Sandra's Story | Flying Surgical Service
Sandra's Story | Flying Surgical Service - video transcript
Dr Francis Osomah 00:18
My name is Francis Osomah I'm one of the Flying surgeons. We normally are based in Brisbane fly for five days to remote Queensland. Initially we fly to Roma and do you know various locations within the a five day period we're here and then go back to Brisbane, so this job that consists of partially working at the Prince Charles hospital and also doing the remote job. In addition, the flying surgeon job is part of the Flying Specialist Services that includes anaesthetic team and also obstetricians on the other side.
Dr Robert Franz 01:05
My name is Robert Franz, I'm Director of Surgery at Princess hospital. General Surgery by training been here for 13 years, previously, for 16 years at Toowoomba hospital. The Flying Surgical Service is an iconic service started off many years ago due to the need to service regional centres of Queensland because as you know, the geography we're very scattered west of the Great Dividing Range. And it is a very unique service in lots of parts of the world. Queensland is very lucky to have that sort of model. When it started, it was combined with the Flying Obstetrician and Gynecology Service. And as the years have gone by the surgeons profile has changed. Initially, we did a broad range of surgery and now we're becoming much more siloed in some ways. Yet the needs of people in regional Queensland remain the same. And the idea that the flying surgical services that we can provide a great deal of care closer to home in smaller communities, rather than patients having to travel for hours when they can, you know, have daycare surgery or smaller procedures closer to home and use their family for support.
Sandra Moore 02:48
Hi, I'm Sandra, I had colon cancer which was detected by the flying surgeons at Dirranbandi, I got operated on and it has disappeared completely Flying Surgeons are really fantastic. They were there when I needed them. And we were sort of stuck in a place that was miles from anywhere. But there was help there for us and reassurance that everything was going to be taken care of. And it was. Met Ian, raise the family, family left home. So we left home, bought a caravan and been on the road for seven, almost eight years.
Ian Moore 03:42
We've lived all over Australia, with the Navy with other things and now that we live on the road full time, we don't count ourselves as from anywhere because everything is move on. After a little while.
Sandra Moore 03:59
We like to go outback, you meet some travellers and they'll say "Oh, have you done the lap yet?" And you think 'no', barely got out Queensland in the last eight years.
Ian Moore 04:13
We like to get a job or we might do volunteer work or might do paid work. And if you get involved with a community, then you tend to stay a little bit longer but I'm in two or three months and be the max.
Sandra Moore 04:39
I got the screening test and for my birthday present and Ian nagged, nagged me to do it. And I did it and within about a week and a half I got results that I had to get some tests, so that's why we were in Dirranbandi, at the time, there was two polyps and he put a tattoo on one. And I've always wanted to tattoo. So I finally got one maybe did a tele conference with Francis to work because we couldn't get into St. George, and seemed that you were dealing with the one person that made you a lot more easier with the way you were starting to think, you know, is it going to be okay or is it more than one tattoo there that I don't know about?
Ian Moore 05:31
Its continuity of care
Dr Francis Osomah 05:34
is very important in a sense that even though people are scattered remotely, they still need care, they need surgical care, as far as all other things, you know, and many a time is very difficult to reach out to them, to offer them the services that they deserve. A lot of them work hard they're taxpayers in the part of the community. So a very good option is to be able to reach out to them and solve the problems that they've got locally. Most people you meet here want to be treated locally. In fact, some will decline even to go to the city for treatment. If it can possibly be done here safely, they will prefer that, of course, many a time you need to where risk versus benefit. And on rare cases like this, you need to send her out to a bigger center where procedures that nature can be done. Rather than you know, pushing through and getting it done in a small hospital. It's important that the first contact is done by us we getting close as close, we didn't get to her hometown, of course, but we got as close as possible. And the first consultation she came in person that was face to face. And she would have often been coming to St. George face to face, except at some point, there was the flooding in between and you couldn't access any roads to those places. And that warranted doing telehealth consultations, which worked perfectly well.
