Hi, Richard here. I'm working on the inpatient unit, and yes it's true they bring the voting machines to the unit and encourage all the inpatients vote. This is just one example of the inclusiveness of kiwi society. Another is the extent to which family (whanau), care managers and other supports participate in patient care. This means that I spend as much time meeting with these folks as I do with the patient. Notions of individualism and privacy are not as strong here as in the U.S. Rather, the expectation is that decisions are made collaboratively. Even the most psychotic patients are willing to sit for a "hui", and several such meetings may take place over the course of a hospitalization, which on average lasts over a month. This may seem exceptionally long, but all barriers to community care must be accounted for before patients can be taken "off the books", so to speak. This means that, in essence, the ward functions more like the "asylums" of old than a contemporary American unit, albeit with some distinctly kiwi twists. Patient's come and go on leave with family members, sometimes for days at a time, and are frequently granted periods of unescorted leave to take care of personal needs such as shopping and banking. Remarkably, almost no patient's go AWOL. On Fridays, there's a BBQ in the main courtyard, which is shared by family, staff and patients alike. Everyone uses first names only here, regardless of "rank", as status is a far less important concept here. Patients wander into the nurses station to ask for a smoke, tea or a snack; nobody bats an eye.
The unit itself is quite shabby, and antiquated by U.S. standards, but the staff are amazingly experienced, dedicated and competent. Moreover, all of the "scutwork"is done by a host of junior physicians under my direction. In essence, my job is to make decisions, guide treatment and to lead. The junior docs are avid for any teaching, and there is ample time for both formal and "on the fly" didactics. In addition to the care meetings that consume the better part of most afternoons, these is a morning team meeting. Wednesday mornings are occupied by peer supervision groups or presentations (followed, of course, by tea), court is held on Thursdays and we meet with the Clinical Director over a leisurely breakfast on Tuesdays. The commitment process here is somewhat byzantine, and does require formal "reports" to be submitted by the "responsible doctor". As with any former British colony, the government paperwork can be a bit silly, especially in the absence of any actual day-to-day medical documentation requirements. Overall, the pace is very laid back and I routinely find myself with stretches of free time on most days.
I guess the most important aspect of any labor is the gratification and enjoyment it provides the individual. By that standard, this is a very good job. I love going to work, genuinely like being there and could easily see myself doing it for a very, very long time.
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