Follow up

One of the hard things about working in this context is follow up.  It seems really hard to finish things - to see a medical problem reach a suitable conclusion.  The medical records software has recalls.  Doctors add recalls to follow up abnormal results.  Then there are all the check up recalls for chronic conditions and general heatlh checks.  And immunisation recalls.  All these recalls - lists are generated for follow up.  But the lists are overwhelming!  It's hard to prioritise.  Often follow up is very ad hoc, and depends on people coming in for something else.  Or, drivers go out into the community with a list, and try to find people and ask them to come to the clinic.  Sometimes they come, sometimes they don't.

As clinic staff, our priority is health and follow up, wanting to do good medicine for people.  But for the people here, coming to the clinic is just one of many priorities, and sometimes it's just not important enough to come.  This is hard for us to understand!  But we need to learn how to work with the community more effectively, and part of that is understanding all the issues.

The clinic staff also have to deal with many priorities.  Often there will be visitors from outside, who come to get us revved up in their field, and do a better job at it.  On Wednesday it was STI's.  No one would deny that testing and treatment is really, really important.  But for the people who came to talk about it, that's all they do.  The clinic has to do everything...  (Actually it was a really good visit, and part of it was that a male Aboriginal Health Practitioner from Nhulunbuy came, and worked with Jeremy (doctor) and others, to run a sex education afternoon for boys)

The chronic disease nurse is just back from holidays.  She said she used to work till 7pm most days, checking the follow up lists, working on things.  But she nearly burnt out, and has decided that she can only do so much, and she needs to look after herself better.  It's the work-life balance.

Speaking of which - it's a long weekend again this weekend.  Monday is NT Picnic Day.  So that gives me 3 mornings for extended bird watching, 3 afternoons for longer walks, with plenty of time in between to read, rest, just watch the sea, do housework etc.  Lovely!  The birds were elusive this morning, till I stepped off the track and went towards some bird song.  Then I saw quite a few!  Perhaps there's a picture there: be willing to leave the comfort zone.. probably stretching it too much.  Actually I was happy just standing in the bush (on the path) and listening.  This afternoon I had a lovely walk, a new route.  Jeremy had told me about it.  It's the sea end of the wetlands.

I love watching the sea. It's changing all the time.  Yesterday , having breakfast , I saw a strange log floating a good way out.  It really looked like a crocodile - and it was!  I could see the morning sun shine on the plates of its tail.  Sometimes only its head was showing.  I did take a few photos - will post one next week when I can get it off the camera.  Big croc!  I passed on the news at the morning team meeting.  No sign of it today.