Sandra Moore 07:12
We didn't I mean, we didn't realize how good the service was
Ian Moore 07:16
Having the continuity of care between Dirranbandi, St. George, Roma, and the care that Dr. Francis and all staff took in Sandra, that takes an enormous burden of worry off your shoulders
Sandra Moore 07:37
Ian Moore 07:38
Dr Francis Osomah 07:47
Continuity of care is absolutely important in dealing with patients, particularly if they've got a serious condition like cancers, etc. We are fortunate that Rob Franz who's the Director at Prince Charles managed to set this up to give us that opportunity to have a foot in, you know, in a metropolitan center where we can facilitate the care as part of the whole package. Having said that, when it comes to follow ups, we then will do it remotely and not necessarily let them come all the way down to Prince Charles again. So, yes, it's it's an integral part of it to have a foot over there it brings, you know, good patient care, but also job satisfaction for us, you know, to make sure that yes, the standard of care is not compromised because they live far away from the city.
Ian Moore 08:44
The people who are out there. They probably know what is available, although they may not have seen the growth and development programs like the flying surgeon, if they haven't seen it, then we need to get the word out to them so that they realize you're not taking three months off your life to travel to Brisbane. Your livestock are not in danger. Your property's not in danger. You can look after your health and still be living on the land.
David's Story | Flying Surgical Service
David's Story | Flying Surgical Service - video transcript
Dr Francis Osomah 00:18
So when we come out here we are on call every day and night, serving the remote community up until Friday when we fly out. And sometimes over the weekend, we get a locum to cover up, etc. But they're working on that as well. So we get calls, people coming in with acute conditions, from places like Charleville, Injune, Mitchell, etc, and so once they come in, we manage them here locally.
Dr Robert Franz 00:50
Well, I think it's just as important as in Metro, Metropolitan services. Just because you live five 600 kilometres west of Brisbane doesn't mean that you should have any lesser care than in metropolitano. regional or a large regional center in Queensland. So yeah, I think it's very important. Surgery is also changed, we're able to do lots more things as day cases, of course that goes with technology, so that it lends itself again, more to care closer to home, rather than traveling for many hours to have a day case procedure. But the quality of care should be equal to if not better than a metropolitan hospital.
David Fitzgerald 01:39
I'm David Fitzgerald.
Terri Fitzgerald 01:41
Initially, David was transferred to Rome for a CT scan to find out what was going on inside. And I had to drive him to Roma. We're only here for about half an hour. And they decided that he was that severe that Dr. Francis would operate on him. Dr. Francis was already in Roma. And yeah, within 45 minutes he was on the operating table, having his appendix removed and the mess that had created inside when the operation was completed at 1230 in the morning, Dr. Francis phoned me to let me know how everything went. And then three days later, the bowel had perforated. And Dr. Francis arranged for David to be flown to Prince Charles, and for a further operation that he could be involved in.
Dr Francis Osomah 02:45
In the case of Mr. Fitzgerald when he came in, essentially he had an acute abdomen and needed surgery. So went in with laparoscope had a look, and it wasn't an easy situation, so had to convert to opening, initial diagnosis was appendicitis possible diverticulitis, for which he's been on antibiotics for days leading up to come into us. Appendix was inflamed. Most of the pathology was in the right iliac fossa. Laparoscopicically, it was impossible so I had to convert to open to do the appendicectomy, however, on the first day he did very well. Two days later, he still developed peritonitis and we got him to be flown to Prince Charles for us to have a relook surgery to have a look. At surgery, essentially, he had a perforated sigmoid diverticulitis, that required sigmoid colon resection, colon resection and a Hartmann's procedure., in other words an end colostomy. He was fairly sick at the time and needed to go to ICU had to be on TPN and all the rest of it. But he made a very good recovery and then went back to Charleville which is where he originally comes from. Down the track, I scoped him to make sure that the yes the colon was clear, took a couple of polyps that were benign. And then he needed a reverse of his colostomy, however his he was a fairly big patient. So we got him to lose some weight as motivation to get his procedure done, which he did very well he lost like 20 plus kilos in a short time for us to do this operation. So we took him back to Prince Charles reversed his his Hartmann's and hooked him up. And today when I saw him the wound is all healed. He's feeding, bowels are working with is still fairly well maintained, which is great.
