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Life's Horrors
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Mini J



Joined: 09 Jul 2006
Posts: 1170
Location: Toronto, ON

PostPosted: Wed Jun 26, 2013 7:42 am    Post subject: Reply with quote

*cough* better than a 7-year bachelor...

Which, admittedly, was across two universities, including a fair number of courses that didn't transfer, and switching majors more than once...

I failed math 100 too. Miserably. Embarrassingly miserably.

oh, and Russ, I know the feeling; I now know a lot of the inner workings at my job, and why things take 3 hours that some people might think should take 5 minutes.

Personally, I am curious: why did everything in that hospital experience go so slow? Even if it doesn't matter, I'm interested. I wonder to what degree it dovetails with my experience at my work.
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Sam



Joined: 09 Jul 2006
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PostPosted: Wed Jun 26, 2013 9:34 am    Post subject: Reply with quote

http://beta.dawn.com/news/1020576

wow
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DeD CHiKn



Joined: 04 Aug 2006
Posts: 10227
Location: Baltimore, Maryla*gunshot*

PostPosted: Wed Jun 26, 2013 10:15 am    Post subject: Reply with quote

Sorry to hear about that Jinx. Hope everything goes well with the recovery.

Dogen wrote:
Having been on the other side of the hospital experience, I could tell you why everything moved so slow, took so long, and was so irritating... but it doesn't really matter. It only matters that it's irritating as hell to be a patient in our modern health care system.


Exactly. There's no comfort in reasoning, only empathy for the frustration.
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Yorick



Joined: 11 Jul 2006
Posts: 12101
Location: In the undersnow

PostPosted: Wed Jun 26, 2013 3:01 pm    Post subject: Reply with quote

Dogen wrote:
Having been on the other side of the hospital experience, I could tell you why everything moved so slow, took so long, and was so irritating... but it doesn't really matter. It only matters that it's irritating as hell to be a patient in our modern health care system.

I hope your wife has a speedy recovery, Yorick.


wrong skull-head, Russ! Very Happy


hope your wife feels better soon, Jinxie.
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Snorri



Joined: 09 Jul 2006
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PostPosted: Wed Jun 26, 2013 10:57 pm    Post subject: Reply with quote

Mini J wrote:
*cough* better than a 7-year bachelor...


7-year bachelor buddies for life! (assuming I don't get into any trouble for the next two years.)

of course, that does include wasting 3 years on medschool getting no points. whatever. Its mostly the debt I worry about but it's not that much compared to some others. And I'm going to be a brilliant philosopher anyway so I don't care!

anyway, point is that taking a little more time is not that big of a deal.
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mouse



Joined: 10 Jul 2006
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PostPosted: Wed Jun 26, 2013 11:11 pm    Post subject: Reply with quote

Dogen wrote:
Having been on the other side of the hospital experience, I could tell you why everything moved so slow, took so long, and was so irritating... but it doesn't really matter. It only matters that it's irritating as hell to be a patient in our modern health care system.


i'm still curious, though - can you enlighten me, just to expand my knowledge-base?
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mouse



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PostPosted: Wed Jun 26, 2013 11:12 pm    Post subject: Reply with quote

Sam wrote:
http://beta.dawn.com/news/1020576

wow


what

the


fuck.
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eureka00



Joined: 09 Jul 2006
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PostPosted: Thu Jun 27, 2013 12:18 am    Post subject: Reply with quote

Threw out back. *sigh* It hasn't really been my day.
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Lasairfiona



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PostPosted: Thu Jun 27, 2013 12:34 am    Post subject: Reply with quote

Jinx - boo gall bladder issues. My mom just had her gall bladder out and she feels much better. I hope that Mz. Love feels better too. Also that is a shitty ER situation. Boo.
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Dogen



Joined: 10 Jul 2006
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Location: Bellingham, WA

PostPosted: Thu Jun 27, 2013 2:15 am    Post subject: Reply with quote

Yorick wrote:
Dogen wrote:
Having been on the other side of the hospital experience, I could tell you why everything moved so slow, took so long, and was so irritating... but it doesn't really matter. It only matters that it's irritating as hell to be a patient in our modern health care system.

