Worn out on Day 5

I have been working in the medical centre now since Wednesday and already I’m worn out…. am I allowed to say that?  Hmmmmm.  I have been the only doctor with one medical assistant (who is great) out of essentially 7 doctors/Medical assistants since Thursday after lunch… and have been really feeling the long hours.

I am extremely privileged to be solely paeds while I’m here, I am really happy with that.  However the pressure is intense.  I arrive at 8am and start the ward round and usually there are about 100 people waiting in the outpatients department.  I have about 25 kids on the ward at the moment including newborns.  I go around each kid and have about 6 nurses watching me and laughing at how the kids cry when they see me!  They then watch me do my notes.  It takes a while. 

I have been getting to the outpatients department at about 11.30am, by then the kids are screaming and parents are getting upset because they are wondering where I am.  A couple of times I have to run to my room to grab a text book and the patients who have been waiting since 5am scream and beg me to see them.  Of course this gets worse as the day gets on and the pressure increases.

Interestingly the nurse who accompanies me in my room and translates constantly tells me ‘doc, go fast’.  And this is on a day I saw 60 patients!!  I can truly say that every patient I see I take a history, examine, do investigations, and even joke around with them.  I have a feeling she wants me to leave out the examining and joking around bit…. 

We also never stop… when one patient walks out another comes in… and so on.  So you never get a chance to stop and think… or eat lunch…

Where I work there is currently one other dr, and one medical assistant during the day, one in the afternoon and one in the evening.  Sometimes I leave my room and look around to find I’m the only one still seeing patients, yet there are many left!  They all scream ‘dr I beg you see my child’…  but at this stage I haven’t eaten lunch, it’s 6pm… and a tropical rain storm is approaching in which I have to bike 30 mins in….. “of course I will…..”

Then I go to the ward to check on my patients and make sure my instructions were carried out….and they weren’t.  One child is running a fever and not had any paracetamol despite it being charted regularly…. Another baby has low blood sugar which I charted dextrose which has not been given…. Another 2 year old is becoming more and more dehydrated while his fluids are sitting next to his bed….argh

Exhausted I bike home and wonder why I’m here…… yet I choose to come here and do this…. I love the kids here, they are absolutely gorgeous, I love their big smiles and laughter… I do really want to be here.

I know working in developing countries are frustrating, and I’ve been down this road before….. but I need advise on how to make it ok to survive….anyone?