The AFP's busy hospital

Media

Part of Philippine Armed Forces Journal

Title: The AFP's busy hospital
Language: English
Source: Philippine Armed Forces Journal Volume IX (No. 4) February 1956
Year: 1956
Rights
Fulltext: Bl!UJ 1/oiljJita~ loy Major Bf'rn* S. ~alang, MC T"Josp~~~~~3~0ami~:n~oa~,e~~~ :~;~~lead~~is!~o:iliaJ ~;oc~1ur::~c;::~~ zon City is the only hospital of its lems confronting the medical and adkind in the whole Armed Forces of ministrative staff in the care and the Philippines. It has been set up management of patients, and what primarily to serve the whole AFP by facilities are offered by the hospital providing the best possible care and to servicemen for theil· cure, rehabilitreatment to all sick and disabled tation, and spe.edy return to either military personnel who need hospital- military or civilian life. i:tation for more than 30 days. Those People S('rved whose ailments or disabilities require 8 much shorter period of hospital Firstly, it must be realized that while the primary mission of the VLGH is to provide the best hospital care and management are taken care of by 25-bed station hospitals serving each of the four Milita1 -y Areas, care and treatment to all members the Philippine Navy, tht- Philippme of the AFP, 1t has also other seeAir Force, the PATC and the Phil- ondary miss1ons_ to a_ ccomplish. wh1ch ippine Military Academy demand from 1ts hmned personnel There is a lack flf understanding the utmost m energy, skill and zeal. of the current policies governin~t ad- It also provides free hospttahza, mission to the VLGH. Th1s lack of tion to direct dependents of enlisted understanding might have aroused personnel m the act1ve service, a liunnecessary criticisms and uused mited number of mdigent veteran~ disappointments to those who not benefited by the Roger's Act, cin.ay ha,·e found difficultr in vil1an commandos, sunendered Huks, gamm~ admi~;~ion for them- civilians wounded dunng military seh·e!i or their immediate de- opemtions, persons in mthtary cu~pencl,.nts It is ti-_< !Hlrpng,. nf this tnrly, and certain .-ases ilf ~xc.,ptinna\ PIIILIPPJN.,;S ARMED FORCES JOURNAL instructional \'alue upon orders of personnel, such as interns and ('X htghf't' hf'adquarters. terns, as a contrtbution to the JlaUndet· the pro\·ision~ of Cil·cular tiona\ effort in the building up of n 77, GHQ. AFP. dated October 17, named medical re~erve. In times of 19.55, medical and dental attendance emergenctes and c11lamities, it is also including hospitalization subject to g"t\·en the added miss10n of takmJr payment of nommal fees, is also au- care of ca~ualties m any part of the thorized fot· retired military person- Philippmes, which are beyond the nE'l, direct dependents of officers, pa capabilities of civtlian medical facirf'nts of unmarned officers and en- lities. Its role in the preventoiDn and listed men, civilian employees of the control of communicable diseases by AFP, and commtsstoned officers of provtding for their Isolation and the Bureau of Coast and Geodetic treatment, and in conducting t·eSurvey and their immediate depend- searches and studies on the mcidence, cnts. Under this provision only the manifestation, and management of wife and minor children of military dtseases are equally important and :if I' personnel are classified as direct or great benefit to the AFP. immediate dependents. Hospital Staff It likewise provides for the train- In accomplishlng these manifold ing of military and civilian medical missions, the VLGH is staffed by only 50 medical officers, 95 nurses The X-Ray Service is equipped to and 678 enlisted men and civilian perform Doth diagnostic examinations · personnel, who take care of 1081 es- and superficial and deep therapy. tab\ished beds. These personnel are Due to the la_rge volJume_ or work done distributed to perform either admin- by this servtce on pattents confined istrative or professional services, and in the hospital, it is necessary that in some cases both professional and requests for X-ray or fluoroscopic administrative. According to hospi- examinations for cases referred by tal staffing guides which provide for surgeons of other units be scheduled one attending personnel for each es- on limited days of the week. It tablished hospital