September 5, 2009

• Family Ties

   

  “Ummm doctor, patients family would like to speak with you”

  I dislike receiving these pages. Usually because they are annoying and detract from time spent actually HELPING people. Doubly so when the family is second guessing my orders. It is one thing when they want to know why I am giving albumin…because so and so has low blood pressure, and this will raise it. But to be questioned on why I chose 5% over 10%? really?
  
  I don’t blame the family for not realizing this, but if you ask for a doctor at 8:30 at night, you’re not going to get a doctor who knows all that much about what’s going on. I have 75 patients when I’m working the night shift. I’m following up on labs, I’m executing orders signed out by the day team, I’m available if anything critical happens during the night, I’m the COVER doctor.

  Yes, when I get called, I’m reading the chart– but I don’t feel terribly qualified to say anything to the family about the patient’s condition. Hell sometimes I barely feel qualified to write orders for pain meds (curse your inability to metabolize, liver patients!)

  Given that, I usually have to deal with two kinds of families.

  1) Families who are geninuely curious and have not had anythign explained: These families are okay…usually I have been paged for the patient for a medically valid reason, and while I am assesing, the family is just curious why a doctor suddenly showed up out of nowhere. This is understandable

  2) Families who have watched House, M.D. or some other medical show and are convinced that this is an equivalent to a medical degree, authorizing them to have the nurses page me everytime I write an order because “you did not do exactly what the last doctor did and they spent a long time trying to figure it out” or “we told the nurse to call you because we want our mother to receive this treatment instead of what you prescribed” (not, why did you choose this, but WE want YOU to change your plan)

  No I did not do the same thing because I was called for a different problem. I read the chart, saw what was done before if it is a similar problem and follow the guidelines in place for that treatment. And I am not prescribing something just because the family likes the name of it better. Usually I will just tell them if they are that concerned with the current plan, they should talk to the primary team in the morning
  
  “This is a hospital. My mother should be getting medical care 24 hours a day, not just when it is convenient or her doctor feels like coming to visit.”
  
  She is getting medical care. If she needs medical care, the nurses and the doctors are able to provide it, 24 hours a day. Right now, she’s sleeping, she’s stable, she’s taking the right medications, we’re giving her all the proper treatment.

  I understand and appreciate that patients are scared and concerned for their family member, but treating me like your personal servant is not going to expedite anybody’s care, and in fact is taking my time away from patients who require it as much, if not more than those second types of families.

  Also, I am grumpy because I didnt get to eat today due to answering all these pages >:-/ 
  

  • 7:17 am
  • 4 Comments