In Emergency and Casualty Out-Patients Department (OPD) many times the patients come in waves. Sometime there are very few patients, and sometime the whole room is filled with patients clamoring for attention. In such situation a fast ‘triage’ of the patients becomes essential.
‘Triage’ is a term when used in surgical or medical setting roughly means categorization of patients in different categories, such those needing immediate attention, those needing urgent care, those where the medical attention can be deferred for some time and those who just needs explanation and referral and treatment on non-emergency basis, such as consultations in routine OPDs.
This process of ‘triage’ requires a high level of expertise and experience as the Doctor dealing with patients has to make important decisions on basis of lighting fast assessment of the patients.
When Dr Dev (fictional name) was posted in AIIMS (New Delhi) Casualty OPD during his junior residency in Surgery, there was a very astute Surgical Senior Resident (SR) who was very fast and accurate in this triage process.
With a quick head to toe scan of the patient with his eagle’s eye and a hand on the patient’s pulse, he would identify those patients who are sick and needs immediate attention. They will be promptly directed to the Cubicle 1 or the Nursing station with instruction to the junior doctors or nursing staff for their immediate treatment. The patients in pain but with no immediate danger to life would be directed to receive an analgesic (pain-killer) injection and were dealt when pain-free and calm. Patients with no real immediate emergency will receive a curt instruction to attend the OPDs next morning with some medicine to provide immediate relief.
The only problem was he had got the habit of referring this scientific process of triage by the term ‘dispose of the patients’. As you well know ‘dispose of’ has negative connotation such throwing away something bad or unwanted.
Once when Dr Dev was on duty, he was sitting alone at the doctor’s table in the Casualty OPD. The Surgery SR was busy with some major accident patient, the Medicine Senior and Junior Residents were busy in the Observational Ward section of the Casualty, and the Orthopedician was busy in the plaster room. A sudden wave of patients came to the Casualty and surrounded the lone doctor (Dr. Dev) sitting at the table. Overwhelmed by the number of patients, Dr. Dev made his best effort to satisfy the patients surrounding him but due to his inexperience his was not up to the task.
Sometime later the SR came to the duty doctor’s table. Seeing Dr. Dev surrounded by the patients he got angry at his inefficiency and curtly demanded. “Why are there are so many patients standing here? Be quick and dispose of them fast.”
On overhearing this, a white-haired elderly patient standing near the table wailed plaintively, “Doctor, I have come to AIIMS for proper treatment. At least look at my age. Treat me properly and not just dispose me off.”
Even with best intention people in medical or other profession sometimes end up creating a bad impression of themselves, their institution or organization by their casual or disparaging terms or loose talk. We have to be very careful even when talking among over selves or instructing our juniors in the vicinity of our patients or clients, lest they overhear and form a poor impression of us or our juniors.
We should show we respect our patients and take them seriously not by just providing them proper care but also addressing them and referring to them with proper respect. No one likes to be taken lightly or treated just as another task to be completed by the doctor treating him or the person serving him.
(Based on true incident)
— NKD
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DISCLAIMER: This article is intended only for fun purpose. The author does not promote or recommend any behavior illustrated here or claim it to be useful. Use of the information herein is at you one's own risk. Before trying to emulate or follow anything the reader is well advised to take into account ethical, moral, legal and other considerations. The author recommends that Medical Practice should be of the highest ethical and moral level keeping in mind the interest of the patient as foremost.
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