bed, the VLGH is should be realized that the taking considered undermanned, in doctors, of X-ray pictures is not just like nurses, and overall personnel to pa- taking a kodak picture. Not infrc-tient ratio. quently the radiologists are confrontThe hospital is equipped and st.af- ed by difficult or problem cases fed to take care of all types of sur- which require much study, research. gical and medical cases except con- and t·epeated X-rays before they can tagious diseases like typhoid, cholera, arrive at a diagnosis or impression. measles, chicken pox, small-pox, and Coupled with the present budgetary diphtheria. Cases of the latte1· cate- limitations and shortage of X- ra~· gory are not admitted in the VLGH films, it should not be difficult t o in ordet· to prevent the spread of epi- understand the problems often condemics within the compound. A few fl-onting our radiological service. cases of leprosy are handled by the We now have a medical officet· in Dermatology Section for purposes of the United States undergoing trainresearch and study, but highly rc- ing in the use of radio-isotopes for sistant and disfiguring cases arc eva- both diagnostic and therapeutic purcoated to the Tala Leprosarium. poses. Whether this hospital will Equipment handle radio-isotopes upon the return The hospital has also a Physical of that officer is still doubtful. At Medicine Section, which is equipped present, Lieutenant Colonel F. V. with the latest and most modern ap-- Quilala, Assistant Chief of the Eye, paratus for all kinds of therapy Eat·, Nose and Throat Service, is prescribed for the physical rehabili- the only officer in the whole Medical tation of patients. Closely related to Service of the AFP who has been the Physical Medicine Section is the certified by the Atomic Energy ComAmputation and Prosthetic Team mission of the United States as cawhich handles the rehabilitation of pable of handling the beta-radiations all kinds or amputees and physically of certain isotopes. During his trip • andicapped and the making or ap- abroad last year, Colonel Quilala propriate artificial limbs or prosthe- purchased a Beta-radiation appara ses suited to their particulat· condi- tus at his own expense, which he now tions. makes available to Army patients needmg such treatment, free of charge. This is not an isolated instance of our specialists making available their Q_ersonal profes1:ional ~quipment to patients in the hospital. r·angements because of the 11ature of the examinations. The greater· YOlome of blood given to patients in' the hospital is taken from the Central Blood Bank of the Philippine National Red Cross and a lesser The Laboratory Sen•ice supports amount is taken from blood donors all the other services of the hospi- which is paid for from hospital aptal and takes care of a11 laboratory propriations when used by authm·examinations, such as blood anrl spi- ized military and civilian personnel. nal fluid examinations, blood che- Dependent's Ward mistry, bacteriological examinations, To take cat·e of the large numix>r· urinalysis, histological examinations, of female and children dependent!: gastric juice analysis, etc. It also who seek admission to the hospital, performs metabolic rate determina- Ward 7 (the Female DependCnts & tions and handles a Blood Bank in Pediatrics Ward) and Ward 8 (Obcooperation with the Philippine Na- stetr·ical and Gynecological War·d) tiona] Red Cl'Oss. Here again, exa were e!>tablished a few years ago. ruinations are scheduled by prior ar- The handling of these wards initial Onlt pol<enll needing 1pecioliud (are ond manogemenl 1havlcl b• ••acuat•cl ar aclmoll•cl to the VtGH. Photo above •how• an officer'• dependent undergoing on orlho peclic aperolion u~der 11•nera/ onellhtsia br Jpeci<>llt·lrain•cl p•roannel o.,, to limited /!<Imber of btdo ollorred lor pt diotroco <Olff, odmruron to the children ·, wc>rd iJ on o prionty Of tmergtncy bo•i• Mony a tirnt, CO$tl not contidertd OJ t mer gencito ht.