David Fitzgerald 04:54
I live in Charleville, and it takes three hours to get here by motor car. If you have roadworks along it takes you longer. And when you really crook you feel every bump in the, in the road when you're driving, you feel it's so rough. Once you get here, you it's good to see a specialist which knows what he's doing and talking about, which was really good to say, Francis.
Dr Francis Osomah 05:17
How have you been?
David Fitzgerald 05:19
Good Francis, yourself?
Dr Francis Osomah 05:20
I'm fine thank you
David Fitzgerald 05:27
This is a good thing for the real people, they got a specialist, they can rely on that and that, and it's really so good for 'em. He's just such a lovely man and lovely gentlemen. And the service is just A one to one, when you get released from hospital, and you come home, he rings up out on his own good to see how you're going, you don't get that from anyone else. And it's just such a lovely thing. And it makes you feel like if special. And it just makes your day
Dr Francis Osomah 05:59
Family members been around patients who are unwell is absolutely important to them many a time that is one main factor, if you give them various choices of allocation, first thing they talk about is I've got family here and there. And so it's certainly very important to, you know, sick patients or patients who really need to be in a hospital setting. Family members being around them help, even with our recovery, as well as providing them all the support socially that they need. So if they are isolated somewhere with out family, that's really a difficult situation, having to deal with the disease itself, as well as whatever news that will bring to them. And if they all by themselves, it makes it harder to take. It's easier if the family members can be around them and you can have a group discussion and make decisions together. So being close home is certainly a huge advantage, no doubt about that.
Terri Fitzgerald 07:05
And now on the day that I had to drive David to Roma. If Dr. Francis wasn't here, David would surely have died that night. So yeah, he was. He was in a set of angels hands as far as I'm concerned.
Bruce's Story | Flying Surgical Service
Bruce's Story | Flying Surgical Service - video transcript
Bruce Harris 00:26
Bruce Harris and I had emergency gallbladder operation in Roma at the Roma hospital aafter a couple of days were picked up in hospital and the surgeon came along and said we'll have to operate on you, so I went to surgury.
Lyn Harris 00:43
I was pretty, pretty dramatic for the first few days so then Bruce went to Maranoa Medical and Nick was there, and Nick wasn't happy and sent him up for a CT scan. And then on the Tuesday, we actually went back for the results of that CT scan, and I sent us straight to the hospital and that operation was at 6.30 7.30 that night. So yeah, his whole color he was just yellow.
Dr Francis Osomah 01:24
So Mr. Harris came in, and it was thought to be biliary colic, which they thought was fairly okay to be managed, you know, as an outpatient. However, he didn't do too well at home, came back one ultrasound on the Tuesday. And then he has spiked temperatures. And so they asked me to see him. And initially, on the day we were in Longreach. But then they called us over the phone. I said, Look, I'll have a look. When we come in and I was thinking, Wednesday is normally my theater day in Rome. So I can, you know, manage him overnight, and then put him on the list for the next morning. So that evening, when I saw him it was getting fairly late and he looked very unwell. He looked miserable. He had a temperature of nearly 39 degrees, his heart rate was high. And he looked sick. And the wife who's been a nurse in this hospital some time ago, said look this is my man he's really crook, Okay, he normally is a completely different human being all together. So of course, the operation couldn't wait till the next morning we needed to do it that night, took him to theater and did an emergency. laparoscopic cholecystectomy it all went fairly well. And he came to the ward, you know, recovered smoothly and that the next day in the afternoon once he was if you bro for 24 hours we got home, we get him home in the in the within 24 hours essentially without even been on any more antibiotics. The alternative would have been to fly him out of here in the night. Now by the time he gets to the nearest hospital which will be in Toowoomba, it will be probably midnight he won't get the surgery done, the delays will prolong on and on, and for a sick patient. I think the best outcome is to do the operation as soon as you can, which is what we did for him and glad the outcomes have been so good.
