Homage to Dr. Pelzer
Dr. Pelzer gave me one of the best pieces of advice ever in vet school.
"I'm begging you. Don't do the bloodwork. It will only confuse you." *
Which brings me to a big old pet peeve. I talked with a woman today who took herself to the ER for chest pain where the triage nurse took her BP and it was high. The hospital admitted her overnight, gave her some narcotic and non-narcotic pain meds, did tons of tests, including 3! spinal taps but NEVER actually gave her any meds to bring her blood pressure down.
Now after spending all this time and money and resources the next day dawned. At which point she was still experiencing high blood pressure w/ random even higher spikes. So what did the hospital do?
Did they get a consultation?
Try some meds and monitor her?
NOPE!!!
They took her blood pressure manually instead of with the machine and got a number that made it safe for them to discharge her with NO medications and NO diagnosis.
I saw the same thing 1 month ago where a nurses aide took a BP didn't like the number. Laid the bed down and used the patient's other arm - got a number she liked and put the bed back up.
LISTEN UP S__T HEADS!!! Either the machine is useless and you don't use it. The criteria are useless and you change them. Or - you need to institute treatment plans. I don't care if the treatment plan is you leave the patient recumbent and tell them not to sit up because it is causing dangerous BP levels - but you don't just manipulate the data until you get an essentially FALSIFIED reading for your charts.
And yes I imagine if the patient isn't allowed to sit up it means a doctor will have to come in and examine the patient. Which is presumably why you are paying the hospital large amounts of money in the first place?
* The other wonderful advice passed on by Dr. Currin was not to take it personally that the farmer wouldn't listen to our advice because they'd been farming for long enough to know that 1/2 of what we were telling them was wrong but we wouldn't know which 1/2 for another 10 years. Also he sagely forewarned us that after roughly a decade when the farmer finally! did make the changes we had suggested for years on end the credit would not go to us but to someone else who likely hadn't set foot on the farm for years.
"I'm begging you. Don't do the bloodwork. It will only confuse you." *
Which brings me to a big old pet peeve. I talked with a woman today who took herself to the ER for chest pain where the triage nurse took her BP and it was high. The hospital admitted her overnight, gave her some narcotic and non-narcotic pain meds, did tons of tests, including 3! spinal taps but NEVER actually gave her any meds to bring her blood pressure down.
Now after spending all this time and money and resources the next day dawned. At which point she was still experiencing high blood pressure w/ random even higher spikes. So what did the hospital do?
Did they get a consultation?
Try some meds and monitor her?
NOPE!!!
They took her blood pressure manually instead of with the machine and got a number that made it safe for them to discharge her with NO medications and NO diagnosis.
I saw the same thing 1 month ago where a nurses aide took a BP didn't like the number. Laid the bed down and used the patient's other arm - got a number she liked and put the bed back up.
LISTEN UP S__T HEADS!!! Either the machine is useless and you don't use it. The criteria are useless and you change them. Or - you need to institute treatment plans. I don't care if the treatment plan is you leave the patient recumbent and tell them not to sit up because it is causing dangerous BP levels - but you don't just manipulate the data until you get an essentially FALSIFIED reading for your charts.
And yes I imagine if the patient isn't allowed to sit up it means a doctor will have to come in and examine the patient. Which is presumably why you are paying the hospital large amounts of money in the first place?
* The other wonderful advice passed on by Dr. Currin was not to take it personally that the farmer wouldn't listen to our advice because they'd been farming for long enough to know that 1/2 of what we were telling them was wrong but we wouldn't know which 1/2 for another 10 years. Also he sagely forewarned us that after roughly a decade when the farmer finally! did make the changes we had suggested for years on end the credit would not go to us but to someone else who likely hadn't set foot on the farm for years.