-e to be rt/u,.d odrniuion ond ""' to other go•ttnme nt ho•p1tol• or '"'' giv<'n medicint• ond od•ice Motor Ponlilio" reen uornining o rid child ly wa» only made po .. sible by volun- It is the earnest desire of tho: ho~ tary contributions. While a modest pital staff to do the most ~ood for amount is now appropriated in the a11 htrge a numbet· far beyond their Army Budget to help maintain these caJial.tilities to attend. ll is, therewards, the hospital is still confront- fot·e, essential that cases for admised with the ever-recurring problem s1on to the hospital be thot·oughly of lack of sufficient beds and pE'rson- >'Creened commensurate with the line\ to handle the large number of mitcd number of doctors and percases seeking admission. This jg es sonnet availab).,. 0{ course, all cases pecially true in the Pediatric,; and of emergencies involving loss of life the Obstetrical Sections where, due or limb arc immediately admitted to the limited beds allotted for such and taken care of regardless of staff cases, admission is on a prio1·ity or and space limitation. emergency basis. Many a time, ca- All hospitals, pri\"ate or governses not considered as emergE.'nCiE'S ment-owned, arc duty bound to at have to be refused admission for tend to emergency cases occurin!Z" in lack of beds and sent to other 1!0\"- their immediate \•icinity. The VLGH ernment hospitals. is no exception to this humane Jlnrhis is a view af the Orthopedic Ward <mder ll. Cal. Santos Ward hou•e• all bone and 1ainl ccue<. In foreground ,·, a campaund lrac!ure caJt reJulling from cambal a9oinsl diuidtnls. Mo<l cast~ e•enruolly reco•er, but" small ptrctn/09e become unli l /gr military Jtrvice and are recommended lor ditcharge en COD bey, but as soon as danger to life cases should go rlirectly to the husor limb is passed, all civilians 110t pttal unless they have been pre\·iousbelonging to the categories previous- \y seen by their unit surgeons and ly mentioned, arc evacuated to the found requiring that special care nearest available proper government and treatment available only in a hospital. general hospital. In the latter in Kinds of Admission stance, these cases are evacuated to Admission to the VLGH may be the VLGH with appropriate recomeither direct or indirect, or by trans- mcndations or medical tags, which fer from other hospitals. Direct ad indicate the nature of the disease missions refer to such cases who or injur~·. when and where it was came directly to the hospital and incurred, previous treatment given, whose conditions were determined by and recommendations for itS'· dispoduty officer as requiring hospitali- s1tion. Admissions through this zation. These cases are mostly per- procedure are known as indirect ad· , sonnel of the hospital or their im- missions, while formal transfers remcdiate dependents and other mili- fer to those cases which have been tary personnel from other units Jiv- previously admitted in other AFP ing within the immediate neighbor- hospitals and later transferred tp / hood. As a general rule, triage or the VLGH, afte1· it has .been detersorting of cases requiring hospital· mined that they need definitive treatization should be done initially by ment which require hospitalization unit 01· dispensary surgeons. No for more than thirty days. t -_ -, r_....~~~ '1 I - . : ; . , , ..... ' :f , 1\ - ~ For !h• btnelot ol ombulonl pol1eM1 who de10re lo learn cerroon !lodeo or hobb••• Ampurol•on cmd Proslhetic hom ond lhe Phy,.col Medocrne Secl<on fOinlly operole !he Or<upolionol Thetopy Projecl. Pholo '""'"' some paloenl$ engaged on rvg and mol ~eovit>p, leolhercro/1, bell-weo•ing. plo>focrofl. I?P' "'"''"9· and metol molding Out-Patient Sen·iee surgeons of other units should go In order to take care or the lar~c directly to the VLGH Out-Patient number of authorized military and Service and Dispensary. Other units civilian out-patients who flock daily like those in Camp Murphy, the Enfor consultation or seek admission gineer Construction Group, Camp to the hospital, the Out-Patient Diliman, etc., have their own ruedService and Dispensary was recently ical and dental dispensaries to take enlarged and reorganized. It now care of their own personnel. Unit occupies a building of its own and surgeons have been advised by the is conveniently located ncar the main Surgeon General, AFP, to attend to entrance. During office hours, all personnel under their jurisdiction so patients arc required to first pass that hospitals and other dispcnsa thru the Dispensary where they are ries will not bc