Navigating Doctors Idiosyncrasies - page 2

by whitecat5000

1,124 Visits | 12 Comments

So back story. . . I had a 32 yr old female patient that was a direct admit around 2300 for hematuria. We call the doctor and get orders for a CT abd/pelvis w + w/o contrast, insert three-way and irrigate PRN, and CBC. So CT... Read More


  1. 0
    Quote from Altra
    OT but ... admission for this? Unless there was intractable pain / nausea, this sounds like an outpatient workup.
    The only issue would be the 3 way. If they have CBI, they would be admitted. Most of the pt's in the ED who have Foleys placed for urinary retention are sent home with f/u with urology. However, hematuria pt's are occasionally admitted if the doc is concerned if the foley will just get clotted. I can go either way, in my experience. Anyway...

    As for the original scenario, there is basically no way I would have called the doc back for orders for an HCG and a BMP (I would say that a CMP is not really necessary just for kidney function--although I'm a bit surprised the doc didn't order either a CMP or BMP to being with). As JBudd mentioned, in the ER, we are fully expected to just order these if a CT with contrast is ordered.

    I also find little (to nothing) wrong with this scenario.
  2. 1
    Quote from Altra
    I don't see this as a physician's "idiosyncrasy" ...
    Yeah, I don't view not wanted to woken up during the middle night as an idiosyncrasy. I think it is a basic human response.
    Altra likes this.
  3. 0
    Quote from Altra
    I don't see this as a physician's "idiosyncrasy" ... I just see it as learning to recognize protocols and requirements for diagnostic testing and so forth.

    OT but ... admission for this? Unless there was intractable pain / nausea, this sounds like an outpatient workup.
    Yeah, she was admitted because there was pain with urination and she kept passing quarter sized clots with much difficulty.

    Thanks for all the feedback everyone!


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