tag:blogger.com,1999:blog-4968787219619380438.post6452130621700590886..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: How does a 16-year-old boy receive 38 times the normal dose of an antibiotic? Skeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger15125tag:blogger.com,1999:blog-4968787219619380438.post-6371603240938870232015-05-31T14:46:08.059-04:002015-05-31T14:46:08.059-04:00@William ...... story of America's life@William ...... story of America's life Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-83798928818549622472015-05-31T14:42:48.636-04:002015-05-31T14:42:48.636-04:00Anonymous said...
I can attest to the patients who...Anonymous said...<br />I can attest to the patients who complain (even rightfully, respectfully and politely) are crapped on. Its like we are expected to take it and I'm sorry but no. A graduate degree does not give any person the right to take my money, mess me up and then tell me to say thank you. <br /><br />That includes nurses who do not give me the medication the doctor ordered. I've done a lot for those who help and those who make a mistake and fix it. I will not in any way tolerate an attitude about it or make it out to be my fault when it was plainly theirs. If they can't fix a problem, admit it and fix it, then you were not 'called' to medicine.<br /><br /><br /><br />PREACHHHHHHHHHHHAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-83124568619913024632015-04-14T16:11:33.310-04:002015-04-14T16:11:33.310-04:00I know EMR can be wrong There are things in mine t...I know EMR can be wrong There are things in mine that I never said but it is what the provider thinks I said. frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-358878742529526112015-04-14T15:17:20.085-04:002015-04-14T15:17:20.085-04:00Skep, I knew there was a reason I admired you. You...Skep, I knew there was a reason I admired you. You are right. Admitting you made a mistake is the first step. Oddly enough, I have said when I've picked the wrong diagnosis in the EHR. Modeling behavior. :) <br /><br />Frankbill you forgot the EHR could be wrong, and I've got parts of several EHR's. So what you see might not be what you get. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-4732051252738809922015-04-14T11:17:19.885-04:002015-04-14T11:17:19.885-04:00I find that the mistakes that that many providers ...I find that the mistakes that that many providers make is looking at EMR and assume that past providers have done every thing right. frankbillhttps://www.blogger.com/profile/05592389641852861124noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-16879634268441341742015-04-14T07:31:49.683-04:002015-04-14T07:31:49.683-04:00Admitting you made a mistake is the first step tow...Admitting you made a mistake is the first step toward maturity.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-80365145375861148912015-04-13T22:28:29.793-04:002015-04-13T22:28:29.793-04:00I can attest to the patients who complain (even ri...I can attest to the patients who complain (even rightfully, respectfully and politely) are crapped on. Its like we are expected to take it and I'm sorry but no. A graduate degree does not give any person the right to take my money, mess me up and then tell me to say thank you. <br /><br />That includes nurses who do not give me the medication the doctor ordered. I've done a lot for those who help and those who make a mistake and fix it. I will not in any way tolerate an attitude about it or make it out to be my fault when it was plainly theirs. If they can't fix a problem, admit it and fix it, then you were not 'called' to medicine. Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-23449882407479687632015-04-13T08:24:06.087-04:002015-04-13T08:24:06.087-04:00Yes, patients who complain are often viewed as nui...Yes, patients who complain are often viewed as nuisances.<br /><br />A doctor cannot be perceived as criticizing a nurse. Such a perception would be harshly viewed if the nurse complained to administration.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-67803407376448473512015-04-12T07:29:19.849-04:002015-04-12T07:29:19.849-04:00Anonymous Europe:You know this is just plain crazy...Anonymous Europe:You know this is just plain crazy...<br />What is more bothering me is how nursing handled you. And your reaction "I did not want to be accused of being mean to the nurses..." A patient gets iv dopamine from somewhere, you find the error, correct it, signal it, and then you are almost made guilty of not being nice to the nurses and you have to be afraid of such accusations... (and I am pretty sure you are a nice guy). Something is terribly wrong...