unnecessaril)· clogged attended by doctors from the dif- and hamstrung by patients who byfercnt sc•·vices and sections of the pass their own unit dispensaries. It hospital who are assigned in Out- may very well reflect adversely on Patient Service on a rotation basis. the professional ability of the hardHere in the Dispensary, the initial working and overworked unit surrecords, history-taking, and physical geon when patients that should be euminations are made. handled by him seek the services of Again it must be emphasized that other surgeons - a situation which only personnel living in the vicinity we hope is not desired nor intended of the VLGH or those referred by by such patients to happen. PHIUJ'PINES ARMED FORCES JOURNAL If the examining medical officer Specialist!! In Dispensaries should require further labonato1·y or The different sections and service>~ • X-ray euminations or specialized of the hos[Jital have professionally, procedures to arrive at a diagnosis, qualific..\ medical specialists assignappropriate wfitten requests arc ed to the Dispensary on different filled in. Only then is the patient !!Chedulcd days, and patients can be sent to the ap[Jropriate service o1· ~tssut·ed that even in the Dispensary section concerned, where he is either they could get the same initial servimmediately attended to or made to ice that they expect to get directly come back on scheduled dates. de- fl·om the wards and clinics. 11ending on the nature of his disease By confining as much as possible or injury, the number of patients all consultations to the Disp~nsary, previously scheduled .:ahead of hirn, the clogging of th~ wards with outor the charactCI' and the ~turation of patients is greatly minimized, if not the consultation advised, etc. totally eliminated. By this method After the attending doctor in the the ward officers could give mOI't' Dispensary has evaluated the histo- care and undivided attention to the l"Y, physical findings, and the :result patient~ alt·eady confined in their of the laboratory, x-ray, and other wards. Undoubtedly this eventually specialized examinations, he decided redounds to the benefit of the govwhether the case can be treated 3 s e1·nment and patients themselves, as an out-patient or whether it requires it enables them to get well sooner, admission to the hospital. In the thus •·educinl'(" the total number of latter case, the patient i.o; directed days lost in hospital. to the A & D (Admission & Dispo- After Office-Hour Admission sition) Office in the Main Building where his hospital records are ini tiated and assignment to the proper ward is made. Military 11atients are admitted After office hours, all cases seek· ing admission to the hospital do not have to pass thru the Dispensary (which is by this time closed), but lH"oeeed dit·ectly to the A & D Ofwhen their conditions requil·e it. Ci- fice, where medical officers-on-duty vilians, on the other hand, except in determine whether they should be dire emergencies, are usua\Jy on a hospitalized or sent home after they space-availability basis. With the have been given proper advic~· and/ OJ" exception of female patients who treatment. seek consultation or admission to h1 no instance t<hould the patients the Obstetrical and Gynecological go directly to the wards or clinics, Ward (Ward 8). no patient is al- especially after office hours. It should lowed to proceed directly to differ- be realized that only duty officet·s /#' ent clinics or wards without having remain in the hospital during these: made previous consultations or ar- hours, and the demand 01, their serv ranll."ements with the Dispensa1·y Of- ices from other wards becomes more firer. pressing and urgent. To the uninformed t~nd uninitiated, it may not ents, when these are prescribed by be apparent that by seeking person- medical officers concerned. Expena\i~ed service from the duty officers sive antibiotic.c; are not usually disduring after office hours they may pensed at dispensaJY le\'el. be unduly spending so much of his When a serviceman is confined in time and attention which may be the VLGH, and it is dete1·mined more urgently demanded at the mo- that his condition would require hosment by four or five other calls pitalization fo1· more than 30 days, from the far-flung wards of the hos- he is recommended for transfer from pita!. Obviously, the solution to this his mother unit to the Detachment of situation is for the patients to go to Patients of the Hospital. Many !