Nothing irritates me more than when I'm asked to do someone else's work. It is, far and away, the most aggravating thing imaginable, and the greatest offenders without comparison are the ER folks. And today was no exception. I was called to evaluate a patient in the ER who was hemodynamically stable, and all that was done was an EKG. There was not a physician eval completed, no labs were back, nothing. For all I knew, the guy could've had a troponin of 56.
So now, I'm taking an H+P from scratch. I am for all intents and purposes now an ER doc that can admit. The ER doc did his charting AFTER I did orders and dictated my H+P. At that point, why even bother? H+P trumps ER papers. All you can do is make me look bad, because what if a lab comes back now and you chart it? Now I've got to make extra special point in my H+P to note that this wasn't done and that wasn't done, just to guard against the possibility that you'll chart on it way late.
I told the ER to get my patient upstairs as fast as they could not because he was acute or urgent, but I didn't want my patient to stay in the ER if that was the level of shitty care he was going to get.
If you have anything to do with the ER, please remember two things. (1) If you're going to call for admit or consult on a patient, be sure to have your own paperwork done. (2) If you're going to call for admit or consult from cards and you haven't even got labs back yet, someone better be dying.
3 comments:
it's comforting to know that the ER at your midwest internal medicine residency is just as shitty as the ER at my midwest general surgery residency.
we got a vascular consult the other day because the ER attending couldn't feel a left DP pulse. he didn't bother to check for the PT, or get out the doppler to listen to signals. needless to say, we checked ABI's to be sure...and they were normal. giant waste of our time...
good lord.. sounds like your ER is about as bad as the ER at my southwest internal medicine program. I love the "we have an intubated patient without any labs or studies, just come get him". bastards
I never want my patients staying down in the ER more than they need to -- the ER nurses are always all uppity about being the best in the hospital when the admitted patients always receive the worst care. I also really hate it when ER docs start writing orders on patients that I already admitted. wtf.
It pisses me off, at my midwest family medicine residency, when I get called to admit a patient and find nothing back yet. But what really pisses me off is when a lab comes back on one of these patients and they need to go to the unit instead. Result...a complete waste of my time.
Post a Comment