It was a sunny Monday. I remember the very first day working in Monash Medical Centre. It was orientation for all the newcomers. Being absolutely foreign to the land, I was intrigued by how they communicated with each other, so polite, and so diplomatic. The way they have portrayed themselves, absolute diplomats. Walking into a hospital full of Whites with a good mix of Asian was a new landscape for me. Having grown up watching Grey’s anatomy, this is very relatable.
Thrown into the Endocrinology specialist clinic on day one, not knowing anyone or how the clinic works, and only the head of the department, I was told to sit in and follow through the clinic and later attend to various meetings. In the clinic, I was really impressed by their consultation and their culture of communicating with patients. I realise the time they have taken to see a patient has by far gone pass any clinic sessions I ever had. The patience the doctor has, the politeness and the invitation to the patient to provide input for their treatment, now, this is new. Being a Monash student, I now believe that in this setting, it befits what I was taught in school.
I realised at an instant – this is a new culture. A culture I was not exposed before.
I had first hand visualisation of a specialist dictating his consultation to the GP regarding the patient’s case, so as to update the GP on the progress and the management plan. Electronic records have never been so enlightening to me.
12.00PM and it was lunch time. I was told that there will be food in the meeting. It was Grand Round and they talk about current research, issues and management. It was intriguing to see how all the bright minds debated about the issue. While research continues to drive every day medicine into new management and new procedures, the outcomes of research has never been more appreciated than what I have experienced in this setting – the Australian setting.
After having gone through 18 weeks, 6 weeks in each posting, 3 postings in total, the learning culture here is far different. At any corner with any doctor, it is a matter of want to learn or go back home early. Every health professional provides an opportunity to learn, be it the doctor, the nurse or the pharmacist. They will invite you, ask you and query your opinions. They will invite you to be part of their team. They will ask you questions pertaining to the case. They will query why you would suggest that. As a member of the team, you are part of the system and you are part of the patient’s case. Being included in the case means that you effectively become part of the managing team. Now, this is the career I signed up for.
I feel many a times the culture in Malaysia hasn’t been the most enabling and supportive. Sure, doctors are busy, nurses are busy, and everyone’s busy. In Australia, they acknowledge that they are busy but they take the time to return to you and actually invites you into their discussion. It is a culture that enables an individual to participate and learn.
Truthfully, this is an article drafted many months ago. I have yet to stop thinking about the work culture and how to potentially bring about this culture forward in the Malaysian setting. I have had numerous discussions over the last 10 months, and in every healthcare-related conversations, I have never failed to mention “you know, in Australia…. this is just how it is.” Truthfully, this is a setting Malaysia will probably never have.
Now, having experienced both the Malaysian and the Australian system, I have never been more enlightened, and inspired to do more, be better. It’s the culture and the amount of professionalism in the hospital, between doctors, doctors and patients, the team, and with the nurses, physiotherapist and all the allied health professionals. The amount of respect given to every member of the hospital is unprecedented.
Are you happy to do this?
It is encouraging and motivating, and it is interesting to see that at every corner I turn, whenever I looked lost, someone will inevitably ask me if I’m okay. I like that the culture and the atmosphere is so uplifting, so supportive. And of course, at every turn, there’s always coffee.
Here’s a typical breakdown of daily work life in a Endocrinology setting:
- Be there at 0750
- 0800 Ward rounds. AM Registrars would have already received the handover.
- If we’re lucky 1000 we finish ward rounds and we go for coffee.
- On days where there’s clinic, the registrars will all go for clinic.
- On days where there isn’t clinic, the registrars and the residents will see all the patients from referrals, placed at other wards. On good days, we finish by 1500. Otherwise it’d be 1700. Nobody ever stays after 1700. Work is always finished before that. Registrars will do handover with the night registrars.
- Patients directly under the Endocrine unit is usually not many, at most I’ve seen is 7. While referral will usually have at least 60.
In the Neonatal setting where I was working in NICU with Monash Children’s Hospital, this is how it goes:
- A typical day starts with Handover in a meeting room at 0800.
- By 0830 we start ward round. There are 4 teams, Special Care and the NICU team. Each team will have no more than 20 babies under their care.
- Ward rounds will usually finish by 1100 and coffee will be bought by one of the consultants for the ENTIRE unit. They will literally call each team and ask who’s on and who isn’t and they’ll note down the orders, properly label each coffee, and deliver to the pantry.
- Lunch will follow and there will either be tutorials/meetings, otherwise ward work continues, e.g fluid chartings (which I really enjoy doing).
- Occasionally in the afternoon, you’ll get emergency cases where NICU will attend to. I once got to see a TGA baby, it was amazing.
12.26 AM and I never ceased to just imagine that one day, I hope to be working in this culture – the supportive and enabling culture.