\ the A & D Office where there are time, due to the delay in the t1·ans always other of!icers on duty to at- mittal of the patient's service retend to them. cords, allied papers, and accountaOther Information bilily clearance from his former Because of limited appropriations mother unit to the CO, Detachment for medicint!s and medical supplies, of Patients, VLGH, the patient's pay only common stocks like aspirin, aut- while in hospital is unnecessarily defas, laxatives, cough mixtures, oint- layed. This often entails the grantments for external use, etc., are fur- ing of passes to the patient connished free of charge to authorized cerned so that he could settle his acmilitary personnel and EM depend- counts in his former unit and expeOwing oflice hovrr, o!l pofi•"'• , .. ~lnQ odmiuion to the hotpitol ore required to fint pou thru the Dilpentory, where initio/ records, dinicol hiJiory, phy1icol e•ominot•on•, ond lttor.,,.,., ore mode. Photo Jhowt the .teceivin11 Secfion where pofient• ore bein11 <ntet•i•"'•dond,./etredtooppropriole,.ctionointheDispenJorr dilt: the forwarding of his papers complete a history of his Illness, folto the CO, Uetachment of Patients. low all instructions a nd orders of This procedure is not only time-con- his ward officers, and hel11 whenever sun1ing and demoralizing to the pa- possible, in providing an atmosphere tient but also d~ays his treatment of o1·der, cleanliness, and good cheer and ~ventually his recovery. lu the ward. The serviceman who While it is the duty of unit per- gets drunk, p rovokes disorders, or sonnel officers to attend to this mat- goes on AWOL, while confined in te1·, it would benefit the serviceman the ward, not only does harm to him· to know that his service records and self but also to his ward officers allied papers should accompany him and fellow patients. Ward officers when he is evacuated to the VLGH have to perform additional adminisfor prolonged hospitalization so that trativc details wasting time which there will be no delay in his pay, could otherwise be employed in the t1·ansf~:r, or possible retirement. professional ca re and treatmeiit of Once the serviceman is admitted cases, cverytime a patients goes on in the hospital he can rest and as- AWOL. ~ured that the best will be done for Visiting hours to the hospital have hm1. It is imperative, however, been limited to three days a week, that he cooperates and obeys all hos- exclusive of Sundays and holidays. pita] reJ,!"ulations. He should give as This is so made in order to reduc~ ,' VIGH i-loo the bell equipment ond opporotu1 for the phfOICOI rehobilile>lion e>nd rree>r men! of the crippled e>nd infirm Clore <uper>>Jie>n e>nd follow-up of e>ll CCIIel ore me>de l>r we/1-tre>ined medice>/ offkero ond nurSer 10 o//eviol& the humon wffeflng the hours usually taken up by visi- duty while he was still in the active tor,:;, which time could \'ery well be service, he is made to llJ)pcar before used for the treatment, follow-up, a CDD Boa1·d, which will determine and r+'habilitation of patients. the se\'e.-ity and extent of his disPatient Rehabilitation ability. All militJry personnel who In line with the present modern are discharged from the service on tr€'nds of givin~ more and more em CDD arc entitled to receive monthly phasis on physical rehabilitation not disability pensions under Republic only as a complement to the cure Acts 610 and 573, depending on and treatment but also as a definite whether their illness or disability step in the preparation of patients was incurred in the Philippines or for gainful occupation, the Physical overseas (Korea), in addition to Medicine Section, in conjunction with whatever retirement pay or gratuity the Amputation and Prosthetic that may be due them by reason of Team, is operating on Occupational length of service in the government. Therapy Shop. Under the guidance In this connection, before the servand superv.ision of trained officers 1ceman due for retirement by reason and corpsmen, practical instructions of disability leaves the