latrevw написа:
а за док - явно нито пациенти има достатъчно, нито достатъчно забавления в къщи, щом толкова активно се забавлява тук
тя и на работа сигурно се забавлява и поучава по същия начин
може там да я разбират по-добре, отколкото ние тук, все пак и се налага да работи в екип
The Happy Hospitalist
Things We Won't Do For You
When you are starting a new hospitalist program, many doctors and nurses, who are hospitalist virgins, don't quite know how the system works or how the program is structured. At Happy's Hospital, Happy's Hospitalist group is a private practice with contractual obligations, rights and responsibilities laid out in our legal relationship. There were quite a few interactions early on where our role in patient care was not understood. So here it is. Here's what we don't do.
1. We are not resident physicians. First and for most, we are not the physician on the case to field to nuisance calls. If a cardiologist is on the case, we do not take calls about rhythm issues. If a pulmonologist is following, we do not take calls about vent problems. If an ID doc is following, we don't take calls for fever. When nurses call me with issues related to a specialist issue, I tell them to call the specialist. Eventually, it will sink in.
2. We do not check chest xrays for central line placement for surgeons who have already left the building.
3. We do not check nasogastric tube placements for patients we are not involved with
4. We do not sign oxycodone scripts for doctors who have already left the building (in my state Schedule II medications require a signed prescription)
5. We do not "swing by" to check on other internal medicine doctor's patients at 2 am to "check on things" because the nurse is concerned and the doctor on the case is at home.
6. We do not go to the ICU to declare a time of death in a patient we are not following, but needs extubated (apparently, policy has stated a dead patient can not be extubated without a physician declaration of death)
7. We do not manage pain associated with surgical site complaints. That's a surgeon's responsibility.
8. We do not do discharges for patients we don't admit or attend on. I actually do sometimes, for free, out of the goodness of my heart, because I know that it won't be done for weeks and weeks and the poor outpatient comprehensive care doc will have no idea what happened when they see Johnny in follow up next week.
9. We do not look at EKGs because the nurse is concerned and the doctor who ordered it is not available.
10. We do not follow stable surgical patients with no medical problems just to answer calls about nausea and headache
11. We do not run a preoperative clinic. Not yet at least. The expectation is for pre operative evaluations to be done by the patients comprehensive care doctor, if one is required.
Now, if you have a medical problem on a patient, call Happy. I'm here to help.
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