you come to the hospital in the morning to see your patients. you say good morning to the housestaff, ask about overnight events. they are surprised, werenāt you just here? yes. yes, you were. you were here. youāve always been here.
it is time for you to do the very important medicine reconciliation. you ask the patient. they say they donāt know, you should have the list. you ask the staff for the list. there is no list, but they reassure you itās updated. you look on the EMR, the updated med list has no dosages. you ask the patient for their pharmacy. you call the pharmacy. there is no record of your patient.Ā
you need a stat lab. the blood gets to the lab. itās hemolyzed. you get it sent again. itās hemolyzed. third timeās the charm? your patient has no more veins.
you have managed your patient. you have a plan. you just need to run this by a consultant. you call a consultant. the phone rings for eternity.
there, you see your consultant go into a patient room. you have a quick question for them. they never come out. what consultant? everyone including your patient swear they were never here. the consultantās note shortly appears in the EMR. it does not answer your question.
you are called to assess a situation. before the situation can be assessed, there are cries for calls - did you call the ICU , did you call cardiology, did you call GI, did you call the lab, did you call xray tech, did you call the family, did you call the caregiver, did you call the POA who is neither the family nor the caregiver...you will, you will, you will, you
"how was your day?ā someone asks you 10 minutes before change of shift. your face falls. you did not use the Forbidden Words all day but now it matters not. a darkness passes over the ward. your pager and phone go off. it was almost the end. now it is the beginning