Someone asked in a comment on the previous post:
"Why are you drawing blood and not a phlebotomist?"
Middle of the night, no phlebotomists. And, hey, sometimes middle of the day, no phlebotomists either. In a perfect world, we wouldn't have to draw blood, sure. And I think I expected coming into residency that I wouldn't be drawing blood. Or, I don't know, putting in central lines. Or doing lumbar punctures. Or doing anything to a patient that someone else is a lot better trained to do, and a lot more comfortable doing.
But there isn't always anybody else to do these things, and certainly not if you need them done quickly. And so we do them. I'd say 90% of the time one of my patients needs blood drawn, I'm not the one doing it... but that still leaves 10% of the time when I am. Like when the nurse is supposed to do it but "can't find the vein" and so it's my job, as if I'm going to be any better at it. Or when the phlebotomist won't have time for six hours, and it's a little more urgent than that.
And in the middle of the night... look, you're lucky if anyone shows up to a code, let alone someone wandering around looking to draw your patient's blood. I've been at codes where I'm the only one there, and if the patient was still alive, well, he wouldn't have been for long.
Monday, September 20, 2010
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I know that at a couple of my school's hospitals, that's supposed to be the norm - I wonder if I was naive for thinking that's a positive? Getting a lot of experience with procedures so you're more comfortable with them, vs. "hey, we don't have the money to hire more people, so you get to do everyone else's job for free"?
ReplyDeletegreat post. as someone from the nursing staff at a teaching hospital, please allow me to pose a couple of questions:
ReplyDelete1. why do physician teams go in, open up a dressing that takes an hour for the RN to complete and leave, most of the time without even informing the nursing staff? and leave a giant mess? do the physician teams really think that nurses are there just to clean up?
2. why do doctors feel the need to pull the code light for a trivial reason (the patient would like ice water) and deny that they did it and "just pressed the call light"
3. Why do doctors tell a patient/family that they are going home momentarily when they know good and well it will be hours before they are finished rounding and writing discharge orders?
Don't mean to sound critical, just always wondered. :)