can i get a doctor?

so let's just say i have made my share of complaints about the US health care system, and i'm sure i'm bound to make more, but after spending 5 weeks here it sure does put my complaints into perspective.  let me preface this with a few things though.  i'm not looking down on health care here, they do the best they can with the resources they have....the resources are limited though.  so my stories are meant to just tell the reality of health care here....not pass judgment on what they are doing.  with that being said, here's a few stories...

i'm working in the trauma ward and get this patient, about my age, up to walk.  he was in a car accident and had a subdural hematoma (head injury) and a broken leg.  he was doing quite well though and had been walking a little the previous days without problems.  he kept asking me to take him outside so we decided to take a little walk.  i'm walking with him down the hall to the door and all the sudden he says he is dizzy and then collapses....luckily into my arms and not onto the floor.  so i'm standing there holding him up yelling at the closest nurse i can find to bring me a chair.  we get him into a chair and he starts sweating profusely and ripping his clothes off.  well there's no wheelchairs in the entire ward so i'm not sure what to do at this point....don't really have that problem in the US...so i go find another therapist to help me.  she comes back and says we're just going to have to walk back to the bed with him.  i'm pretty sure he's going to collapse again but i keep my mouth shut because things work differently in south africa than they do in the US.  so we stand up to walk...take a few steps and he collapses into my arms again.  so we sit back down in a chair and the other therapist says we're just going to have to carry him on his chair back to bed.  so we literally pick up the chair that he is sitting in and carry him on it back to the bed.  can't imagine the looks i would be getting in the US if i did that!!  so on the way back to bed he starts complaining of a pounding headache and then starts grabbing his chest in pain....bad signs for a patient after a head injury....major concern.  so i find a doctor as quick as i can and tell them what has happened.  they look over at him lying on the bed in obvious distress and say they will be with him later when they get to him on their rounds.  i'm in disbelief.  in the US there would have probably been at least 5 people surrounding the patient, checking his vitals, etc.  here they don't probably even have a vital monitor to hook him up to.  so i stand there, completely shaken up by the whole episode....feeling like if i leave the patient he could literally stop breathing and no one would even know.  i only know so much...and what to do with a patient after a head injury who is in acute distress is not one of those things.  in the US that's what we have doctors for.  so i do all i know to do and literally stand there and watch the patient keep breathing until the doctors finally get to him.  turns out the story has a happy ending and the patient is doing fine now.

second story happened today.  i'm working with another patient who is about my age. it's the first time i've seen him and he starts pouring out his heart to me...telling me about his 3 year old daughter, and how he's in prison and can't take care of her, and how he feels so alone and wants to be a good dad.  and then he tells me that he overdosed on pills last night..he took 25 and hasn't told anyone except me now.  well about this time he starts getting really dizzy, then he starts dry heaving and says something is about to come up.  then he starts having a seizure and isn't really responsive.  so i yell at another therapist to help me and she says i need to take him back to his room because they're aren't any doctors in the gym where we're at.  so we get him back in his wheel chair.  i keep yelling his name the whole way back to him room...trying to make sure he stays awake.  the walk back to the ward is outside and i'm back there by myself and the pt is really out of it.  at one point his eyes rolled back in his head for a second and i was certain i was going to have to put him on the cement in the walkway and start doing CPR....and i had no idea when someone would walk by that could help me.  luckily he kept breathing the whole way back to the ward.  so we get there and i find the nurse to tell her what has happened and she is completely unphased and says she will check on him in a bit.  so i find the head nurse and take her the bottle of pills that he overdosed on and she is also unphased.  it's craziness compared to the US.  again i'm scared he's going to stop breathing or throw up and aspirate and no one is even concerned about monitoring him.  so i find a doctor at the bed next to him and ask them about it and they say they don't know, he's not their patient.  again, thankfully, the story has a happy ending and the patient was doing fine this afternoon when i went to check on him.

but the craziness of the stories still baffles me.  i don't think there's such thing as a code blue here.  i feel like  anyone working in the hospital is potentially going to be asked to function as a doctor because there just aren't doctors around all the time.  like one day one of the other therapists got ask to intubate a patient...definitely not within our scope of practice.  so i am thankful for doctors, i am thankful for crash carts, i am thankful for the availability of qualified staff in the US, i am thankful that i don't feel forced to function as anything beyond what i am trained to do.