Thanks to the many state, federal and private regulatory bodies and the activities of their devoted employees, I have beenrecently reminded of the absolutely terrifying workplace in which I ply my profession. Kudos to you, clip-board carrying men and women! You stalk the hospitals, enjoy your lunches, fill out your forms and year after year find more reasons you should be looking over my shoulder! I can’t say you increase our efficiency, but I can say you dress nice!
What, perchance, am I ranting about? Well, in the last two weeks I have learned that:
Our nurse manager should address the perilous boxes of printer toner that sit under a cabinet, safely out of the way of everything. Why? ‘They need to be sitting on a piece of plywood, or soemthing like that, off the floor!’ Thank heaven’s I didn’t realize how dangerous it was! I mean, for years I’ve walked past that toner, sitting on the floor, perched like a Cobra waiting to strike! With the addition of some administrative oversight, and a little bit of plywood, we can all be assured of our safety once more. Go back to your lives, citizens! The toner is on plywood! Everything is under control! But wait, what’s the plywood sitting on? What’s that? The floor? Then, shouldn’t the plywood be sitting on plywood? Quite the Gordian Knot, isn’t it?
Next, I learned that when I ordered that Ketamine to help me intubate the vast specimen of humanity thrashing and gasping in front of me, I couldn’t. ‘We’ll get in trouble if we push it,’ the nurse informed me. Makes sense, I suppose. Ketamine, after all, doesn’t suppress your respirations or cause decreases in blood pressure. So, we gave a vastly safer drug; Succinylcholine, which paralyzes all of your muscles for 5 minutes. That sounds much safer, doesn’t it, kids? Of course, the nurses can also push thrombolytic drugs for MI and stroke that migth leave you bleeding out of every orifice, and into your brain. Or Insulin, that could make your blood sugar plummet to a very functional level of ‘zero.’ Thank heaven’s, no Ketamine! We’re still safe! Thanks to all of the clip-board artists who made that decision, without ever thinking at all.
And finally, best of all, I was informed that if I draw a vial of local anesthetic while doing a lumbar puncture, and if the lumbar puncture tray subsequently has Betadine on it (the brown, Iodine based antibacterial solution we use in hospitals), then I have to label both the vial and the Betadine, or get rid of one of them. Clearly, I’m such an idiot that I can’t tell them apart. Why, just last week I started to inject Betadine into someone’s spine, until someone said, ‘hey, that’s labeled Betadine, you can’t do that!’ Duh! I felt like such a loser! All of this, I suppose, has to do with the injunction by an administrator who was explaining the ‘time-out.’ ‘It’s all so we’ll just take a minute and think!’ Guess what? I think all the time. I get paid to think. I have to think. And I do it sans clipboard. I do it at all hours of the day and night.
How about this? Label every pen on your desk, oh watchers of the rule-book, oh wizards of the regulation! And let me set some safety protocols for how you’ll use your desk and computer, and how you’ll attend meetings; what clothes you’ll wear and how long you’ll pause before you do the thing you’ve been doing just fine until I came along!
Someone show my why Ketamine is more dangerous than anything else. Somebody show me why things on plywood are safer than things on the floor. And somebody please explain to me how many people have been harmed by inadvertant injection of Betadine during a lumbar puncture.
And then, tell me how many clip-boards it takes to make medicine more efficient.
How come with all the push for HIT, the ‘suits’ are using clipboards in lieu of tablet PCs??? We need another stimulus bill. Think how much less health care would cost without the bureaucrats looking over our shoulder checking off boxes…And why do the toner boxes have to be on plywood? Can it be plastic, or will that spontaneously combust.?? How about a time out for the CEO when they come in the door to see if they need to go right or left, or a time out when they need to use the rest room…we need an attendant and… Read more »
Angie Cromer
14 years ago
Oh my goodness – can I relate! I feel that so much time is needlessly wasted on the “pre-timeout checklist”, followed by the op-checklist, followed by the pre-epidural checklist, followed by the epidural “time-out”, followed by the op “time-out”. I realize safety is of the utmost, and I am a believer of all things that help me eliminate error. Yet, not once in my 18 years of labor & delivery nursing, have we ever inadvertently performed a lap appy on a Cesarean Section patient. Our patients are all alert for surgery, so imagine how silly I feel asking her if… Read more »
mamadoc
14 years ago
Have you been infested by JACHO or perhaps just some overzealous administrator from Corporate? Both are indeed, da devil. And just remember, while you are trying to deal with said vast specimen who is thrashing around at 3:00 am that lot are sound asleep in their little white beds dreaming, no doubt, of their bonuses. When exactly, did those of use who actually DO healthcare give up control to these people?
Justin
14 years ago
I’ve never intubated the wrong patient. I’ve never lanced an abscess on the wrong limb. I’ve never LP’d the wrong spine. Guess JCAHO has done a good job with our hospital.
