I read this post from Arianna a few weeks ago and I’ve been saving it for just the right time to blog about myself. (Go read it and come back, it’s about "disconnected medical care")
TW has been dealing with a mystery bump for quite some time. The GI doc wanted it GONE ages ago. Another GI doc was sure she could snag it via colonoscopy but the "dark lady of digestion" was not sure. She thought she would perforate the colon and that was not a risk she wanted to take. So, she referred TW to a surgeon.
The surgeon was not sure he wanted to deal with this because he didn’t want to cut the colon if he didn’t have to. Scar tissue on a Crohn’s colon is bad news. So, the "dark lady of digestion" did another colonoscopy and we thought she was going to remove the mystery bump but she didn’t. She just got more pictures of it to show the surgeon. MRI was done, just to get more pictures. All of the pictures were shared between the docs, pretty quickly and easily – they’re all available online but only in black and white So that led to the surgeon having to request the color slides, which took more time.
Finally, they scheduled a combo colonoscopy/laproscopy to deal with the mystery bump and all went well. All in all, I wasn’t feeling like we were getting "disconnected care". I didn’t understand why the color slides weren’t available online to the surgeon, only black and whites – that doesn’t make sense to me at all. I should find out why that’s the case, surely there must be some good reason.
Where I do find a disconnected healthcare issue is within the hospital itself.
TW had to go to the hospital where the mystery bump removal was going to be done and pre-register. At pre-registration, she was asked for her complete health history, current medications, emergency contact person, "do you wear glasses or dentures etc…" Makes sense to ask those questions before surgery, before nerves set in, while a patient is clear-headed and able to answer questions properly, right?
Why is it that after surgery, when the patient is either groggy from surgery or in pain after surgery, that the nurses on the floor must ask every single one of those questions AGAIN? I don’t understand this at all.
During this visit to the hospital, the nurses actually put the data right into a computer – why wasn’t it already there? It’s the same hospital. Why couldn’t the nurse pop in her name or scan her bracelet and immediately have her pre-registration info there? That would be quicker and less stressful for the patient and it would seem like it would be safer as well. What if the patient forgets to say "I’m allergic to ____" or "I have a history of _____" and those things become an issue during the hospital stay? If that data was already available to the floor nurse, then the process would be down to "do you have any personal items with you?" and "what’s your pain level?"
Nursepammie? Anyone else out there have a good reason as to why MY idea wouldn’t be more effective and helpful to everyone involved?
Well that makes total sense but back in March when I was in the hospital, hopped up as well on heavy pain meds, it seems every nurse and doctor who came to see me asked me those same questions, what meds are you on, at one point I said I have no freaking clue at this point might want to ask the last nurse. More times than not Mark would answer the questions for me because I honestly could not recall that I was allergic to Pennicillian at that point 🙂
Exactly the point. If you can’t remember you’re allergic to penicillin, that’s a problem. Read the chart people, surely it is IN THERE.
When I had surgery earlier this summer, I didn’t know which way was up, much less my medical history. I remember my doctor asking me whether the pain was RSD or surgery related and could I tell? I had no idea. It is incrredibly stressful to not be able to answer the questions, and you’re right about the unsafeness of it. Also, I could barely talk from the post-anesthesia nausea.
The nurses were wonderful and really did great, it was just very frustrating.
That is just because you didn’t hear the nurses in pre-op discussing the fact that the Doc Farmer didn’t know he was doing such and such during the procedure. Uh he doesn’t? He did yesterday when we talked to him. Maybe he didn’t know which side of the table he got to stand on to do it?