Bruce Harris 03:38
I found Dr. Francis quite good like I only met him for a couple of minutes before I went to theatre he liked only arrived there late on Tuesday, came in there about 5 to 10 minutes and he assessed the problem pretty well straight away knew what was happening. And arranged theater and the next day we had a resonable chat about what happened and whatnot and how bad it was. And I found in the report was no beating around the bush saying it could be this could be that he knew what it was and got on with the job.
Lyn Harris 04:19
If we had to fly out i don't think i think that it would still be in Trump device or somewhere like that because it would have actually ruptured that but thing you know, was pressure getting into aeroplanes and things, it's not good. So it was very, very important. You know, and for recovery because we didn't have to be away from home. I didn't have to be wiped from same way and lots
Bruce Harris 04:52
of hours left to the next die. It would have been another 24 hours before I would have went home So very thankful to Francis will say regarding the surgery was always really gotten to recover more. Linda Can you tell you how much fluidized bed? Well, Phil
Lyn Harris 05:25
country men are different. You know they fly San Diego pines and it's four out of 10 it can be 10 out of 10 he was yellow and getting more and more mo e li and that was the first thing that Nick picked up but now medical Senator, I really liked Francis because he's operated on one of their other family members. And the services they we have a fantastic hospital. They are the staff are beautiful,
Bruce Harris 05:57
or is it more covered with good buy for you? Because I suppose Francis decided upright that North when he got there, it was more extended. It will heal before it was done. I recovered quite well. He's operating with PL probably my recovery a lot better. However no problem the other people talk about they have Ivan drive and drive in and near beside Roy while going into Woolworths and shutting them down have a sandwich bye five on that little bit of a joke. Whereas other people now have a gallbladder icon. So whether that's good luck with surgery, I couldn't tell you.
Dr Francis Osomah 06:44
It's rewarding when you manage them and within a short timeframe. They're going home and you follow them up after a couple of weeks and now it's all resolved. It's that's the driving factor for us.
Bruce Harris 06:59
Though it was a real matter the night before.
Francis' Story | Flying Surgical Service
Francis' Story | Flying Surgical Service - video transcript
Dr Francis Osomah 00:24
My name is Francis Osomah. I'm one of the Flying surgeons that work both in the Prince Charles hospital and also in remote Queensland. We do come five days in a fortnight to serve the remote community with surgical services. We are part of the Flying Specialist Smarkervices that includes anaesthetic teams, as well as obstetricians that come along with us as a group together. Today, we find a Roma, and I'm with my colleague, Sarah, and our pilot is Mark. As we are in the remote setting, we visit different locations and provide surgical services. I originally come from Ghana, which is a developing country, so I didn't grow up with that much luxury, if you see what I mean. So when I come out here for me, you can make the best or most of the situation you get, sometimes you can be busy at times is not is not busy, have fun. Now we do play table tennis with other colleagues. Sometimes some of the medical students can have a good head. There's also the possibility to play tennis, occasionally go for a run, you know, to stay fit. So the little time you have left in the evening, you can, you know, use it fairly wisely, you know, you have Wi Fi in the unit you're given. So that gives you access to the rest of the world, if you want to that way, there's a lot you can do to keep yourself occupied, if that makes sense. So that's the way it is. Yeah. The plane that they provide us got very good services got a very good radar system on it. And it's probably one of the safest there is, from what I know, they've been former Air Force planes, etc. So they are really well maintained, it is much, much safer than maybe driving your car to the grocery store to be honest. Rarely, you get some bumping and turbulence here and there, but you quickly get used to that.
Terri Fitzgerald 02:41
I worked for the Royal Flying Doctor Service for nine years, and I just was in awe of them every day, these smaller communities wouldn't get the benefits that we get because Dr. Francis does come out to Charleville as well. We're just so blessed because of the Royal Flying Doctor Service.