Have they started counting how often you use alcohol gel?
{"id":null,"mode":"form","open_style":"in_place","currency_code":"USD","currency_symbol":"$","currency_type":"decimal","blank_flag_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/blank.gif","flag_sprite_url":"https:\/\/edwinleap.com\/wp-content\/plugins\/tip-jar-wp\/\/assets\/images\/flags\/flags.png","default_amount":100,"top_media_type":"none","featured_image_url":false,"featured_embed":"","header_media":null,"file_download_attachment_data":null,"recurring_options_enabled":true,"recurring_options":{"never":{"selected":true,"after_output":"One time only"},"weekly":{"selected":false,"after_output":"Every week"},"monthly":{"selected":false,"after_output":"Every month"},"yearly":{"selected":false,"after_output":"Every year"}},"strings":{"current_user_email":"","current_user_name":"","link_text":"Leave a tip","complete_payment_button_error_text":"Check info and try again","payment_verb":"Pay","payment_request_label":"EdwinLeap.com","form_has_an_error":"Please check and fix the errors above","general_server_error":"Something isn't working right at the moment. Please try again.","form_title":"EdwinLeap.com","form_subtitle":"If you enjoy the content you read here, please consider dropping something in the tip jar!","currency_search_text":"Country or Currency here","other_payment_option":"Other payment option","manage_payments_button_text":"Manage your payments","thank_you_message":"Thank you so much! I appreciate the tip!","payment_confirmation_title":"EdwinLeap.com","receipt_title":"Your Receipt","print_receipt":"Print Receipt","email_receipt":"Email Receipt","email_receipt_sending":"Sending receipt...","email_receipt_success":"Email receipt successfully sent","email_receipt_failed":"Email receipt failed to send. Please try again.","receipt_payee":"Paid to","receipt_statement_descriptor":"This will show up on your statement as","receipt_date":"Date","receipt_transaction_id":"Transaction ID","receipt_transaction_amount":"Amount","refund_payer":"Refund from","login":"Log in to manage your payments","manage_payments":"Manage Payments","transactions_title":"Your Transactions","transaction_title":"Transaction Receipt","transaction_period":"Plan Period","arrangements_title":"Your Plans","arrangement_title":"Manage Plan","arrangement_details":"Plan Details","arrangement_id_title":"Plan ID","arrangement_payment_method_title":"Payment Method","arrangement_amount_title":"Plan Amount","arrangement_renewal_title":"Next renewal date","arrangement_action_cancel":"Cancel Plan","arrangement_action_cant_cancel":"Cancelling is currently not available.","arrangement_action_cancel_double":"Are you sure you'd like to cancel?","arrangement_cancelling":"Cancelling Plan...","arrangement_cancelled":"Plan Cancelled","arrangement_failed_to_cancel":"Failed to cancel plan","back_to_plans":"\u2190 Back to Plans","update_payment_method_verb":"Update","sca_auth_description":"Your have a pending renewal payment which requires authorization.","sca_auth_verb":"Authorize renewal payment","sca_authing_verb":"Authorizing payment","sca_authed_verb":"Payment successfully authorized!","sca_auth_failed":"Unable to authorize! Please try again.","login_button_text":"Log in","login_form_has_an_error":"Please check and fix the errors above","uppercase_search":"Search","lowercase_search":"search","uppercase_page":"Page","lowercase_page":"page","uppercase_items":"Items","lowercase_items":"items","uppercase_per":"Per","lowercase_per":"per","uppercase_of":"Of","lowercase_of":"of","back":"Back to plans","zip_code_placeholder":"Zip\/Postal Code","download_file_button_text":"Download File","input_field_instructions":{"tip_amount":{"placeholder_text":"How much would you like to tip?","initial":{"instruction_type":"normal","instruction_message":"How much would you like to tip? Choose any currency."},"empty":{"instruction_type":"error","instruction_message":"How much would you like to tip? Choose any currency."},"invalid_curency":{"instruction_type":"error","instruction_message":"Please choose a valid currency."}},"recurring":{"placeholder_text":"Recurring","initial":{"instruction_type":"normal","instruction_message":"How often would you like to give this?"},"success":{"instruction_type":"success","instruction_message":"How often would you like to give this?"},"empty":{"instruction_type":"error","instruction_message":"How often would you like to give this?"}},"name":{"placeholder_text":"Name on Credit Card","initial":{"instruction_type":"normal","instruction_message":"Enter the name on your card."},"success":{"instruction_type":"success","instruction_message":"Enter the name on your card."},"empty":{"instruction_type":"error","instruction_message":"Please enter the name on your card."}},"privacy_policy":{"terms_title":"Terms and conditions","terms_body":null,"terms_show_text":"View Terms","terms_hide_text":"Hide Terms","initial":{"instruction_type":"normal","instruction_message":"I agree to the terms."},"unchecked":{"instruction_type":"error","instruction_message":"Please agree to the terms."},"checked":{"instruction_type":"success","instruction_message":"I agree to the terms."