Friday, January 17, 2014

Can't breathe for the bureaucracy

This post conforms to the blog rules. When I become a resident, I won't delay patient care for the sake of my numbers.
When I become a resident, I won't intubate people without consulting the team.
When I become a resident, I won't forget to consult surgery for a pleurx catheter.
But mostly, when I become a resident, I won't delay patient care for the sake of my numbers.

Because when we do that, people who should have 5+L of fluid drained off of their lungs don't get squat drained for three days, and then they have mental status changes and someone intubates them without telling the team and they get placed in a medically-induced coma and have hypotension and SIADH while their spouse is watching all this heartbroken, slowly adjusting to the fact that he might not get his wife back.... So although the patient was terminal with an occult malignancy, we could at least have palliated during the last few months, instead of ending up on a vent and then withdrawing care because "she would never want this."

When I become a resident, I won't delay patient care for the sake of my numbers.

But when I'm a resident, I hope I still become attached to patients, even though that's painful. (Especially when people delay those patients' care for the sake of their numbers. I think I need some help with forgiveness. Oh look, it's time to pray.)

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