Dr Mark Garrett 03:05
I'm Dr. Mark Garrett, I'm the Clinical Director of the Flying Specialist Service and I'm also a specialist anaesthetist for that service here at Roma, the Flying Specialist Service is an outreach service that is composed of a Gynecologist and a General Surgeon, and an Anaesthetist. We engaged by the Southwest Hospitals Health Service to visit 13 facilities around our west and south Southern Queensland, to provide the ONG and general surgical consultations and operations. Was a way of giving rural and remote population access to those services that otherwise they would find it difficult to get to. And this is the reason why that we're going to them rather than them coming to us.
Dr Francis Osomah 03:55
So the benefits for the rural hospitals and we do visit quite a number of locations apart from Roma where we base when we come here we go to Goondiwindi, we go to St. George, Miles, Longreach, they have the opportunity to not get through their tough ones and all the rest of it, you know, so that they don't breech you know, the categorizations and, and tense right up plus the serving thier community, there aim is to serve the community which is what we also aim for. So certainly it's very beneficial to, you know, the rural hospitals that we visit. When it comes to emergencies, from what I understand the cost is 10s of 1000s. To fly one person out to just get an appendix done for example, a gallbladder surgery done accurately, being there on the ground to deal with these conditions is really beneficial is also cost saving plus is good service too, to all parties involved.
Dr Robert Franz 05:10
The service when it started was was run by quite a iconic surgeons, it ran on for many years until they retired or passed on. And then it was because of our training and so forth changing over the last couple of decades, and family commitments is very difficult to recruit to smaller centers, more likely from family and educational things as children get older, of course, and the scope of or breadth of surgery is difficult to maintain with skills. We had, I was invited and privileged to be invited to look at the service some years ago with a couple of colleagues, both from nursing and surgery to see if we can reinvigorate the service and still provide a good breadth of service to these communities, which were then relying on locums to a very large degree. In fact, they couldn't recruit for several years. And we sort of spent several days looking at the service, speaking to patients, staff, and then trying to come up with a model where we could have continuity of service, particularly from surgeons point of view, as well as nursing staff and then also patients because while locums are fantastic, they were only there for three weeks at a time and came from international sites into interstate sites. And there was not that continuity that one would hope to get us a patient in or in a small center.
Dr Francis Osomah 06:40
I think it's a very rewarding job. It's it's satisfying, you know, you come out here, you get the job done. And you get, you know, very grateful people who really acknowledge the job you do for them, and is completely different from when you are in the city. You know, we take a lot of things for granted in the metropolitan, here you have patients who really understand the situation and really are grateful for the fact that you are coming to them and not the other way around. So it is a very rewarding and satisfying job. I would like to see the service expand, I would like to see it have more, maybe publicity or recognition, it's something new, I would say and it doesn't exist in many different places that that we know of is probably a unique situation that we've got. One thing I find very interesting in this part of the world is no matter how small a community or a town is, you may have a runway where you can easily land that's a huge advantage. But yes, flying out to them is fast and more efficient than driving several kilometres to reach to the patient. So it's a very ideal way of being able to serve the community with what they deserve.
Dr Mark Garrett 08:11
There's a great deal of benefit of working and living out in rural sites, because of a lifestyle for one thing, the type of work that you're doing is encompasses a whole lot of different areas, you get experience in different types of nursing, different aspects of medical management of patients, whether that be surgical, or otherwise. There's not there's there's great opportunities for for rural generalists who have got advanced skills in rural and remote Queensland. That is people who have done aneasthetics, people who have got advanced skills and obstetrics and people and advanced skills in surgery which is the reason why we have got a quite a number of these rural generalist out here providing services.
I would strongly encourage them to do it. I'll be very happy to hear that really because not too many young people will want to go the medical pathway you know, looking at sometimes they criticise our working hours and our lifestyle etc. They've got options. So if a young person came to me wanting to be part of what we do, I was so much embrace it. I love it. Yeah.