FLIMFLAM: “Appropriate waste bin wasn’t provided”- ARD President

The President, Association of Resident Doctors ARD, Obafemi Awolowo University, Teaching Hospital, Ile-Ife, Osun State, Dr Nana Fayowole, was interviewed by a correspondent of Punch Newspaper, BOLA BAMIGBOLA about the alleged harassment of a young doctor by a senior nurse at the hospital.

Let’s quickly read an excerpt from the press release by OAUTHC ARD, signed by Dr. Nana Fayowole, Dr. Anthony C. Anuforo, the General Secretary, and Dr. Adelaja, Olasubomi M., the Public Relations Officer, before reading the interview and the innovation and criticism board’s commentary, Nursing Media Network on some of his distortive statements.

It is with great displeasure that I stand before you at this trying time in our profession, where a series of despicable incidents threatens the survival of this noble profession. I express with dismay the rising cases of workplace assault on doctors in this hospital, in which one most recently involved a female Medical House Officer.

On Thursday 16th of June 2022, a female doctor was forcefully held hostage, confined and verbally assaulted while discharging her duty, by a Senior Nurse in the Female Adult Orthopedic ward (FAOW).

The female house officer had gone to the said ward with her team which included different cadres of doctors, to carry out a procedure (central line placement) on the only patient in the ward at that time.

The team on arrival at 4:30pm informed the nurse on duty.

After obtaining the patient’s consent, they requested for a trolley from the nurse who pointed the trolley to them and told them to get it.

In order not to waste time because the team already got a call from children emergency to see a patient, the house officer willingly brought the trolley.

After the procedure, the team discarded appropriately all sharps used. They wrapped the empty kit with the drape used and kept on the lowest shelf of the trolley and wiped the topmost part of the trolley clean and moved the trolley away from the patient’s bedside.

They proceeded to document for the patient and were leaving the ward when the house officer was accosted that she should go and discard the waste. The house officer was the last to leave so the nurse went to block her way asking her to go back and discard the waste and when she didn’t answer, the matron locked the gate with the padlock.

As if that wasn’t enough, she started shouting and rained a lot of insults on her to the extent that nurses from other wards came to Plead with her to stop and open the gate but she refused. One of the other nurses even offered to bring her attendant to come and help with the waste but she declined

INTERVIEW WITH OAUTHC ARD PRESIDENT BY PUNCH

There was a viral video about a young doctor at the Obafemi Awolowo University, Teaching Hospital being locked up and harassed by some nurses at the hospital. Can you tell us what exactly happened?

What transpired was that my association’s members were contacted to have a specialised form of intravenous access for a female adult in the orthopaedic ward on Thursday, June 16, 2022, which they obliged. The procedure was done and they were leaving after properly discarding the sharps and separated other medical waste for whoever would dispose of it because an appropriate waste bin wasn’t provided where they were.

Dirties left at bedside by resident doctors at OAUTHC 3

Dirties left at bedside by resident doctors at OAUTHC 1

Dirties left at bedside by resident doctors at OAUTHC

Dirties left at bedside by resident doctors at OAUTHC 2

The story, in short, is that when they were leaving, the most junior of the doctors was locked in. I was told they said she wouldn’t be allowed to leave until she disposed of the waste. We learnt that the nurse on duty did that. That led to our emergency general meeting where decisions were made.

Commentary: The assertion that no waste containers for sharps and other waste were provided is erroneous; the wastes in the pictures above were not packaged for disposal, let alone disposed of correctly.

Why was the young doctor expected to do that? Is cleaning up the theatre or waste disposal part of her job description?

Disposal of waste is not part of a doctor’s job description. I perform surgery from time to time and I do not think I have been asked at anytime to dispose of waste generated. If a patient is coming into the ward and he or she is vomiting or defeacating, I have never seen where the patient is made to pack the vomit or the feaces because he or she generated it. It is supposed to be a team work. When things are done properly, nurses are supposed to be there from the beginning to the end of procedures because they will continue the care. They will administer drugs and other checks will be done by them.

Commentary: Are those two doctors patients? And it is absurd to compare bodily fluids (such as vomit or feces) with used sharps which they used at the bedside of a patient in the ward, not even a surgical theater. In addition, the unique role of the nurse is to support the patient—whether they are ill or healthy—in performing those tasks that will promote their health, recovery, or peaceful death if they had the necessary strength, will, or knowledge.

Do you mean it is the duty of the nurses to clean up the theatre and dispose of waste?

