I read Lim Kit Siang’s post titled “Let Mohd Yusry be the last accident victim to die because of public service indifference” with great interest, anguish and anger.
It is a tragedy that a young person had to pass his life all due to the careless and selfish attitude of the driver who knocked him down and yet hesitated to bring the victim to the hospital (ok, I agree that the driver was in shock but still..), the people who gathered around the injured and did nothing and finally the recklessness of the person handling the ambulance service.
Yes, a person’s life could have been saved if only everyone had done their part – if only.
Trip to TAR Hospital
Last Saturday, I was watching television when I got a call from my relative just before lunchtime. She asked me to bring her mum to the hospital as she had broken her toe due to a small accident and running a high fever. There was no one else with a car but me that she could turn to.
We went to the Tengku Ampuan Rahimah Hospital in Klang instead of my usual University Hospital in PJ because her mother had her medical records there and the situation was not so critical. After dropping her, her daughter and my wife at the Emergency Unit, I left to park my car.
When I arrived at the Emergency unit and walked towards the non-critical clinic where they were waiting for their turn, I noticed that there were only 2 clinics was opened and there were at least 100 people waiting for their turn to see the doctor. This was not a good sign.
As there were nothing much I could do there, I walked back to the entrance of the Emergency Unit – the place where ambulances would bring in the emergency cases. It never gets boring here – the place where all the action happens and immediately shortcomings were apparent – especially for a hospital that has been tagged as having the country’s second-busiest emergency ward.
Layout of Emergency Unit Entrance
First I noticed that the entrance is certainly badly laid out – the entrance could accommodate 2 ambulances at one go but that is all it can take. When I was there, I noticed that people who arrive at the emergency had a hard time reaching the entrance if there were 2 vehicles at the entrance.
Sometimes even the ambulances had to wait for the cars to drop the patients and drive out and it is not easy to drive out. You need to make several turns before you can align the car to exit. It is made worse by the large area designated for ambulance parking.
There is only 2 parking lot allocated for the emergency ambulance but 10 other parking lots were taken by non-essentials hospital vehicles (including one which the staff took to “tapau’ (pack) their food from outside) making the whole area crowded.
Compared to the University Hospital Emergency Unit which is well planned, you drive up to the entrance, drop the patient and immediately are able to make a U-turn to leave the place. The entrance is also not cluttered with non-essentials vehicles – the security guards made sure of that.
The last thing you want is someone dying just because there was a minor “traffic jam” at the Emergency Unit entrance.
Readiness of Hospital Staff
Certainly not like the series ER that we have seen on TV.
Here, despite the arrival of an emergency case, the couple of staff at the emergency counter rather spends their time chit-chatting than rush out to greet the emergency case with a wheelchair or bed. It’s pathetic to see someone have to actually go in and tell them that they need a wheelchair or bed to bring the patient in.
There was one case that I witnessed – a car came in and 2 guys rushed out. One opened the back door whilst another rushed into the Emergency Unit counter and then returned to the car. There was an elderly lady laid at the back of the car (I assume it is their mother) and she was not moving.
A couple of seconds may have passed before the hospital staff leisurely walked towards the car with a wheelchair. This act angered the guys who were trying to carry out the elderly lady. This staff then went back and once again leisurely walked towards the car with a bed.
He and the security guards who were standing beside him did not help much to carry the lady to the bed. All were done by the guys who brought the lady in. A couple of seconds of action could decide whether the person lives or dies and yet the hospital staff at the Emergency does not seem to care much.
The only one who worked hard was the ambulance drivers and their assistants who work fast to get the patient into the critical area (as I saw one where the patient was bleeding from the head).
At University Hospital as I have experienced when I send my dad to the Emergency Unit, things were different. The emergency counter was always in view of the entrance and whenever a vehicle pulls up to the entrance, the hospital staff will always be on standby to assess the situation.
Not Easy Registration Process
It is disheartening to see people with injuries to the neck, hands, fingers and head are made to wait for minutes at the registration counter to register the particulars and then to walk towards another counter to pay RM1.00 registration fees.
Only after that, they are allowed in to see the doctor. Man, this emergency unit that we are talking about – it should be the other around.
Go and see the doctor first and whilst that is being done, get a nurse to jot down the personal particulars and once done, do a proper registration and make the necessary payment.
Ambulance Service SOP
In Lim Kit Siang’s blog, one of the main complaints was the lack of urgency by the person handling the ambulance unit. After watching how things got done at the Klang hospital, I have to agree that it is a bit chaotic at the Emergency Unit.
There is nothing to indicate that the ambulance is being sent out for emergency cases. The driver comes to the entrance, looks around for a couple of minutes and then walks towards the ambulance. But then he has to wait for the nurse and the assistant to come and enter the vehicle as well. It takes some time before everyone is “reported” in and only then, they rush out with siren blaring.
They should look at the Fire & Rescue Department’s SOP and start learning a thing or two on readiness for an emergency, practically running towards their vehicles with the necessary equipment all ready and packed up. Crucial time may have been lost by the ambulance telephone operator getting the location and other particulars and the last thing they want to do is to aggravate things by driving out the ambulance at a slow pace.
The emergency unit must be operated in a “Fast & Furious” mode and not in “Slow & Steady” mode.
Level of Cleanliness
There is a small issue on the lack of cleanliness but the last place you will expect them to happen is in a hospital. The drains around the Emergency Unit were clogged and stagnant making it a perfect breeding place for mosquitoes.
During my time there, only once I saw a cleaner mopping the floor but I failed to understand why no one had bothered to clean the awning which was full of rubbish or to clear a worn-out shoe on top of one of the hospital vehicles.
Emergency Case Timing
When we arrived at the Emergency Unit, it was about 2.00 pm and by the time we left, it was already 7.30 pm. Almost 5 ½ of hours in the Emergency Unit for only to spend about 10 minutes with the doctor who only advise that having a high fever was normal and gave the usual medicine for the fever. Of course, they also did a blood test to be sure but it took almost 2 hours for them to get the results.
Perhaps the staff at the Emergency Unit are not motivated enough to act fast or the budget for the unit is insufficient. I do not know but certainly, there are obvious shortcomings in the way the Emergency Unit is being handled and certainly, the means to improve on them is not expensive or takes a very long time.
But to start improving things at the hospital, someone needs to wake up first and get back into the realm of reality.