WhiteCoat

Archive for May, 2011

Happiness is …

Wednesday, May 11th, 2011

Two portraits drawn for me during and after a tough day.

 

 

 

 

 

 

 

 

 

 

 

 

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What Goes Inside?

Wednesday, May 11th, 2011

After my hospitalization, I got a letter from a patient satisfaction survey company.

It contained a envelope addressed back to the same patient satisfaction survey company and the envelope stated that “POSTAGE WILL BE PAID BY ADDRESSEE.” I wasn’t sure what I was supposed to put inside of the envelope, though.

Can you all give me some ideas?

 

 

 

Things NOT to say in a Hospital

Tuesday, May 10th, 2011

In one of the hospitals were I work, there is a policy that security has to escort all newborns and their families to their vehicles once the babies have been discharged.

While security was in the emergency department observing another patient, over his radio came the following statement:

“Hello! This is Susan in OB. I have a discharge.”

The security guard became red in the face when a nurse said “Boy, she should have one of the docs up there check that!”

Healthcare Update — 05-09-2011

Monday, May 9th, 2011

Also see the satellite edition of this week’s update over at ER Stories.

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Kudos to Tuscaloosa, Alabama hospital and medical staff for treating more than 650 patients in the 6 hours after a devastating tornado hit the town (and also took out part of the hospital). Much of the time, the hospital was running on only a backup generator. “Many staffers worked despite losing homes or hearing that loved ones were missing.” Every one of you is a superstar!

$13 million awarded to 10 year old girl born with cerebral palsy after labor was medically induced, the child developed a low heart rate, and child was then delivered with vacuum suction.

$7 million settlement against doctors, nurse practitioner, and genetic counselor after child born to parents with rare genetic disorder called cri-du-chat syndrome.

Yet another reason not to practice medicine in Florida. Doctors soon may be convicted of a crime for discussing gun safety in the home with patients (thanks to Doreen for the link). In other news, Florida lawmakers are also trying to craft legislation that will make it a felony for people to wipe their rear ends in the wrong direction.

Another unfunded mandate. Feds now will require that states prove Medicaid recipients will have “sufficient access” before cutting Medicaid payments to providers. And what happens if there is insufficient access to care before the cuts? Why shouldn’t the states just be allowed to provide “insurance” like the feds are doing? Insurance is only worth the access it provides the insureds. It is much cheaper to provide “insurance” for medical care than it is to provide “access” to medical care.

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Under the Knife – Part 6

Saturday, May 7th, 2011

I turned around, shuffled backward, and eased myself back onto the clean bedsheets. Mrs. WhiteCoat removed the lines from the IV pole and moved the pole to the other side of the bed so it was on the same side as the arm where the IV was placed. Then she gently hung the Foley catheter bag back on the bed.
I told her “Dang, this thing hurts,” referring to the catheter.
“Then hit the button,” she replied, nodding to the PCA pump.
“It doesn’t help when I do hit the button anyway. Simple physics. Think about it. Look at the IV line. It is about 4 or 5 feet in length. Every time I hit the button, it squirts about 1 mL of medication into the IV line. That amount of fluid takes up about, what, an inch or two of IV line? I would have to push a button a good 40-60 times before the medication from the syringe actually reached my vein.”
“Did you ever think that maybe they primed the line with medication before they attached it to the machine?”
“If they did, then why do they have to lock tube of medicine inside the pump? For aesthetics? All of medication is already in the IV line. Why don’t they just put a syringe of saline there?”
“Then people would either think they were getting saline for pain or they would know that they could get a huge bolus of medication just by cutting the IV line and letting all of the medication run into their veins.”
“Good answer. I guess I won’t publish that on my blog then. Besides, since when is pain from a rubber tube causing a friction ulcer on the tip of my woo hoo an indication for pain medication? The answer is to remove the rubber tube, wouldn’t you think?”
“Don’t make me come over there and wrestle that button from your hand.”
“Fine.” I pressed the button. “You happy?”
“Yes. Now maybe we both can get some sleep.”

