once a patient from Lolab, Kupwara, came to the hospital with a complaint of preeclampsia—a condition involving high blood pressure in pregnant women. She also complained of spotting, he said.
“The intern who saw her was so inexperienced that she sent her home after prescribing some tablets. After a couple of minutes, the patient delivered a dead baby on the floor of the hospital,” the officer shared.
The postgraduates blame the seniors for the mess.
“The meaning of a postgraduate doctor here in Lal Ded Hospital is ‘Pyaara Gadha’ (darling donkey). We have to do whatever we are asked to do,” a postgraduate medico said on the condition of anonymity.  “We are in a learning phase. How can one expect a first year postgraduate doctor or an intern to handle a complicated case? Yes we do have a register here, but she remains busy with her own work. She is rarely available for assistance when we call her.”
Another postgraduate doctor added: “The head of a unit and other senior doctors remain present when a patient sent from their private clinics is at the hospital. But they never rush to the hospital if it is for a poor villager who cannot afford to go to a private clinic. And we are just Pyaari Ghadiyan here and will continue to be so.”
Principal Government Medical College, Srinagar, Dr Qaiser Ahmad, said he would enquire into the issue.
“The job of a postgraduate medico or an intern is to just screen the patients. A patient who is critically ill has to be sent to the labour room straight away,” he said.
“If this is happening at the hospital, I will look into it. A third year postgraduate doctor must be there with the interns and first year postgraduates for guidance.”

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