It is to be impressed on the minds of doctors and nurses right at the beginning of their training that patients are human beings with self respect and rights, and are not merely objects for learning. It has not been a part of the curriculum, probably because it is presumed that everyone should understand it without being told about it. Then patients are not patients but interesting cases, troublesome cases, or unwanted work, as the case may be.
One manifestation of the attitude of healthcare providers is that they mark on or write on the bodies of the patients without impunity. I recall the student midwives used to put a cross on the abdomen of the pregnant woman in the antenatal ward and labor ward to indicate the position of the fetal heart sounds. It was to make things easy, since they used to monitor the fetal heart sounds in those days. Now we do not find those marks, because they have stopped monitoring the fetal heart rate. That work is left to the doctors. It is quite sad, but true. The nurses are all overworked with paperwork, it seems.
That day I was examining patient in the antenatal outpatient clinic. There was a woman who did not have her blood pressure on the case paper.
"Please have your blood pressure checked before coming for an examination" I told her.
"But I have had it checked" she said.
"Where is the record of your blood pressure on your case paper?" I asked.
"It is on my hand" she said. I looked at her right palm that she showed me, and indeed "120/80" was written there with a blue ball-point pen.
"Who wrote it there?" I asked her.
"The doctor" she said.
So I went with her to find the doctor who had done it. It was an intern.
"Why did you write the patient's blood pressure reading on her hand instead of her case paper?" I asked the intern.
She looked at me for a couple of seconds, and said "sorry, sir!"
We repeated the question and answer cycle five times, with the same result. She would not tell me the answer.
"All right! Tell me your name" I said. "I will write about you on blog." That did the trick. She jumped in her skin.
"No, no! Not on the blog" she said. "A lot of people read your blog."
"Then tell me why you did that" I said.
"The house officer was writing her history on the case paper when I checked her blood pressure" she explained.
"You could have told her to write the value of the blood pressure" I said. "You cannot treat patients like this. They are human beings too. How would you like me to give you your completion certificate written on your hand?"
"Sorry, sir. I won't do that again" she said.
