(click to enlarge)
Monday, July 18, 2011
Monday morning hospital rounds
(click to enlarge)
Subscribe to:
Post Comments (Atom)
skip to main |
skip to sidebar
I love it when I see contradictory stuff like this in a chart:
(click to enlarge)
A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
(click to enlarge)
Welcome to my whining!
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
Singing Foo!
Singing Foo!
Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Blog Archive
-
▼
2011
(616)
-
▼
July
(51)
- Weekend reruns
- Overheard at home
- Bad ways to meet girls
- Then why did you come here?
- Driver's Ed
- Checkmate!
- Neurology, 2011
- Do not try this at home
- Helpful
- Fun with drugs
- Sunday night. 11:35 p.m.
- Memories...
- Today, on the Travel Channel
- The joy of Wikipedia
- Friday afternoon whatever
- Urgent matters
- Balancing act
- High speed chase
- Guess again
- Maybe I should dress better
- Today's criminal tip
- Life in line
- That doesn't sound good
- Monday morning hospital rounds
- Sunday Reruns
- Random Saturday pictures
- Minor details
- Attention patients:
- Annie's desk, July 13, 2011
- Ways you don't want your body found
- Let's hope she was adopted
- July 13
- Public Service Announcement
- Lost in translation
- Huh?
- Rhyme and verse
- Dude, am I driving?
- Memories...
- Things that go BOOM!
- Pick-up lines from a pizza
- Concern
- "Hey! Let's get drunk, steal a gator, and go 4-whe...
- Random memories of Monday
- Dear Ms. Patient,
- Mary, give this man an appointment
- Show him the BaRF!
- July 4th history lesson
- New page announcement
- Sunday reruns
- Random pictures
- I stand corrected
-
▼
July
(51)
20 comments:
Yep, I love this kind of thing. On Friday I filled 240 Percocet for someone whose 'allergies' included oxycodone. Looking back over his med list I could see this was approximately his 50th fill, so I cleverly disregarded the 'allergy'. See it all the time, though!
As a transcriptionist, I would have flagged that. But I can't promise anything after that. I am not sure half my flags aren't ignored anyway.
Lawyers love it too!! :-P
Another transcriptionist here. I see this way too often. It doesn't help that some docs put them in as an aside in the H&P or PMH. Hello, guys, separate heading, capped and bolded! We do everything but put them in flashing neon lights. Doesn't anyone check?
Another transcriptionist here. Our problem at our facility is that the allergies are put on the EMR by the medical assistants, and the doctors don't see them or review them (not sure which) at the time of their dictations. Therefore you get the allergies that drop into the report and medications the doctor dictates. I think I see this kind of oops at least once a week.
I think there should be an "intolerant of" section in addition to allergies.. a patient telling me vicodin is an allergy because it makes them throw up bugs me..but severe vomiting is a noteworthy side effect/intolerance that probably should be listed somewhere important..
Medication making someone throw up may not sound like a side effect, but let me tell you, when you're screaming in pain and your blood sugars are all over the place from the stress of the 50 out of 10 scale pain, discovering that oxycodone makes you barf like the kid in the Exorcist (and, gee, has no effect on the pain) does NOT help your health any.
There's another side effect where the "kindly" nurse tells you you can't have any other pain meds, since you just had some. In me, apparently, oxycodone can cause murderous rage.
This makes those of us in pharmacy SO MAD!!!!!! I get PAs with the med requested listed as an allergy and wonder if anyone even made a connection to this egregious error. Then as I dial the office I cross my fingers that it was listed as a mistake.
As any experience nurse, doctor, pharmacist knows; half the listed allergies are total and utter crap.
As my fellow transcriptionists have already noted, we see this stuff regularly and try to flag it. Our concern is that the EHR is going to eliminate those checks and balances that have been taken for granted, and largely gone unnoticed, as more and more physicians do their own documentation with no QA in place. The problem is that doctors are constantly interrupted-nurses, pagers, phone calls. It is no wonder that doctors cannot complete a thought or finish a sentence.
I hope somebody figures out that the EHR is only going to compound documentation errors and propagate those errors exponentially (compared to paper records in physician-office silos). MTs have been silently flagging this stuff for years but we are being taken out of the picture more and more these days.
Was the diagnosis 'allergic reaction'? Or, perhaps, the patient suffered a head injury from falling down due to precipitous syncope related to anaphylaxis?
I always get a kick out of looking over ER charge sheets for methylprednisolone and diphenhydramine and perhaps a little famotidine, and the diagnosis as 'allergic reaction' but allergies listed are 'NKA', like maybe we should avoid giving this parson any more of what to avoid an emergency trip to the ER in the middle of the night?
Geez, we see this ALL the time. patient allergic to Tylenol given vicodin. patient allergic to Oxycodone given percocet. makes you wonder if the allergy profile is really worth much really....
Maybe the doctor really hates the patient and is hoping they will go into fatal anaphylactic shock?
Pharmacy Chick- They did that to me, which is why I've become just like Moose in my murderous rage. I know that projectile vomiting is 'technically' NOT an allergy, but for the health and safety of everyone involved in my care, I list it as one, because when you can digest it, it won't help make the pain go away.
Best ever I've seen is a type 1 diabetic having insulin listed as an allery! Saw that today in a chart and laughed out loud.
Sounds like the PA I saw at a big name pain clinic. After I told him I have serious neurologic reactions to SNRIs (sunburn type pain all over including inside the mouth) he prescribes me Savella for FM pain. At least I'm smart enough to look this stuff up before I go to the pharmacy to order it.
But if you ignore the stupid allergy info, and something, ANYTHING, happens to the patient...
As a clinical hospital pharmacist, my first impression would be that the patient doesn't want generic Dilantin, so he listed it as an allergy. How close to truth is that?
Truthfully, if you fill it without questioning, that will be the one that has a horrible reaction and you'll have to live through a root cause analysis and friendly discussions with a few directors.
And when you call to question the allergy, the nurse and physician will act like you're an idiot.
There's just no winning in our big happy dysfunctional health care system.
Back again, the best allergy I've ever seen was IV saline. So how come you're not dead already?
As a former transcriptionist, this made me laugh too. I can't add to anything that the other MT's said, other than it never stops... Just keep typing what's dictated and flag, flag, flag...
Post a Comment