* * Anonymous Doc

Tuesday, June 1, 2010

I started on nights last night, for the next two weeks.

I quickly remembered why working nights is terrible.

Especially the first night.

I know none of these patients, I'm the only intern on the floor, there's no time to get up to speed on the problems any of them might have before the pager starts going off...

There's a reason why visiting hours end at a certain time in the evening, and the fact that it's never enforced doesn't mean the families should expect that they can speak to an informed doctor 24 hours a day. The nurse pages me and tells me the family is refusing to let them take blood from the patient.

"We want to talk to the doctor. They keep taking blood from our father and we don't know why they need all of this blood. We think they're taking too much blood from him, it's going to make him sick."

"I understand your concern. We need to monitor a number of things in your father's blood, that's why we're taking blood every few hours. Especially if he's going to have surgery tomorrow, we need to make sure he's a safe candidate and everything is doing okay with his blood."

"Well, it's not going to be safe if you keep taking all of his blood."

"I promise you this is standard procedure, he has enough blood, we need to keep taking samples to test, every few hours. This is not putting him in any danger."

"I don't believe you."

"I'm sorry you feel that way, but I assure you, it is much more dangerous for us not to do this than to do this."

"We're not going to let you."

And they proceeded to physically block anyone from touching their father. An hour of reasoning-- went nowhere. As I shuttled back and forth between their room-- where the family got more and more agitated as they kept arguing with the nurse-- and the other rooms I kept getting paged to check on.

Finally, we had no choice. We called security to physically remove the family, kicking and screaming. So we could take the patient's blood.

Hopefully they won't be back tonight.


  1. Wow... is this real?

    1. Would a written agreement, such as a waiver of some sort, stating their refusal of the procedure and being fully aware of the associated consequences, not have worked?

    2. I'm just quite shocked that the family was physically removed. Isn't there some law against that? And is not forcing your management against a patient's will contrary to a code of ethics of some sort?

  2. I just re-read my post, and in the spirit of trying to anonymize I changed enough details that you're right-- I should not have said it was family members, it was a friend (who was not a health care proxy) and the patient himself wasn't of sound mind to refuse anything. Thus the attending decided to override the friend, who he felt was being irrational, in the best interests of the patient.