Mrs. WhiteCoat and I watched television for an hour or so. Both of us got text messages on our phones. I took pictures of my stomach and sent them to people who texted me. I was getting to be quite the voyeur. In the back of my mind, I was determined not to go to sleep.

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The Trial of a Commenter

Wednesday, May 4th, 2011

Because several people have asked me to address Matt’s comments, I have decided to take action.

I will preface the text below by saying that I believe everyone has a right to speak their mind, within reason [no shouting "fire" in a crowded theater and all that stuff]. I also find value in the opinions of others which dissent from my own opinions. They cause me to reflect on my values and in some cases have caused me to change my opinion on topics.

With that being said, several readers have asserted their beliefs that Matt the Commenter has overstepped the bounds of commenting decency.

Therefore, as the Attorney General of the County of WhiteCoat’s Call Room, I have filed the following complaint in State Court of EP Monthly.

It will now be left up to a jury of Matt the Commenter’s peers to determine whether Matt the Commenter is guilty of the e-crime listed below.

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—WITNESSSETH—

In the State of EP Monthly, County of WhiteCoat’s Call Room, Matt the Commenter has hereby been charged with the e-crime of Disorderly Commenting Conduct in the First Degree.

Elements of this crime include making ad hominem attacks against other commenters, creating irrelevant comments unbecoming a commenter, and otherwise sordid commenting behavior.

Readers, as the jury, are instructed to review transcripts of comments made by Matt the Commenter on this blog in coming to their decision.

The jury may choose to find the Defendant guilty of this e-crime and impose a penalty, or the jury may choose to acquit the Defendant.

In order to convict the Defendant of this e-crime, more than 66% of the jury must find the Defendant guilty.

After familiarizing yourself with the evidence in this case, please cast your vote below.

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What is your verdict regarding charges of Disorderly Commenting Conduct in the First Degree filed against Matt the Commenter?

  • Guilty of Disorderly Commenting Conduct in the Second Degree. Issue a public reprimand and allow readers to continue refuting his comments. (43%, 130 Votes)
  • Guilty. Ban him from further commenting on this blog. (36%, 107 Votes)
  • Not Guilty. He walks. (21%, 64 Votes)

Total Voters: 301

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**As you should be aware, there is no crime of “Disorderly Commenting Conduct” and Matt is not and will not be charged with a crime. There is no State of EP Monthly. There is no County of WhiteCoat’s Call Room. This post is intended solely as a parody of a legal proceeding.**

Now About That Nasal Congestion …

Tuesday, May 3rd, 2011

I’m still a little skeeved out by this.

An adult patient comes to the hospital for evaluation of wrist pain she has had for three months. I get a little history and then start to examine her hand.

I turn over her wrist so I can tap on it to check for Tinel’s sign … and there is a giant booger on the pad of her index finger.

[shudder]

Healthcare Update — 05-02-2011

Monday, May 2nd, 2011

First year medical student writes about what it is like to dissect cadavers in the anatomy lab.

Abuse-resistant form of oxycodone on the horizon? I give it a month before someone has figured out how to abuse it.

Emergency department access not the same as health care access. Here’s why. I disagree with some of the statements made, such as asthmatics can’t get prescription refills, but many of the other statements are true.

“No wrong should be without a remedy.” That is, unless you are a judge who plagiarizes 321 of 368 paragraphs of an opinion from an attorney’s brief in a medical malpractice case. The judicial misconduct caused a reversal of a plaintiff’s $5 million medical malpractice judgment.

Arizona gets federal approval to cut funding for catastrophically ill or injured patients. Up next for Arizona: Hospital stays capped at 25 days, limitations on emergency department visits, eliminating non-emergency transportation, mandatory co-pays for care and additional fees on patients who smoke, who are overweight, or who don’t comply with physician treatment plans.

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