}},"email":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email address"},"success":{"instruction_type":"success","instruction_message":"Enter your email address"},"blank":{"instruction_type":"error","instruction_message":"Enter your email address"},"not_an_email_address":{"instruction_type":"error","instruction_message":"Make sure you have entered a valid email address"}},"note_with_tip":{"placeholder_text":"Your note here...","initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"empty":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"not_empty_initial":{"instruction_type":"normal","instruction_message":"Attach a note to your tip (optional)"},"saving":{"instruction_type":"normal","instruction_message":"Saving note..."},"success":{"instruction_type":"success","instruction_message":"Note successfully saved!"},"error":{"instruction_type":"error","instruction_message":"Unable to save note note at this time. Please try again."}},"email_for_login_code":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email to log in."},"success":{"instruction_type":"success","instruction_message":"Enter your email to log in."},"blank":{"instruction_type":"error","instruction_message":"Enter your email to log in."},"empty":{"instruction_type":"error","instruction_message":"Enter your email to log in."}},"login_code":{"initial":{"instruction_type":"normal","instruction_message":"Check your email and enter the login code."},"success":{"instruction_type":"success","instruction_message":"Check your email and enter the login code."},"blank":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."},"empty":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."}},"stripe_all_in_one":{"initial":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"empty":{"instruction_type":"error","instruction_message":"Enter your credit card details here."},"success":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"invalid_number":{"instruction_type":"error","instruction_message":"The card number is not a valid credit card number."},"invalid_expiry_month":{"instruction_type":"error","instruction_message":"The card's expiration month is invalid."},"invalid_expiry_year":{"instruction_type":"error","instruction_message":"The card's expiration year is invalid."},"invalid_cvc":{"instruction_type":"error","instruction_message":"The card's security code is invalid."},"incorrect_number":{"instruction_type":"error","instruction_message":"The card number is incorrect."},"incomplete_number":{"instruction_type":"error","instruction_message":"The card number is incomplete."},"incomplete_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incomplete."},"incomplete_expiry":{"instruction_type":"error","instruction_message":"The card's expiration date is incomplete."},"incomplete_zip":{"instruction_type":"error","instruction_message":"The card's zip code is incomplete."},"expired_card":{"instruction_type":"error","instruction_message":"The card has expired."},"incorrect_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incorrect."},"incorrect_zip":{"instruction_type":"error","instruction_message":"The card's zip code failed validation."},"invalid_expiry_year_past":{"instruction_type":"error","instruction_message":"The card's expiration year is in the past"},"card_declined":{"instruction_type":"error","instruction_message":"The card was declined."},"missing":{"instruction_type":"error","instruction_message":"There is no card on a customer that is being charged."},"processing_error":{"instruction_type":"error","instruction_message":"An error occurred while processing the card."},"invalid_request_error":{"instruction_type":"error","instruction_message":"Unable to process this payment, please try again or use alternative method."},"invalid_sofort_country":{"instruction_type":"error","instruction_message":"The billing country is not accepted by SOFORT. Please try another country."}}}},"fetched_oembed_html":false}
How come with all the push for HIT, the ‘suits’ are using clipboards in lieu of tablet PCs??? We need another stimulus bill. Think how much less health care would cost without the bureaucrats looking over our shoulder checking off boxes…And why do the toner boxes have to be on plywood? Can it be plastic, or will that spontaneously combust.?? How about a time out for the CEO when they come in the door to see if they need to go right or left, or a time out when they need to use the rest room…we need an attendant and… Read more »
Oh my goodness – can I relate! I feel that so much time is needlessly wasted on the “pre-timeout checklist”, followed by the op-checklist, followed by the pre-epidural checklist, followed by the epidural “time-out”, followed by the op “time-out”. I realize safety is of the utmost, and I am a believer of all things that help me eliminate error. Yet, not once in my 18 years of labor & delivery nursing, have we ever inadvertently performed a lap appy on a Cesarean Section patient. Our patients are all alert for surgery, so imagine how silly I feel asking her if… Read more »
Have you been infested by JACHO or perhaps just some overzealous administrator from Corporate? Both are indeed, da devil. And just remember, while you are trying to deal with said vast specimen who is thrashing around at 3:00 am that lot are sound asleep in their little white beds dreaming, no doubt, of their bonuses. When exactly, did those of use who actually DO healthcare give up control to these people?
I’ve never intubated the wrong patient. I’ve never lanced an abscess on the wrong limb. I’ve never LP’d the wrong spine. Guess JCAHO has done a good job with our hospital.
Have they started counting how often you use alcohol gel?