“Sir, I have to tell you something”
the sister-in-charge of the antenatal ward said apologetically when I
was taking a round of the ward.
“What is it?” I asked. She was not
one to complain needlessly.
“Look at this” she said. I looked.
There was a trolley, on which there was a used syringe with needle
attached to it and blood inside it. The cover of the syringe and a
couple of blood-stained swabs were there too. A vial lay on its side.
There was blood all over the floor and also on the mattress of the
adjacent cot.
“Who has done this?” I asked. It
was very much against safe practices.
“The unit which had outpatient clinic
yesterday” she said. Luckily the doctors of that unit were also in
the ward taking ward round. I called them and advised their Associate
Professor to find out who it was and take some constructive
disciplinary action against the person. I proceeded to see other
patients in other wards. When I went back to that ward, the culprit
had been found.
“Sir, this is the House Officer who
made a mess during her blood collections” the Associate Professor
said. “I have asked her to explain all the information on safe
practices for infection control and biohazardous waste disposal to
the other resident doctors in the unit. That will be her punishment.”
“OK” I said, and looked at the
guilty one. She was an embarrassed looking girl, tired after
emergency duty the previous day, and scared too. I looked at her
apron. Usually they have blood on it. Hers was not very clean, but it
would not be after 24 hours in the emergency ward. But there was no
blood on it.
“Show me your hands” I said, and
demonstrated how by holding my hands forward, palms down. She
complied. There was little tremor in the fingers, but no blood on
them.
“Turn them around” I said, and
showed how by turning my palms up. She copied my movement. There was
a 2 mm diameter solid-looking dark red spot on her right palm.
“What is that?” I asked, pointing
at it. It looked like blood to me. She wiped it with fingers of her
other hand, but it did not go away. Her colleague tried to help by
wiping it away, but she would not let her do it. She scraped it away
with her nail. It came off. It was a small blood clot, and it was
someone else's blood, as her skin underneath was intact.
“It is a patient's blood” I said.
“We do not have to punish her in any way. She does not wear gloves
while collecting blood, and does not wash her contaminated hands. If
we just let her be herself, she will punish herself in due course.”
I did not say 'by infecting herself',
but I could see from her facial expressions that she had understood.
It was a new but effective way of educating those who do not get
educated by the conventional means.
