Friday, November 9, 2007

ICU attendings Who the F--- do they think they are ?

Doing my MICU month now as a resident. I am lucky in the fact that my intern already finished a speciality in his country so HE knows what to do in case of emergency. What I noted though in the ICU is the God complex these attending's have. We had a case this week of a very sick patient. She was on a ventilator because of a pneumonia and her kidneys shut down. The only way for her to survive and possibly recover was dialysis. That's where our attending's and "ethics" panel come in. The husband married to her for 50 years wanted everything to keep her alive, she wasn't some demented Alzheimer like patient, but was alert and oriented with her mind functioning perfectly. Our Ethics panel though thought differently. They wrote in their opinion that she was a sick lady and dialysis would be of little benefit because of her age and illness. Now I don't disagree that this women was ill and a few months or years later would not return with another pneumonia but it would have made a world of difference for him to have his totally functioning wife back for any period of time. Instead we let her lapse into a coma and die.


Kid Charlemagne said...

do not know how I came across your blog but it is refreshing to see the hospital from a different point of view. I have been working in basements of hospitals (pharmacy) for over ten years. do I have stories.

just yesterday, we had an arrogant resident who insisted that clindamycin 720mg iv q12h was the correct dose b/c he found the dose in a book. oh, how I hate harriet lane for dosing! after failed repeated calls to the resident, the resident comes to the pharmacy to demand to know why is there a delay in the medication, demanding to speak to a supervisor. I had just walked in the door and into this meshugas. I grab a 600mg bag and a 900mg bag and hold it up to his face and say pick one and write for q8h. the resident then says to me "what do you have against me? have I killed someone in your family?" knowing better I did not answer, but with an MD like this he might.

and then later, RN calls looking for a pt's IVIG. the order was entered seven hours earlier and she says she can't find it. at that hour I did not have gammagard and the storeroom was closed. spoke with the MD who told me it was a monthly infusion and I ask if it could wait till tomorrow. MD said ok. so I asked the MD to rewrite the order for the next day and I went on break. when I came back and checked if the order was rewritten. it was not. so I called the MD and the MD said that the infusion was almost done. it seems that the IVIG was in the patient's room, hanging on a pole and all primed for infusion. I think that RN needs a refresher course in cognitive awareness

Anonymous said...

oh my god, poor woman and man :(