It is not the work of the nurses to dispose of waste but people that ought to do the needful were not allowed to do their job. Nobody was calling on the nurse to dispose of the waste. The team that operated didn’t ask her to dispose of the waste.

Commentary: It was not the Doctor’s intent to dispose of the sharps as they hurriedly left, and it is unacceptable to leave sharps by the bedside of a patient. Medical waste should be treated carefully by whosoever generated it for the safety of everyone who comes into touch with it. It should also be managed for ultimate safe disposal and transportation, you ought to do your needful part before others can do theirs well.

Since that incident, what has become of the relationship between doctors and nurses at the hospital?

It is not a nurses-versus-doctors issue at all. It is just one doctor and a nurse that had an issue. This is just a one-off thing. We have resumed work since Thursday and we have been working fine with every other person as a team. Personally, I have had interactions with a couple of nurses. There is no animosity at all.

You said that was a one-off case; but your association, in one of the statements circulating on the social media, mentioned incessant harassment of doctors by nurses. Can you clarify that?

I want to disagree with that. I have not seen in any of our statements where we made any categorical statement that doctors are being abused by nurses. When we talk of incessant harassment, we are referring to what our members suffer across the board even from patients and patients’ relatives. We understand the volatility that is in the land because of hunger and poverty, but, of course, that doesn’t give anybody the right to assault anybody anywhere, not to talk of at workplace.

Nationally now, the Association of Resident Doctors has recorded about 345 workplace assault on members who are junior doctors and that is like one happening per day and it is becoming disturbing. This is the time we should be talking about how to address brain drain. This shouldn’t be tolerated in any form.

Commentary: Though it was not stated categorically that doctors are being abused by nurses, how does 345 workplace assaults correlate with the above press release, signed by you and fellow executives, which was stated that “the rising cases of workplace assault on doctors in this hospital(OAUTHC), in which one most recently involved a female Medical House Officer.”

The question is that:

1. Does that support the fundamental justification OAUTHC ARD claimed for their strike, ignoring Nigeria, which needs your services because they act to be “volatile due to hunger and poverty”?
2. Does OAUTHC ARD have to address a national issue at the risk of endangering the lives of patients at Ile-Ife, while other ARD chapters are working?

This last incident seems to suggest that there is a battle of supremacy between doctors and nurses at the hospital. Is that the case?

Well, I am not aware of that. If a patient comes and he needs to see a doctor, I have not seen where a nurse will see a patient and say, “Doctor will not see you because I am superior to the doctor.” It has not happened before in my recollection. So, that supremacy battle talk is one that I don’t want to agree with. Well, there might be other workplace-related issues.

How can future occurrence of the June 16 incident be prevented?

Like we stated in our communiqué, which the management is currently working on, we need clear-cut job description, detailed and explicit, so that people will know what they are supposed to do. A lot of time, doctors bend backwards to do things that they need not to do, but in order for the patient not to suffer they eventually get those things done. If we have clear job description, somebody cannot be held against her wish for not disposing of waste. If there is somebody who knows their job is to dispose of waste, there will no longer be arguments.

Commentary: It won’t come as a surprise to see resident physicians leaving sharps inside an incision site in the future since “a lot of times, doctors bend over themselves to do things that they need not to.”

Moving forward, what kind of treatment do doctors expect from the nurses?

Doctors and nurses are inseparable. Everyone should just know what they are supposed to do. Let everyone stick to their gun in terms of ethical expectations.

But why the choice of industrial action to protest the alleged harassment?

We don’t want to have another experience where a doctor is locked up for one hour against their wish. She (the doctor) was made to endure that. Her name is flying all over the place; she keeps getting calls from everywhere. It is not good for her mental health as a doctor who is supposed to see patients. She is supposed to be in her best state to be able to perform her duties. The strike was in protest against what she went through.

Commentary: Resident doctors’ failure to provide patients with a fair level of consideration and loving care at any of their association’s dealing is simply evil; it is a careless act intended to undermine or exacerbate a patient’s current health condition, but other medical professionals have patients’ backs.

Before resorting to strike, what internal mechanisms did you explore to address the incident?

The incident happened on Thursday (June 16, 2022) and we (doctors) met. Decision was reached and it was communicated to the management on Monday (June 20).

READ ALSO:

1. OAUTHC Nurses Association (NANNM) responds to malicious claim of Resident Doctors
2. Koyejo & Co, Solicitors of Supreme Court, writes to OAUTHC

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