I hope your wife has a speedy recovery, Yorick.


wrong skull-head, Russ! Very Happy

Don't lie, I know you're really Jinx.

mouse wrote:
i'm still curious, though - can you enlighten me, just to expand my knowledge-base?

I can suggest what may have been involved (since I wasn't there to know for sure).

Quote:
They moved her to the Chest Pain center, started an IV, took vitals, and sent blood to the labs. At some point, they also asked her for a urine sample, which took her a while to provide. I did note that once she filled the little cup, it was almost an hour before it went to the lab.

So there aren't many reasons to check urine for a person having chest pain (lots of reasons to draw blood, though). They were probably going to do a pregnancy test, which isn't time-sensitive. They would need one before they did surgery or the CT. Still, it's just bad form to leave it sitting there.

Quote:
The doc orders a CT scan of the abdomen. Between going for that and getting the results, another couple of hours passes.

Depending on how busy the CT was, this was probably due to two things: 1, ER docs don't interpret CTs, radiologists do, and when results will come back depends on how busy/on top of their shit the radiologist is; and 2, how busy/on top of their shit the ER doc is after the results are in. The radiologist has the CTs queued up in the order they're taken and spends however much time they think they need on each one, reviewing it, comparing it to previous scans, etc. Then they dictate their findings, which goes to a transcriptionist, who has their own stack of dictations, who then types it up and puts it into the computer. Then the ER doc, who may or may not be on top of their shit, has to sit down and read it before deciding what to do about it. All while taking care of whatever else has just walked in the door.

Quote:
At 8:30pm, the doc says she will be admitted, and they will schedule her for surgery to remove the gall bladder.

At this point they should have let her eat. Typical orders are not to eat anything after midnight the night before surgery. A low fat, low cholesterol diet isn't hard to come by in a hospital. Give the woman a salad. ERs aren't really geared to this type of thinking, though. They solve big problems and then ship you off to other places to fix the little ones. It's just how they are. Sucks, but true. If you (any of you) find yourself in an ER with a non-emergent diagnosis... start asking for the things you want/need, because the staff will probably be focused on the OD in the next room, the trauma in the trauma bay, etc.

It's also fair to say that, if her bile duct was obstructed then eating may have caused her more pain. So, the attending physician may have been kinder than it seemed. Someone should have talked to her about it, but see above.

Quote:
A little after midnight, I tracked down the ER doc and asked for some idea of when she would either be moved to a room, or prepped for surgery. The short answer was that the doc didn't know.

You have no way of knowing this if you haven't worked in a hospital, but at this point the ER doc probably didn't even remember you were still there. They'd most likely handed over care to a surgeon and were no longer technically her doctor. The surgeon is the one who decides where she gets admitted (there may be multiple surgical floors) and whether she's first case or is put in line (triaged by severity [we use 'acuity']).

Why did she have to wait so long? Hard to say. I'm assuming the receiving unit (where the surgeon wanted her admitted) didn't have any open beds, either because they literally had people in all of them or because their nurse:patient ratio was too high to take another. A nurse on a nursing unit has a maximum number of patients they can take at a time for safety, usually around 5. If they have 30 beds but only 5 nurses then they're "full" at 25 patients, and can't take any more. Sometimes that's short staffing, and sometimes you just get more patients than you bargained for (you never know what will come into the ER; they may have started the night with 20 patients and been bombarded, you never know). Hospitals have procedures for dealing with that situation, but the simple fact is that until they have enough nurses to safely take the patient they're not going anywhere.

