Previously, I had written about my experiences working at the Covid 19 frontlines earlier this year, and a detailed list of my job scopes as a Patient Care Assistant at a small Malaysian hospital. However, I have never told you about the various events of sakit kepala (meaning “headaches” in the Malay language) I get from working there.

However, these little mishaps and frustrating events are now only in my fond memories, as they are great insight into what the healthcare system is really like, and remind me that there will always be things to worry about when it comes to the health of the people. It also dawns on me that running a hospital is not easy, and there are bound to be disagreements and inefficiencies in the system, even if everyone truly does tries their best to provide the best care for their patients. If I were to become a doctor in the future, I must not become one of the strawberry generation (in Chinese, a strawberry is said to “bruise easily”, symbolizing our new generation that cannot take little failures and hardships). Therefore, a little hardship is good for training the spirit.

Of course, when I am writing about this, I am aware I have to tread lightly.

The first headache that comes to mind is this particular time we tried to do something as simple as registering a patient, that needed to be seen outside the hospital due to observed possible symptoms of Covid 19. I was sitting behind the counter of the emergency unit, doing admin work (handling of registering of the patients, writing in the case log book, opening certain bills, preparing lab forms etc). I was already juggling more than three things in my mind when a doctor from the specialist center walked up to me and said: “I want to see my patient outside the hospital. Register her under the emergency unit.”

I was confused. This was a patient of a specialist doctor. She should be registered under the specialist clinic, not under emergency. What should I do?

I asked the nurses this question. “Hey, dia patient specialist centre!” called the nurse, voicing my concerns exactly. “Bagilah specialist department register patient sendiri.” (Let the specialist department register their own patient.)

I then brought this patient’s personal details form to the specialist center. I explained to them that a doctor under their department wanted to see a patient outside, and instructed me to register her under the emergency unit. “Jika doctor nak tengok kat A&E, registerlah kat A&E. Bukankah doctor sendiri dah suruh register A&E?” (If the doctor wants to see the patient at the emergency unit, register them there. Did the doctor not request for the patient to be registered there?)

That did make sense, so I left and walked back to the emergency unit, but I was getting more and more perplexed now. So, the question is, should patients be registered under their doctors’ department, or should they be registered at the location there were being treated? Yes, that is precisely the question. I did not know the answer to that, but I knew that there was probably no answer. Perhaps no one has even thought of it before, since it is the first time we have had COVID 19 come attacking the people and and our already overloaded hospital system.

Knowing that doctors usually have the final say in everything (and perhaps rightly so), I expressed this issue to that doctor. “Is it possible or not, to register her here? If it’s possible, I want her registered here. Just register her here.” He demanded, pointing down at our registration computer. I nodded and he bustled off.

“Um,” I said clearly, hoping my colleagues (nurses at emergency department) had noticed, so that they wouldn’t demand yet again why I was registering a specialist doctor’s patient under our unit. “Dr X said to register them here. So I must register them here.” A nurse next to me had heard and agreed.

I tried to register the patient, but… I can’t remember at this point what exactly happened, as it has already been a few months since I stopped working at the hospital, and all this studying at university has probably displaced all my prior knowledge of the details of working! I do recall something about this patient having just visited the specialist center yesterday or something of the sort, which meant that her medical record folder had not been sent back up to the medical record department (known for short as MRD) yet and was still in the depths of the cupboards at the specialist center. So the patient’s details had to be brought to the specialist center yet again, but this time the nurse next to me said she would handle it, storming off with the patient’s details. Just like that, I was no longer involved in this issue.

For your information, dear reader, this is not uncommon. When working at the hospital, I face problems with tracing medical record folders all the time. Hence, for my medical interview to enter foundation leading to MBBS at my university, in the essay we had to write on the spot on our ideas for improving the healthcare system, I suggested that a electronic medical record (EMR) system should be imposed widely throughout the country. My interviewers praised me for being well read, but actually, I still have a lot to learn, haha! It’s just that when you had worked for two months at a hospital facing exactly that kind of problem, with folders missing, hidden in the cupboards or I-don’t-know-if-it’s-at-Emergency-or-Specialist-Centre-or-MRD-or-could-it-have-accidentally-gone-into-the-trash, it’s difficult not to wonder about a solution to this issue yourself.

There are two things I have learnt from this event alone. One, the importance of implementing a electronic medical record system on all medical premises, but of course that takes time and perseverance on the part of the government. Two, I have also discovered that doctors make most of the primary decisions, and as a doctor in the future, I may not be as lucky as I now am to be able to bombard my colleagues with questions or push duties to my fellow nurses if I’m not sure about anything. If I were to become a doctor, my nurses may be the ones to look to me for answers and although doctors are human, too, you just cannot always be saying: “Sorry, but I’m not sure.” Along the way as I am taking in medical education, I must also ensure that I am well read and updated, and find ways to help myself become smarter and be able to think on my feet. That is what is required of a doctor.

Although I have faced many predicaments during my short time as a patient care assistant, I now remember them all fondly and I know they have all helped me in some way!

The truth is – I have managed many things efficiently, juggled five things in my head to do at once, taken orders from two people talking at the same time, run from the first floor to the third floor, and performed at my best on many days. However, I have also made tons of mistakes, been ordered about and scolded often, and faced many frustrating issues while working; but when I think about everyone’s higher purpose here – providing the best care for the patients, it is easy to take every problem with a pinch of salt. It really is. I think it is healthy, it is a blessing, to have a higher purpose. That is what I hope my medical career will be like in the future, since I am sure problems like these, or even much worse, cannot be evaded. I am going to work very hard to attain good results so that I may earn my place along those who own this higher purpose together.

Stay tuned for other obstacles I’ve faced while working at the hospital, during the Covid-19 crisis! I will make the links available here once I have written Part 2 and Part 3 of the little problems I’ve overcome while working. Bye for now 🙂