(31 March 2018)
I find myself marveling at the
difference between the public sector, and private practice. I never imagined
myself to have experienced some of the things I have so early on in my career.
Working in a government hospital
in South Africa for a year has exposed me to a whole different world. Being
fresh out of varsity (well, sort-of), you walk in to your first ever job, and
are expected to take the lives of sickly people into your hands and make a
confident call regarding their treatment. That is a scary thought. Let me
explain…
As a Speech Therapist, part of
our scope of practice is working with people who experience swallowing
difficulties. That is, a neurological, physiological or muscular problem has
occurred, causing a patient to either aspirate (food enters the airway) on
their food, or be at high risk for this to happen. In a nutshell, imagine
drinking a glass of water, and having some of it go to your lungs. Now this
doesn’t only happen on water, but on everything you eat. It will most likely
result in the development of pneumonia, or worst case scenario cause a
patient to drown on their food.
So nonetheless, I walk into community
service, head held high, feeling very important, and trying my absolute best to
hide my very intense nerves. Needless to say it took me no longer than two
weeks to be humbled and very quickly realize that those nerves were there for a
reason. Doctors ask you questions that you (a) don’t understand 80% of, and (b)
are expected to be able to answer with accuracy. So you waffle, and talk the
biggest load of hogwash, throwing a couple of academic terms in to sound like
you know what you are saying. Not even to mention you now have to work with
patients who have all kinds of funny illnesses, diseases, psychological
imbalances and some very traumatic injuries. To mention a few, I worked with
people who were brutally attacked to the verge of death, kidney failure patients,
epilepsy patients, babies who were born unable to suck, children with neurological
difficulties, autism kiddies, cerebral palsy kids, psychological traumas,
stroke patients, and more. Often you will come across a patient by accident,
who has been misdiagnosed by the new intern doctor who “forgot” to refer to
you. This is government. You don’t wear your nice shoes and good clothes to
work, because at the end of the day you walk out feeling a sense of urgency to
find a shower, and wonder what will come across your path tomorrow.
I started in private practice in
January of this year (2018), and am astounded by the complete change in
atmosphere, the respect now shown to you, and the prevalence of dysphagia
cases! Suddenly, doctors (well, about 60% of doctors) know what you do, and
will refer patients to you. Your requests for feeding tubes are seen to as soon
as possible, if not on the same day, and low and behold, your patients
understand you!! Coming from a setting in which most of your population is
third, fourth or fifth language English speakers, suddenly 90% of your clients
are first language speakers, and can communicate with you on a level far beyond
any experience you may have gotten. Eeeek!! Now suddenly I have to start
sounding like I know what I am talking about, and actually making sense too. I
have now been working in private for a total of three months, and already I have
learned more than what I learned in community service and university combined.
Okay, perhaps varsity laid out the groundwork for me, but the extent to which
application of knowledge is actually used is astronomical. You dig so deep, and
come up with these seemingly far-fetched conclusions that really actually make
sense, and earn a high level of respect from the doctors and the allied
community. Critical in-patients need to be seen daily, and bi-weekly or weekly
for out-patients, where in the past many were only seen once a month.
You often come across people who
say they hate their jobs, and that work will always be work. I am one of the
lucky few who can honestly say that I love my job. Yes sure, I very often feel
like I am drowning, turn into a stress-ball, and wish that I could finish work
earlier, or have a day off here and there, but on the whole, my job never
ceases to amaze me. Not a day goes by that something interesting doesn’t
happen; sometimes patients will say things that have you balling with laughter,
you will make someone’s day by telling them their PEG tube can be removed, you
will get a smile from that very sick ICU patient who can hardly function, or
you will be called a “rude pig” by your delusional patient for not giving them
a sip of water.
Although the nature of many of
the cases we come across in public and private is the same, there is a certain
level of care demanded from you in private that you won’t find in government.
You are now able to communicate with patients on a high level, you are taken
seriously by your colleagues and other professionals, and your job suddenly
becomes important. Hospitals now become your home. Medicine fascinates you, and
you are no longer that afraid of needles (hmmmm, yes okay that is debatable,
but you do become accustomed to the necessity thereof, and won’t fight against
it anymore). The transition from public to private was daunting, and took some
time, but man oh man has it been a fun journey.
Later…
Xxx
