Work

LBJ Tropical Medical Center, where I happen to work, is complete insanity. I love my patients dearly and they are in legitimate need of help and so very grateful; but, sometimes I come home wanting to burst into tears because of the injustice here. LBJ is the ONLY medical center on the island. Medicine is definitely lacking here and sometimes I try to take on cases only the most qualified specialist would take in the states…because I know there is no else to do it. On top of lacking resources, funds, ect…the politics of the hospital anger me so much. I am not trying to pull a race card here, but I am definitely looked down upon for being a white woman. I would say 80% of the doctors here have no US training or certification. And I know US training isn’t the end all, be all…but it is kind of scary when the doctors here have a 4 year medical officer degree. It is scary how much wrong medicine is being practiced. Patients are given NSAIDs with Renal Failure daily, people don’t show up for work on time I mean like 45 minutes + on a regular basis, people wait for an average of 3-10 hours to even be seen by a doctor, the is no accountability, the lab loses specimen, and the frustration goes on and on. I think that is why no one from off-island stays here long term. Patients do not come to the hospital because they are scared, so they wait until it is too late…I see so much End Stage Disease. American Samoa is the number 1 fattest area in the world…An estimated 93% of American Samoans are overweight or obese…the majority of my patients have Diabetes, High Blood Pressure, Cholesterol, and Gout…I think this is because of a lack of education regarding personal health. I had a patient go in for an appendicitis and came out with a colostomy bag because they nicked his bowel so bad. Today I was left in the clinic with no supervisior as a Physician Assistant…I was running Head CTs, dealing with liver masses, nystagmus, broken toes, polycythemia vera, just absolute craziness. I am so overwhelmed when I come home that I am numb, overwhelmed, and exhausted. I do not regret my decision for coming here, but it seems like it is a little too much to handle. I became a Physician Assistant because I wanted to practice medicine…I liked the idea of autonomy and the supervision at the same time. My training was intense...the hardest thing I have ever done, but I am not a Physician. I practice as a Physician under the supervision of a Physician which I don’t feel like I always have here. When my boss Dr.Bouslough leaves, I don’t know what I am going to do. I know this is great training for when I go back to the states. But is this fair for the people here? Honestly, I have more training than the ‘doctors’ here, no vanity involved…just plain not right, not cool. I can’t believe I am actually writing this but I am frustrated! I leave to go home in 3 weeks for my best friend’s wedding and I am emotionally ready to get out of here. The hospital isn’t even looking for replacement for when I and 2 other PAs leave next year; I have a huge patient database, what is going to happen to them? If I was valued here and the hospital was held to standards, I could see myself staying here because I love my patients…but sadly that is not the case and will never be. Bottom line, is I can deal with everything written above…but my dying patients, what are they supposed to do? I seem so helpless sometimes, there is nothing I am going to do for some of my patients that need to get off-island. When I go back to the states I hope I remember nothing is worth getting upset about unless life and death are involved. Absolute insanity here…glad I am here but it is completely overwhelming...how can people dying, injustice in healthcare, ect not get to you?