Friday, October 05, 2007

Losing Control

"Doctor, your patient's blood pressure really low, it's 60/40!"

"Wha....??? What happened?"

"I don't know doctor. I know he had that catheter ablation yesterday where you poked holes in the patient's legs and thread catheters to all kinds of chambers in his heart to ablate his atrial fibrillation, and he was doing so well..."

"So what the hell happened?"

"Nothing."

"What do you mean, 'Nothing?'"

"Well, I guess I gave him that flu shot."

"What flu shot?"

"That one that you ordered."

"I didn't order a flu shot!"

"The computer says you did."

"What the hell are you talking about?"

"Our computer says that all patients will get a flu shot if they are over 50 and a pneumovax vaccine if they're over 65 as part of the quality assurance initiative, so they added it to your orders. And I went ahead and gave it, because the patient didn't refuse, and I have to take off all of the orders, you know."

"Please give him 500cc saline bolus, hydrocortisone 100 mg IVPB and benadryl 50 mg IVP right away. I'll be right in."

* * *

How many other orders will be added on my behalf without my knowledge in the interest of "quality healthcare?"


-Wes

7 comments:

scalpel said...

We cannot allow this to happen, ever.

DrWes said...

Scalpel-

It's happening. Right now. Despite the objections of many physisians.

Anonymous said...

I did an outpt pre-op eval on a pt going to surgery.
When he got admitted post op the ICU nurse used my name for a routine protocol order for an MRSA screen.
I then got notified that he was MRSA positive.
Aggravated the heck out of me because I was not even responsible for his care in the hospital. The vascular surgeon was.

CardioNP

Scott said...

Wow! That is cute. I love what they are doing to the poor patients these days!

The nurse should have called you, though!

BrianW said...

For us laymen out here, why would a flu shot cause blood pressure to drop like that? Thanks!

DrWes said...

brianw-

Flu vaccine is usually grown in fertilized chicken eggs. Both types of flu vaccines are contraindicated for those with severe allergies to egg proteins due to the potential for anaphylaxis and its associated drop in blood pressure.

ERnursey said...

Thank you JCAHO or whatever inane regulatory agency says we have to assess your alcoholic intake, see if you are a victim of domestic violence, check if you have an advance directive, fill out the medication reconciliation form, find out your vaccination status and so on and so on and so on.