hospital, it in mat, rug, and belt-weaving, lea- would benefit him to seek the asthel·craft, plasticraft, typewriting, sistance of the Military Welfare and metal molding, are gi\'en to as Service unit in filing his application many ambulant patients who can be for the disability pensions provided excused from their respective wards. by the Jaws above-mentioned. Ward officers a1·e advised to encourage as many patients as JlOSsible, especially those suffering from protracted ailments, to take advantage of the opportunities offered by this shop and to break the monotony of long hospital confinement, as well as to keep them occupied in acquiring gainful trades or hobbies. The VLGH is the only hospital in the whole AFP authorized to discharge military personnel on CDD (Certificate of Discharge for Disability). After a sick or disabled serviceman has received the maximum bem•fits of hospitalization and the attending ward officers have found him unfit for further military service as a result of some disease or disability contracted in line of Understaffed Hospital It may be of interest to note that of the total admissions to the VLGH, 60 per cent are civilians and only 40 per cent are military personnel. Most of these civilians are direct dependents of military personneL The VLGH is staffed by personnel suf ficient only for the care of military patients, and it should be obvious that due to this additional load of civilian patients they have to double their efforts and draw heavily on their 1·eserve energies and ~~otamina to meet the challenge. Nearly all military personnel of the hospital go on 24-hour duty every three or !our days, in addition to their normal daily working hours. Since professionals have to keo!p on reading and studying new developments in their ties. In most instances the~e mispartieular specialties, it is also nee- understandings and eo1up\aints 1ne essary that part of their limited traceable to an igno1·anee or lack of time should be '-budgeted for this sufficient information regllrding adpurpose. mission procedures and hospitaliu In spite of the varied and multi:~:~ ~:~~~~a:;::u!g::::ati:n w~;;~ farious tasks which the VLGH per could have been easily threshed out ~:=~e:r::~~:::~!u~:~i~~o:~::~~:: ~r:t~::ee ::~:~::e C:~~er;:!e mdu:~ to be done. To the uninitiated and ::ns~~::itnp:;~:::l. ~: ~;e::o~:~ ::;;!~1 °~~:::~:· 0t;eth:ee:!~f~!t i::;~ interest of good public relations that fieer may be construed as one of in;:~h:::: a~~n!::il~:r th:~~~le;~:~ difference, lack of human touch, and and admission of cases to the v. Lueven callousness. They expect him to commiserate with their individual ills and problems, to get excited and show an almost nervous concern for their ailments, and give them a very personalized attention. They fail to understand that the calm mien and na General Hospital. All these sytematiz:ations of working procedures in this hospital have been painstakingly thought of and enforced with the sole purpose of allowing the hospital staff to rendemeanor of the physician do not der the maximum professional care truly reflect his inner feelings that to all who look for it. The irony he is also human and beset with of it is in the confusion that may emotions of his own. The physician, be created in the minds of those through his intimate daily contact coming for the first time in such with disease and death, has become a complex organization like a modalmost inured to the conflicting emo- ern general hospital. The VLGH tions evoked by these dangers and was established for the alleviation learns to become impersonal and un- of hun1an suffering and the betterruffled if he must continue serving ment and speedy return to normal others. health of those afflicted with disease Conclusion or· temporarily main1ed by injuries. It is, therefore, improper, not 1.1) In the accomplishment of the avowsay most unfair and unjust, that ed mission, the VLGH dedicates it:~:~P~~:!:tsin wt~~ ::~ :~;; ::: self, wholehea1·tedy and devotedly, to been treated or in the seemingly the end that the fighting strength casual attitude of some VLGH of- of the AFP could be preserved and fleers, readily bring their complaints the serviceman made a healthier and to higher headquarters or authori- a happier man.