<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-10593990048267165152015-04-11T23:29:18.714-04:002015-04-11T23:29:18.714-04:00Wow, what a scary read! I used to work as a pharma...Wow, what a scary read! I used to work as a pharmacy tech back in the '80s and would have also assumed, as the nurse had, that the 37 extra tablets were there because the pharmacy was out of the appropriate dose. I wish the author would have mentioned the occasional hospital/pharmacy tendency where patients and their families are belittled when someone complains, "Hey, that doesn't look right." or "This isn't what he usually takes." Patient's who complain are sometimes viewed as nuisances, no? Lesnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-57192024385221174332015-04-11T13:44:18.714-04:002015-04-11T13:44:18.714-04:00William, that's a fascinating story.I'd li...William, that's a fascinating story.I'd like to turn it into a separate blog post.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-34607008838251735002015-04-10T21:36:13.654-04:002015-04-10T21:36:13.654-04:00Some time ago, I was consulted on a patient becau...Some time ago, I was consulted on a patient because of excessive<br />urination. The patent was putting out 4 or 5 five liters a day and no- body knew why. I checked out all the usual suspects, DKA, hyperglycemia, diabetes insipitus,ect. and all the meds listed on the <br />med sheet that documented his care. No diuretics. Finally, at my wits end, I entered the ICU room and noticed a number of med bags , some full, some empty hanging there on the IV pole . I checked each and discovered a bag labeled "dopamine ', slowly dripping in. I went to the nurse and asked how long the patient had been on dopamine . She said "He's not on dopamine". I said "come with me" and I showed her that he was in fact getting low dose dopamine ( that behaves like a diuretic.)<br />He had been on it for 2 weeks unbeknownst to those "taking care" of him. The next day I got a call from the head of nursing informing me that it was not nursing's fault. Perhaps the IV team or the pharmacy was responsible. I agreed with her. I did not want to be accused of<br />being mean to the nurses.Anyway. according to the computer printout and the nursing notes he was NOT on dopamine..Maybe a relative snuck in and hung the drug .No one was faulted. . The problem resolved. No "root cause analysis was undertaken " Why bother?<br />William Reicherthttps://www.blogger.com/profile/10062067819184876941noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-73667289019330671052015-04-10T00:37:38.955-04:002015-04-10T00:37:38.955-04:00I believe the ratio of administrators to doctors i...I believe the ratio of administrators to doctors in the US is 10:1. I agree about the mindless rules in hospitals. I've blogged about that. <br /><br />You may be right about the future roll of doctors. As I've said many times, I'm glad I'm retired. But I'm sad for the younger generations. Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-44896630316143751172015-04-09T16:57:40.882-04:002015-04-09T16:57:40.882-04:00The answer to your question, in my mind, is: Absol...The answer to your question, in my mind, is: Absolutely. There are portions of medicine that have been greatly enhanced by the use of computers, but there is an equal set of areas that have either not benefited or, as this article points out, seen the birth of only new problems. Not only has the delivery of medical care been affected by the profligate, unchecked dissemination of technology, but the training of and professional roles of physicians have also been affected. As one colleague once asked, "What are these young docs gonna do when the lights go out?" I dared not offer an answer. <br /><br />The other day I had a nurse tell me that in the not-too-distant future, all physicians will be good for will be signing off on diagnoses and orders made and placed by nurses or mid-level providers augmented by AI in every field from radiology to surgery, and patients won't mind since they'll still technically have MDs in the background and their out-of-pocket costs will finally be controlled. Granted, I'm fairly certain she was a bit off, but the looming reality of physicians losing their place on the front line and being relegated to cramped offices in the background isn't a very pleasant one.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-46567677737069683692015-04-09T16:34:30.997-04:002015-04-09T16:34:30.997-04:00Anonymous Europe: Wow.. You guys can prescribe pil...Anonymous Europe: Wow.. You guys can prescribe pills to kids?? Here where I am they hardly swallow the syrups we try to give them.. Seriously: the whole problem lies in automatizing the handing out of medicaments to the public as well as badly organized and paperwork ridden hospitals. Where I am there are three pencil pushers for every doctor and guess what: We go on a ward round around 8 ( that is normal European ward round time) and they pass us and each has a steaming cup of tea in her hands.... The problem is, hospitals are full of idiotic, mindless regulations, which are decided by people who did not even finish college let alone medschool... One more great story for this: in OR a new anaesthesiologist told me the story that when in the upper region of the state two clinics merged, there were 30 burocrats at the merger and 3 doctors....If we let this constantly happen to us,we will be way worse off than badly written prescriptions get handed out...Anonymousnoreply@blogger.com