TLDR Hospital superintendent wants junior doctors who do majority of the work in ER to stop ordering tests and stop treating patients. We are suppose to call for for Senior Residents, and wait. We asked for it in writing, he takes his decision back.
I work as a Junior Resident {J.R} at a public hospital in India. This was one of the only large and somewhat decently equipped public hospital in the area. Next such hospital was at least 60-70 km away.
We get a lot of cases in ER. We junior residents are supposed to triage and as well as do the initital treatment of the patients. We do have senior residents {SR} but most of the time they are not present in the ER room. It can take from 5 to 20 minutes for them to arrive when called, depending on where in the hospital they are, and what are they doing.
Most important part is patients won't wait even 1 minute in the ER, They must be attended immediately. If for some reason you are not able to then you risk getting threats and get yelled at by attendents of the said patient. Also there are only 2 to 3 JR on duty at a time in the ER. So you can imagine how we and the nursing staff are running around like headless chickens.
Despite all this we are somehow able to manage and treat the patients within best of our and this hospitals ability.
Our superintendent once saw some charts and realised almost all the tests done were signed off by JRs, not SRs. This somehow upset him. What was happening was SRs would take the round with us and write down the tests on the paperwork of the patient and we would make the slips that were were given to the attendents of the patients so that they could present it to the labs to get the report. Yes it was them who had to bring in the report from the labs, but it was just in the next building like 40-50 ft over this one.
He once called us in a meeting and told us it was not our place to write the tests and it should be done by SRs or anyone above them. He also said that “we were not there to treat, our jobs were triage”. As much as we all wanted to go into malicious complaiance, we couldn't because this would result in killing tens of people daily, amd many more people spending beyond what they can afford in private hospitals.
We argued that SR were the ones writing the tests and we were just signing the slips. He told that he has seen our writing on the paperwork prescribing bloodworks and CT scans. We further told him that we were more than qualified to order simple tests like CBC, LFT, RFT, chest x ray etc but his needle was stuck there. He said all we were supposed to do was keep the patients stable with fluids and painkillers and call for SR and let them do the rest. He said that this was final and he didn't wanted to hear anything. We were dismissed.
We got out of the office and we started discussing among ourselves that how could we wait to start gastric lagave in a patient who has ingested poision, {weed killer/rat killer is the mostly used poison in sucide attempts here and we het at least 1 to 2 such cases daily} or to order ct scan in a patient with a head injury or ecg in a patient who was clearly having a heart attack. We were afraid for both lives of the patients and our well being. As if a patient died due to lack of treatment their people could get violent.
We entered the office again and superintendent started to acting all pissed off. We told him, you want us to kill people, if it is so pass an order in writing, and until he does so none of us will set a foot in the ER. He knew if he gave us that in writing he was f***ed, and the same if we didn't step in the ER, as a non functional ER in such a big hospital would make quite some news, and none of us would hesitate to tell the truth to the journalists.
During that time our ER in charge and deputy in charge came and asked us to go out and after sometime they came out and told we were to keep doing what we were doing. Superintendent didn't even had the guts to come out and accept that we has wrong. This guy tried to pull such bullshit many times but never succeed.