pandangan tentang on-call ke rumah.

randau hal baka nya ba 'sembang2'

ditok topik lain akih~

ada tak sircullar ttg on call ke rumah?... aku belum jumpa agik... so bermakna on call di rumah bukan la satu larangan tapi atas budi cara kita. Asalkan kita tanggung risiko. Tapi untuk lebih selamat bagus suruh relative bawa ke klinik untuk further management. kalau ngesah org mati tak hal.. sebab mmg tak boleh nak buat apa.. kalau org itu masihbernyawa tapi nyawa2 ikan , sedangkan kita bua on call ke rumah tapi tak bawa apa2 kelengkapan malah tak buat apa2 pun . Nanti kena inquari org kmpg.. makin susah kita di buat nyer. sedangkan niat kita baik tapi di salah anggap merka yang tak tau apa2 pasal kesihatan ni.

auk, aku pun sik pernah nanga circullar ya! aku rasa bagus ko check buku KD management untuk kepastian. mun sikda jawapan dalam ya, ko consult SAMO IC ko sia. tp aku rasa sikda pun disebut tentang house call dalam KD management. mun SAMO IC kau sik dapat meri jawapan maksudnya benda tok terpulang pada budi bicara kau aja lah. patient datang suruh buat house call terpulang pada kau jak mau pegi ke sik. kelak mun orang complain ngan PKB ko salahkan SAMO IC kau sebab nya sik dapat meri jawapan.aku sekali udah pegi conform death kat sitok. 2 bulan lepas.

Kita bukan deresa yang di upah buat kerja sampai di rumah..... Cukp la setakat di klinik bila attend kes... kelak jadi kebiasaan plak...

ada sekali patient suruh aku buat house call, pandai2 nya suruh aku bawak neb machine. aku sikmo. hujung2 aku pakai keta sendiri pegi amik patient di rumah bawa pegi klinik lepas ya hantar nya balik gik. tapi patient tok nang kesian la. 78 tahunumur nya, diam sorang, K/C B. asthma. lepas ya sikda MDI. mujur jak jirannya selalu ngabas nya dirumah mun sik, aku rasa nya mati pun orang sik tau. lepas aku antarnya balik nya meri aku RM10 nyuruh aku beli minyak tapi aku sik terima, walaupun nya masukkan duit ya dalam poket aku. aku amik masuk dalam poket nya balik. lepas ya keesokkan harinya aku refernya ke hosp. tulis ku dalam referral letter pasal masalahnya dan nya perlu MDI. kinek tok jarang dah aku nampak patient ya sebab nya dah ada MDI. berpuluh tahun nya kena asma sik pernah diprescribe MDI. aku request baru ada tindakkan. susas susah..

bagus tindakan tu.... itu lah maksud nyer bertimbang rasa...kalau ada niat baik , maka yang baik juga datang... GOD ALWAYS WIF US>>>

Saudara mathew memberikan ide yg sesuai utk you prevent masalah tok. Tapi beritahu big boss ( SAMO )dolok. Sebelum molah meeting you mesti rapat2 dengan orang kuat kawasan kau. Etika kerja mesti diterangkan dengan jelas. Aku dolok pernah dipanggil kerumah, oleh kerna pt ya nazak, aku terpaksa pergilah. Sebenarnya, masalah tok bermula dari orang pertama yang memulakan oncall di rumah , jadi org kampung ambik kesempatan. Kelak mun you mdh sik boleh pergi ke rumah, cdak org kampung jawab kenak deresa dolok boleh. Time ya lah kita jadi mangsa. Memang susah mun ada mslh camtok apatah lagi nak deal dgn org kampung. Aku arap ko sabarlah dolok, lagipun ko baruk sebulan lebih di tempat ya, PR mesti maok dijaga. Jgn sampe ada yang bermasam muka dengan kau. Kita kerja mesti maok happy, baruk kerja boleh jalan dengan betul. ( org kampung nak menguji deresa baru )
-ikut apa nak dipadah oleh saudara Mathew-

betul la padah kau ya musrgmude, semua nya start dari deresa dolok2 yg bt oncall ke rumah ya. then kita ya baru tok jadi mangsa cdak nya. 'kenak deresa dolok boleh dtg ke rumah ktak x mau lah?'
susah jua mau jawap cdak pt. ya. klk x dilayan, YB dirujuk cdak nya. maklum la political area.

