07/14/2020
GOING TO A TERTIARY HOSPITAL FOR THE FIRST TIME; WHAT TO EXPECT...
In my interactions with many people, I found out that the major reasons many people detest going to tertiary Hospitals [ In Nigeria, Teaching Hospitals and F.M.C s ] is fear of the
bureaucratic processes before seeing a specialist...
Let me try to break it down a little here on the portal of entry or admission into these hospitals and what you should know.
There are mainly three ways in which a patient can get to see a doctor in the hospital setting...
1. Through General Outpatient Clinic/Department simply called GOPD...
These department is manned by Family physicians and is the major port of entry into the hospital...
Usually many patients that come to the hospital without life threatening Emergencies go through this route, it is like the filter to the hospital...
What happens is that when you come to the hospital , you will be required to get a hospital card... this card is very important because it will contain your personal medical history... after the card, you are then seen by the Nurses who will take your vitals signs and direct you appropriately... after you are done with the Nurses, you are seen by a Doctor, the Doctor will take your detailed history and then examine you... after which He determines whether you many need further laboratory investigations (test) or not...He will make a provisional diagnosis based on the information you provided and his physical examination findings... At that point, The Doctor will determine if you need to be transferred to a specialist according to your diagnosis or if it is what He can handle at that level alone...
When the patient is referred to see a specialist, He/she have to rescheduled to visit again but this time around at the specialized clinic where cases similar to his is seen....
The specialist carries on from there!
2. The Accident and Emergency [A & E]...
Most patients that come in through this unit are people with life threatening Emergencies...
Occasionally, there maybe need to triage the patients according to the severity of their cases so they are seen as such and not necessarily according to â first come first serve basisâ...
It is a very HOT ZONE, where everyone is on their toes 24/7... unfortunately, in most A&E in Nigeria, Health care providers are left frustrated due to many factors... from under staffing to lack of basic tools such as Hand gloves, thermometers, glucometers, etc...
Most atimes, there wonât be electricity!
The A&E serves as a resuscitating/stabilizing unit before transferring the patient to the specialists unit for onward management...
Occasionally, a patient can come to GOPD and be transferred to A&E if the Doctor thinks that the patientâs case needs an urgent attention...
3. The last Port of entry is via the specialized clinics... A patient can come to the clinic for routine visit and get admitted into the ward or may be referred to another clinic for co management e.g.
The Cardiologist may refer a patient He/She has been seeing for HeartFailure to Endocrinologist for uncontrolled Hyperglycemia...
A very important thing to note is that the Tertiary Hospitals usually have different cadre of Doctors in a unit...
The Consultants are the BOSS of the unit and makes the final decision on the line of management/treatment for the patient... He therefore receives daily briefings from the most senior In the team about the patients progress and He is consulted before major decisions are taking as regards patient care.
Then you have the Senior Registrars( Who are one exam away from becoming Consultants).
Followed by the Registrars and then the House Officers....