Anyway, that's why the ER doc didn't know: 1, they weren't Mz. Love's attending physician at that point, and 2, it was all in the hands of the charge nurses in the ER and the receiving unit to work out when she could go up. Which is another takeaway lesson... if you want to ask questions, ask your nurse or the charge nurse, especially if it's of an administrative nature.
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mouse



Joined: 10 Jul 2006
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PostPosted: Thu Jun 27, 2013 6:58 pm    Post subject: Reply with quote

see - we get useful tips! thanks, dogen!

things like nurse patient loads limiting the number of admissions are the sort of things i never would have guessed. (nor that you actually have to wait for a radiologist's report to be transcribed - why, doctor doug just looked at it himself! and talked with his colleagues! there was no _reading_) if you look at it from one side, it makes perfect sense: of course nurses shouldn't be overloaded! patient care standards must be the priority! what if there was an emergency?...but then it sort of does from the other side, too: but we have a patient that needs immediate care! and there are empty beds! and she's just going to be lying there sleeping! we can't have people clogging up the emergency room beds!

i always like understanding how stuff works. on the one hand, it shows you that it's actually a complicated problem, which may not necessarily have easy solutions. on the other hand, it gives you a better idea of where to focus your efforts to get those solutions. so i do appreciate the answer.
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Snorri



Joined: 09 Jul 2006
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PostPosted: Thu Jun 27, 2013 8:59 pm    Post subject: Reply with quote

Dogen wrote:
1, ER docs don't interpret CTs, radiologists do,


Are you saying tv lied to me?

It's one of the biggest things that gets on my nerves whenever I watch med shows. Everyone is just casually doing the job of several different people. Like, I get it's really the only way to write any good drama but man.
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Michael



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PostPosted: Thu Jun 27, 2013 11:50 pm    Post subject: Reply with quote

What about ECGs?
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Dogen



Joined: 10 Jul 2006
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PostPosted: Fri Jun 28, 2013 6:15 am    Post subject: Reply with quote

mouse wrote:
...but then it sort of does from the other side, too: but we have a patient that needs immediate care! and there are empty beds! and she's just going to be lying there sleeping! we can't have people clogging up the emergency room beds!

In emergency situations it all goes out the window. Usually, the charge nurse (who typically doesn't have any patients because they're running the unit) will take one of the easy patients from another nurse so they can take the new patient. Or, if the admit is an easy patient or it's near the end of the shift, the charge nurse or someone with a full but light assignment will take them for a fluff and tuck (fluff the pillow, tuck them into bed, then hand them off to the next shift).

Snorri wrote:
Are you saying tv lied to me?

It's one of the biggest things that gets on my nerves whenever I watch med shows. Everyone is just casually doing the job of several different people. Like, I get it's really the only way to write any good drama but man.

There's almost nothing factual about hospitals in TV, from who the first person is you talk to when you walk into the ER to who's doing rounds (chief of medicine? chief nursing officer?). In 24 a guy smothers a woman who's on a heart monitor, and it starts alarming so he just turns off the bedside monitor... like if there was a reason to monitor her heart they wouldn't actually have a person watching it at all times (remotely, triggering alarms and sending a half dozen nurses into the room as her smothers her). My favorite is when someone codes, has a flatline and then they shock 'em. They're either terrible doctors (if they die) or miracle workers (if they live), because shocking is for VTach, or if you're too late, Vfib, but it doesn't restart the heart. It resets it. Shocking a person in asystole would be like blowing your electrical breaker and then pushing the reset button on your computer.

Michael wrote:
What about ECGs?

I dunno, what about them? Where I worked, a nurse could order one, a tech records it, and any physician can interpret it (but only cardiologists should, because everyone else sucks at it). So if you have chest pain after you're already in the hospital, someone with an MD will evaluate your ECG, but may read it wrong. I can't tell you how many patients got moved to our floor for "new afib" and when they got to us and hooked up they were really in MAT.
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fritterdonut



Joined: 24 Jul 2012
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PostPosted: Fri Jun 28, 2013 8:29 am    Post subject: Reply with quote

Took my dog to the Veterinary ER at around midnight last night, he had to be put down. His lymphoma was getting worse and he could barely breathe.

It was a pretty heartbreaking car ride.
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