Tak termaktub pun dalam kamus kehidupan PPP, kalu dia orang komplen biarlah...kita create problem yang baik dengan mereka...buat problem...jangan lari...selesaikan sekali....nak tonjolkan diri ader banyak cara..terpulang...kalu mereka boikot tak nak berubat kat KK Kuala lawas, biarkan..hospital Lawas kan dekat...senang kerja kita....

c boh nak susah ati geng..mun nak on call, stay jak d klinik...c buh lalek setegal kita x g house call alu d report ngan YB.., ya urusan cdaknya ngan YB.. P mun YB yang educated nya x akan layan punya hal yang remeh tok..mun dah u terpaksa nyebrang sg n bwak peralatan klinik g umah orang, a than, jika apa2 yang berlaku terhadap u, sapa yang bertanggungjawap...? YB nak tanggung.. ..klinik di buat utk org berubat...i rasa pnduduk d cia saja nak uji dressa baru kot....baik u rundng ngan chif u..k. x yak nak cari penyakit...yang susah diri sendiri..

rilek rilek jak isap gam lok.

betul tu, kalau perahu yg i naik tu tenggelam terlanggar kapal selam siapa nak tanggung? da la buat kerja yg x da dlm skop kita. tu la org kata risiko tanggung sendiri.

"on call " ke rumah adalah tiada dalam etika keja kita sebagai AMO...on call ke rumah adalah di lakukan oleh DR. Private/luar/swasta..ia telah berlaku sejak dahulu lagi....On call ke rumah akan menyebabkan perihal yang tidak baik kepada diri sendiri dan profesion tuan - tuan sekelian kerana ia menyebabkan banyak masalah yang tidak di ingini belaku....Sebenarnya ia tidak boleh di lakukan ...Jangan Lakukan Kalau kena Ia akan menyebabkan tindakan undang2 ke atas anda.

hai kawan..... perkara ni bukan perkara yang harus di pandang ringan...dan jangan buat keputusan sendiri... berbincanglah dengan SAMO atau CAMO di tempat kamu.. catatkan jumlah kes on-call kerumah...apa kes... (ringan/serius).... beritahu mereka dengan segala buktinya....
bukan apa... contohnya... kalau U pergi on-call kerumah... U tak tahu apa kes sebenarnya... apa yang harus di bawa.... ? tank Oksigen... Neb machine.... semua itu saya rasa mustahil.... dan yang penting.... masa U buat on-call ke rumah..... ada pulak pesakit datang ke klinik..... bangaimana?.... kita dituduh..... meninggalkan klinik..... sebab kita tak tahu.... adanya kecemasan atau kes yang lebih seruis...... jadi kita akan serba salah... oleh itu... berbincanglah dengan SAMO/CAMO.. supaya adanya satu kenyataan bertulis dari Pejabat Kesihatan Bahagian yang memberitahu bahawa... PPP akan ON-CALL di klinik sahaja.... tak kira ap kesnya..... memeng itu tempat kerja kita.... supaya penduduk dapat sedia maklum dan kita dapat menerangkan kepada mereka mengapakah ON call tidak dibenarkan lagi kerumah.... Sebab di tempat kami disini... kita tidak melakukannya... atas arahan dari pihak atasan samada untuk merawat pesakit atau mengesahkan kematian........
Walaubagaimanapun.... perkara ini.... berbailk kepada pihak atasan kitai....
Kita semua PPP yang perihatin

