many letters from govt departments end with these words. it means that the writer is just following instructions "from above," even though that person may well be the head of the dept. i thought it rather odd - if everyone is following instructions, can no one do things differently, or must it be strict compliance to "the instructions" from whoever who issued them?
i was interrupted in my sleep early this morning by the nurse from ICU, informing that my patient's breathing was laboured & the oxygen content in his blood was very low. having rushed to hospital in double quick time, i was dismayed that the nurse had administered to him only 2 lit of oxygen per minute all that time, a miserly amount given his dire condition. she defended herself by stating that was the flow rate the previous doctor had ordered.
naturally, i snapped at her & criticised her for not using her discretion. 2 lit/min of oxygen is fine for most patients who are not critically ill, but when they develop breathing difficulties that result in low oxygen content in the blood, the oxygen flow needed to be increased. the level of treatment must be appropriate for the condition of the patient - is that too difficult a concept to grasp???
anyway, everything turned out ok for the patient. i left the ICU with the sinking feeling that the public sector's "saya yang mengikut perintah" culture has already pervaded private medical care.