fact: on average, every 2 minutes a doctor spends with a patient, they spend 25 minutes documenting
this morning, i walked into my patients 'room' [curtain...] and asked him how he was doing. then i said "do you know what is going on, has anyone talked to you about the plan."
nope, i have no idea what is happening. i tried to explain as best as i could...but then i had to go to finish documenting his progress note before rounds started.
later in the day, instead of explaining what is going on and how we are helping, i spent about 2 hours writing transfer paperwork for my patient. by the time i was done, i was so tired i spent maybe 10 minutes with him and then left for the day.
our medical system is ridiculous.
instead of using time wisely, talking to the patient, counseling them, explaining what they can do to help themselves...we end up having a ton of paperwork and documentation to do in order to legally protect ourselves from lawyers. thus, we never educate the patient well enough and they return again and again for things that can be prevented.
our medical system is ridiculous.
Thursday, May 24, 2012
Monday, May 21, 2012
the first time i nearly killed someone
The title may be a little more dramatic than the actual events...but really, i could have done something very bad. good thing there are many safety guards in place to protect my patients from me :)
this morning during rounds i had 5 patients to see and came in extra early to be on top of everything. i was doing great, looked like a rockstar, had all my notes and updates organized. wrote the orders the doctor and I discussed he glanced em over and we moved on. we saw a couple more patients and then went to the doc's office to get a lecture from him. not 2 minutes in, we got a phonecall. he puts it on speakerphone [like usual] and its a nurse...asking about our order. "I just wanted to clarify the order you left for patient X, you want 60 units of long acting insulin 3 times a day? He was only on 58 twice a day before."
crap
we verbally clarified the order to 60 units twice a day. the doc wasnt mad, thank god. he just went into a speech about mistakes, how it is easy to make them, and to triple check all the orders we write. [to note, that extra 60 units would have made him hypoglycemic putting him into a coma and probable death]. We were told that from the time we write the order, 7 people see it, read it, and double check it before it is actually given...several nurses, nursing clerk, pharmacist, etc.
food for thought: "The average, major teaching hospital experiences an increase in risk-adjusted mortality of roughly 4 percent in the July-August period."
this is when new intern's [just graduated 4th year medical students] begin their residency...practicing medicine on 'their own' for the first time. granted, like this example, there are lots of things in place to keep us from killing patients...despite our best efforts. but, accidents still happen.
stay away from the hospital in July and August....
this morning during rounds i had 5 patients to see and came in extra early to be on top of everything. i was doing great, looked like a rockstar, had all my notes and updates organized. wrote the orders the doctor and I discussed he glanced em over and we moved on. we saw a couple more patients and then went to the doc's office to get a lecture from him. not 2 minutes in, we got a phonecall. he puts it on speakerphone [like usual] and its a nurse...asking about our order. "I just wanted to clarify the order you left for patient X, you want 60 units of long acting insulin 3 times a day? He was only on 58 twice a day before."
crap
we verbally clarified the order to 60 units twice a day. the doc wasnt mad, thank god. he just went into a speech about mistakes, how it is easy to make them, and to triple check all the orders we write. [to note, that extra 60 units would have made him hypoglycemic putting him into a coma and probable death]. We were told that from the time we write the order, 7 people see it, read it, and double check it before it is actually given...several nurses, nursing clerk, pharmacist, etc.
food for thought: "The average, major teaching hospital experiences an increase in risk-adjusted mortality of roughly 4 percent in the July-August period."
this is when new intern's [just graduated 4th year medical students] begin their residency...practicing medicine on 'their own' for the first time. granted, like this example, there are lots of things in place to keep us from killing patients...despite our best efforts. but, accidents still happen.
stay away from the hospital in July and August....
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