Hi guys, especially Rie
House call is a phenomenon not just in the rural areas but also in the towns and cities. And believe it or not, it is more common in the town than in the kampong! In the town, the well-to-do patient calls the general practitioner to his (patient's) house and he gets what he wants. The GP on the other hand charges the patient five to ten times more than would normally if the patient were seen and treated at his clinic. Now, both the patient and the GP are happy. Fair, isn't it?
Now, let's look at your situation. From the tone of your words, I could see that you are very frustrated and disillusioned. Well young man, that's life in the outstation. Nobody said it would be easy. Your supervisors (and I suppose they are your very seniors) would smile at your complaints because deep in their hearts they know that their concerted efforts in educating the kampong folks of the disadvantages of house calls during their times in the outstations in those days (the sixties to the nineties) have finally paid. You see, in those days, we attended to between ten to twenty house calls in a month. Some stations experienced more. Our supervisors then understood our predicaments and advised us to look at it (house call) as a challenge and an opportunity instead of as a problem. By an opportunity I am implying here that this is a chance to speak albeit politely of course directly to the patient and the rest of the household members and their neighbours (and I am pretty sure there is quite a number of village folks both young and old who are eager to see their beloved deresa perform the begama, nerepong and the puchau and the sampi - nyebut munyi laut, nelah munyi kenyah, nyampi munyi tambi, etc.) of the disadvantages of examining the pitiful patient without access to proper lighting, good ventilation, oxygen, drip, observation, etc. you cakap ajalah apa-apa. If there is a WKK in the crowd so much better and make sure to get him to assist you. In other words, make him look as important and an indispensable partner in our health delvery system. Please remember to treat all the people as your friends and not clients as you do in the clinic. Believe me Rie, gradually you will see lesser house calls, have a better relationship with the people and more friends than you can ever imagine. Once you regard the kampong folks as your friends and you as theirs, life will be more interesting and joyable. You will find that it is much easier execute your programmes which involve the participation of the people in the village later on. You will be very proud of yourself eventually having accomplished a zero percent or at least a reduction in the percentage of house call during your PPP meetings.
Do not explain procedures. Kampong folks are not interested in that kind of stuff. It's not in their dictionary. You too if you face an emergency, you won't want a lecture. Are you not from a kampong yourself?
And politics? What politics? Rie, in your operational areas, you are the director of health, or if you want it, you are the minister of health. Don't you realise that you are representing your YB Health Minister, YBhg Director and DHO? You are the most powerful health personnal in the area man. You execute this and that programmes. And for whom? For the wellbeing of the rakyat of course. Doen't that make you look like a YB? And the secret to achieving success is firstly to humble youself and not be selfish. Work smart. Identify the community' health problems and needs. Know your areas and the people well. Next is to work closely with your supervisor and the other sectional heads. Do not underestimate their abilities for they can be of great help when it comes to project implementation and finance. And finally, always attempt to improve yourself in your chosen field.
(Sempurai)

setuju....ku penemu nya kaban,,,setiap ada yang buruk ada juga kebaikan juga..tiada setiap keburukkan itu tidak ada kebaikannn...........

TQ geo... it's true what is u had mentioned... it's much depend to ourself as PPP in that kind of kampung folk in the KK operational area... how we can let ourself by dealing with the cases and kampung needs/folks due to House call.... as professional...and rasional...i thing it's should not be a problem if u have 2 PPP in the clinic was stay-in.... but i sure not all of our PPP been through this kind of situation.... maybe.... in some area... only.. because we have our WKK in the kampung to look to simple case incase on emergency...... how about of MCH case....are our JM willing to attened the case.... i sure them can! Back to the what had Geo mentioned.... we have to make good relationship, friendship with kampung people... wherever we are.. what is the purpose we was there..... this is for short of time only..... you will miss it's when u are transfer to other KK later on... this it's the challenging to we all.... know... our senoir know too.. our SMA know too, our CAMO know too.... but not for the MO... because we(PPP) are the boss.... as impress by Geo..... do the best my friend... we are Super PPP... any problem... have rise up... now we have a FORUM...use it!... let all our friends know(not are Personal matter)...let us disscus... and find out the solution.. Bulat Air Kerana Pembentung, Bulat Suara Kerana Muafakat..... kami semua PPP Perihatin.... tq.

