Thursday, 25 July 2013

Not your place

Imagine you have a job to do.  A very difficult and important job, one that took you years of education and training to get good at doing.  And now imagine someone comes along and says something that completely undermines your authority and prevents you from being able to do that job.  You would be pretty upset, right?

Now imagine that person has no business saying anything at all.  Now how upset would you be?

Probably as angry as I was.

I was asked to see a patient in the emergency room who had an acute gall bladder infection.  He had already had a special gall bladder scan that confirmed the diagnosis.  It's is a very common problem, one that has a very simple solution - give some antibiotics and do surgery to take the damned infected thing out.  Even before I saw the guy, I was planning on booking him for surgery that evening.  Even though you have to have eaten nothing for 6 hours prior to surgery, this usually isn't a problem for gall bladder patients because their pain gets worse when they eat, so nearly all of them have fasted for hours by the time I see them.  That way I can whisk them straight into the operating theatre.

So what's the problem?  Well, as I was about to walk into his room, the nurse informed me that he had just eaten dinner.

"WHAT?" I asked in utter disbelief.  "WHY?"

"The tech who was doing the scan told the patient, 'Yup, your scan is positive, but if you're hungry, you can eat from my standpoint," the nurse said.

I was literally speechless (this, as you can imagine, is a rare occurrence for me).  It is one thing for a tech to tell a patient what they think the result of their test is (although many of them are very good, they are not doctors and do not have formal training in reading the scans they perform).  But it is quite another thing (not to mention entirely unethical) for them to give any clinical advice of any kind.

Unfortunately, by the time I picked up my jaw off the floor the tech had already left the hospital, so I didn't even get to tear her a new asshole (which I CAN fix, by the way).  But I did have to tell the patient that his surgery would have to wait until tomorrow.

My job is hard enough with all the idiot patients I have doing stupid things.  The last thing I need is MORE idiots like this one getting in the way.


  1. I guess this is what you need protocols for!

  2. I had the occasional gall stone a couple years back, and that was pretty painful and had me not eating for days. I can't imagine eating anything with a full blown infection. Unless the person was on strong pain meds at that point (Ibuprofen did nothing). Those would have to have been prescribed by a doctor. Who would give the patient pain meds without knowing what is wrong? And if they knew what was wrong, why wouldn't they tell the patient not to eat and wait for surgery? I suspect there was more that went wrong here than just a stupid tech.

  3. Doctors give pain meds without knowing what's wrong quite often. Sometimes they do it so the pain subsides enough so they can do an exam.

    It's a common thing to give pain meds even if they aren't sure what's wrong.


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