Friday, November 11, 2011

Poor Patient Compliance

Went in late to work
and found my friend in a disheveled state.
She had been on, straight for 2 shifts.
11pm-7am and 7am-3pm.

Yesterday we had zero patients,
today I found 4 toxic patients.

Bed 1 was the worst,
apparently she came in
with her baby probably dangling
from her uterus.

She was already full effaced and dilated
meaning she is crowning
and the baby would pop out in 
one miserable 'push'
(isang bahing na lang lalabas na yung bata)

But she came in at the lying-in 
for all the wrong reasons.
We have no resident doctors on duty.
Only midwives and nurses
attend to our patients.

This was her 7th baby,
she was already 44 years old,
her last delivery was already complicated,
she only had one prenatal 
consultation at her health center,
no ultrasound records,
plus she is a chain smoker
(all throughout her pregnancy).

All the high risk factors were there!

This was a patient
who had a death wish.

She was even caught lying,
when asked how her last delivery went,
she said she had no complications.

When her husband arrived,
he told the staff that she almost 
died during her last delivery.

If I was on duty,
I would have asked them
to find a priest
to give her the last rites
so as to truly scare them.

Ang sarap pukpukin!

When I scanned her
prenatal pink card records,
she still had the referral slips
for her lab works,
meaning she did not comply!

The usual excuse!

"Wala kaming pera!"

My friend told them - 
"Yun na nga ho e nag-anak pa po kayo.
Libre po ang family planning 
sa health center."

An ultrasound scan is worth
around P300 while
feeding another child 
would definitely cost more.

The last straw was when she admitted
she was smoking a few hours
prior to her admission -
she was already smoking
when she was in the early
stages of her labor!

Ang sarap sakalin!

No concern for her welfare
nor her unborn child!
Walang kwentang ina!

When her placenta came out
instead of the usual
one big mass of human organ,
it came out in pieces.

Her placenta's tissue integrity
was already compromised
from the beginning.

Not all the placental fragments came out
some adhered to her uterus
which made her bleed.

The institution has no resident doctors
on duty just on call.
My friend was not able to get
hold of any of the 5 doctors
save for one.

I could just imagine what my friend went through,
that situation was a nightmare.

Good thing the doctor was
able to relay her orders over the phone
in the wee hours of the morning.

The patient was technically in shock,
her BP was around 60/40 mmHg.
My friend hooked a double line
and a volume expander.
She managed her patient well
and I commend her
she saved this woman's life
from her own stupidity.

Her stubbornness and non-compliance
to health related advice put
her life as well as her baby's
in jeopardy as well
as the license of my friend.

Lagi na lang walang pera ang rason,
madali yan huwag kang bumili ng pangbisyo
at magipon ka kahit lima-limang piso
araw-araw para sa panganganak.

Hindi emergency ang pagbubuntis,
siyam na buwan ito.

Imagine ang city namin na walang income,
nililibre pa sila sa gastusin ng pangangak,
libre ang gamit at serbisyo.

Compliance na nga lang ang hinihingi,
na dumating sa appointed dates
ng prenatal check-up
at mapalaboratoryo ng libre,
hindi pa din nagawa.

Aba e kung wala ka din naman palang
concern sa pangangatawan mo
at pagbubuntis e di sana
hindi na lang siya nag-anak.

Dapat talaga ipasa na yang
RH Bill para maliwanagan
ang mga mangmang.
(sorry sa harsh word pero totoo ito)

Hindi na nga sila nakapag-aral
sa dami nila hindi din nila mapapag-aral ang anak nila.
Obligasyon ng bawat magulang na magbigay
ng maayos na kalidad ng buhay at edukasyon
sa mga anak nila hindi yung
pagtatrabahuin sila at gawing gatasan
kasi tamad na sila magtrabaho.

Sus! Ad misericordiam lagi,
paawa effect!

Hindi sa lahat ng oras maisasalba
ng awa at ng Dios ang buhay mo.
Kailangan kumilos ka rin bilang tao.

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