well then, it's seems that we had a solution from this geo7365 person. BUT talking is always easier than done. it take only a single breath to talk, give ur opinions and risen up your ideas but to actually implemented or do what's said is much harder. please know that no job is easy. personally, i wouldn't be proud of those little changes and decreasing in housecalls. u yourself said this problem has arise since the 60's and up until now its still does occur. its been almost 50 years for heaven sake. housecall still does happen. do we really want to be proud of those little changes we make that took us about 50 years to solve. personally i think its a silly problem. but you are right geo about looking at the problem as a challange because it will make us work even harder/smarter/better. but opportunity?? i do not considered this problem as opportunity..opportonity as u implied is by speaking direct to the patient about the disadvantages of housecall BUT u are just hipocrit because u yourself said that people wouldn't want to be lecture when facing an emergency. so i dont think that they will listen to us. maybe back in the old days, those kampong folks isn't interested in knowing what procedures we done but now most of them are educated and they want to know every procedures we do. they will ask us about everythings. i think what rie mean by political inteference is sort of like this. have u ever come across a patient that come to clinic then started to demand special attention like wanted to cut the waiting line, not paying the RM 1 fee, wanted us AMO to refer them to MO without any apparents/ obvious reason or sickness and when AMO cannot agree/ comply to their special needs they would started talking about they know this YB, or all those high ranking politicians. its these kind of patient that rie talk about. back in the old days, maybe those kampong folks look at AMO as YB's, director of health or even minister as u had said. but now things have change. those kampong folk are now well educated. some of them are DR., lawyer, YB or high ranking goverment officer and believe me that they wouldn't look at us a second time. nowadays we are just an ordinary goverment serventhat work as AMO to give health service to those rural folks. we are not more than that. maybe you were treated as YB back then but now i dont think so. last year when i was still working at A/E i came across this patient who wanted to be seen first even though he was coded as G2. normally in a/e we treated patient according to coding. red, yellow and green. also there is G1,G2 and G3. but this guy want to be seen first. at that time we ourselves are really busy and lots of other patient to attend to.we did explain to him about our procedures and priority and he started talking about he know this YB, that politician and so. dissatisfied he call a politician to call our a/e in favor of him. the politician did call a/e and i was the one who answer the call. thankfully this politician is quiet a gentlemen and politely asking me what really happen and i did explain to him and he is very understanding. i thing the patient just left after that.. hahaha... just a couple of weeks ago there is this man came to my clinic. asking me to do housecall. i thought it was an emegency case but i was wrong. they actually want me to go to their house to take a look at their mother who was sick and they want me to decide for them wether they should bring their mother to hospital or not. isn't that a very silly thing to do?? the patient is a very old lady, broncopneumonia w coad. just discharge from hospital a week earlier. she even has a follow up appointment that has pass 2 days earlier but she didn't go because the son doesn't want to lift her up. he said her mother has been really sick for a week. they actually request to discharge from hospital. so i said i cannot go and they should really take there mother to the hospital if she is really sick like he said. personally i think if something drastic not done to solve this sort of problem, this will still continue for a very long time to come. it took us about 50 years and we only manage to reduce it only. are we going to take another 50 years to really reach that zero percentage housecall? but geo, you are certainly right about treating patient as our friend. thats a very nice thing to do. infact we should treat patient as our family. to me, when i see an old lady come to the clinic i think about my own grandma, when i see an old man i think about my grandpa, when i see the little children i think about my own children, when i see a pregnant women i think about my own wife when she was pregnant and all the hardship that a women go trough while pregnant. and we really should improve ourselves. to give a much better quality service to our society.

hai renndy... u are absolutly right... brothers.... even my KK just 15km from Hospital... i;ve experince all this things...... the kampung folk is very demanding.... even that they have a own transport to send the pts directly to hospital.... but them still insist us to sending the to the hospital...what should we do???... I also been working at A&E Kuching..... lot of kind of this thing happen.... almost every day... maybe some of our PPP facing a smillar prolem also... almost the make trouble is for the cases code G3.... waiting in long period of time... it's hard to do like u just said.... it's damm true... for U and ME....us treat every pts like our family....and we always improve our service and upgade our knowledge...but we didn't let they abuse our cencerness... sabar brother... berbincanglah dengan CAMO.....

Bujang Lelayang Mandi Lemai
Anak Iban Ngeregau Indu Bidayuh

pedis mata meda jarak kita diak ungal

Nda nemu ku spiking2 tu parrr... nerang ka ku meh

nama nyak deh..

well....u know....don't know haa.....no need lah....

auk,meda gaya meh