Well I have officially completed the first 36 hours of gainful employment for the Beechwood Community Clinic. As luck would have it, I began my time as a Canadian doctor in the Emergency Room. It was not too bad, a pretty forgiving 24 hours all things considered. The role of the emergency room in Canada is very much the same as it is in the United States in that it serves as the catch all for anyone who does not have a personal family physician (called orphans in Canada) or those who cannot get in to see their personal physician. The patient complaints were not all that dissimilar to those seen in any urgent care setting: coughs, colds, gastrointestinal problems, as well as the odd trauma. In addition to these general difficulties you also see the expected cardiac difficulties etc that come along with an Emergency Room.
The two biggest differences that I noted were the social admissions and the difficulty with language. Let’s begin with the social admissions. Since the health system is socialized, this includes the nursing homes. So, when a patient comes to the hospital and needs to go to a nursing home and the nursing homes are full, then they stay in the hospital until there is a bed available. It is probably not the best use of resources, but it does fulfill the needs of the patients and upholds the social contract. It will be interesting to watch this over the next several years.
The second difference that I noted was the difficulty I had with the dialect as well as the colloquialisms. The dialect was very interesting for me and on a couple of occasions I had to grab one of the nurses to help me decipher what the patient was trying to say. It was especially difficult for me as the evening wore on, and my fatigue increased. Add to this the use of different phrases to explain things and it made for a very interesting evening. My favorite saying form the evening was from a patient in response to the question describe your pain…..’it’s like water running down my legs’. Now I have no idea what that means, but it is certainly descriptive. I am just glad the response was not along the lines of ‘ the way water smells when you make butter’. The nurse translator was not very helpful in figuring this phrase out, and so we had to come at the question form several different angles.
My first day in clinic was very enjoyable as well, and it was much like any other clinic in many respects. What made it more enjoyable was the small town feeling of the clinic. It is a familiar feeling for me, and reminds me very much of my time as Dugway Army Proving Ground. One of the best treats of the day was the presence of a coffee break that happened around 10:30 am. Since there is no scheduled time for tea or coffee, one of the nursing staff brews a pot of coffee and steeps a pot of tea and brings all of it to the doctor’s work station for everyone to enjoy. It was a very pleasant treat in the middle of the morning.
All in all it was a very enjoyable start to my Canadian medical system. In the next several days we will talk about the other big differences and the challenges that I can see myself facing as time progresses. In short, standard international units (http://jama.ama-assn.org/misc/auinst_si.dtl) in place of conventional units as well as different medications. More to come.
The two biggest differences that I noted were the social admissions and the difficulty with language. Let’s begin with the social admissions. Since the health system is socialized, this includes the nursing homes. So, when a patient comes to the hospital and needs to go to a nursing home and the nursing homes are full, then they stay in the hospital until there is a bed available. It is probably not the best use of resources, but it does fulfill the needs of the patients and upholds the social contract. It will be interesting to watch this over the next several years.
The second difference that I noted was the difficulty I had with the dialect as well as the colloquialisms. The dialect was very interesting for me and on a couple of occasions I had to grab one of the nurses to help me decipher what the patient was trying to say. It was especially difficult for me as the evening wore on, and my fatigue increased. Add to this the use of different phrases to explain things and it made for a very interesting evening. My favorite saying form the evening was from a patient in response to the question describe your pain…..’it’s like water running down my legs’. Now I have no idea what that means, but it is certainly descriptive. I am just glad the response was not along the lines of ‘ the way water smells when you make butter’. The nurse translator was not very helpful in figuring this phrase out, and so we had to come at the question form several different angles.
My first day in clinic was very enjoyable as well, and it was much like any other clinic in many respects. What made it more enjoyable was the small town feeling of the clinic. It is a familiar feeling for me, and reminds me very much of my time as Dugway Army Proving Ground. One of the best treats of the day was the presence of a coffee break that happened around 10:30 am. Since there is no scheduled time for tea or coffee, one of the nursing staff brews a pot of coffee and steeps a pot of tea and brings all of it to the doctor’s work station for everyone to enjoy. It was a very pleasant treat in the middle of the morning.
All in all it was a very enjoyable start to my Canadian medical system. In the next several days we will talk about the other big differences and the challenges that I can see myself facing as time progresses. In short, standard international units (http://jama.ama-assn.org/misc/auinst_si.dtl) in place of conventional units as well as different medications. More to come.
Posts
No comments:
Post a Comment