On Breaking One's Neck:Injured physician experiences healthcare from the "other side"

  1. This piece was written by a 90-year-old retired physician who sustained severe injuries in a fall. He discusses his injuries and treatments in great detail (perfect for the medically educated or interested reader!). He also talks about what it was like to spend time in the ICU and at a rehab hospital, and observes the roles of nursing, physicians, ethics, finances, and technology in caring for patients.

    My favorite part is near the end: "What personal care hospitalized patients now get is mostly from nurses... I had never before understood how much good nursing care contributes to patients' safety and comfort, especially when they are very sick or disabled. This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good."

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    About wannabecnl, MSN

    Joined: Sep '09; Posts: 345; Likes: 605
    from US
    Specialty: 4 year(s) of experience in PACU, presurgical testing


  3. by   dudette10
    I noticed that he said the ICU nursing care was superb, but the rehab nursing care was inconsistent. I conjecture that has to do with ratios, not the competence of the nurses.

    About the medical notes: I was sitting next to three attendings charting one day, and they too were disappointed with the MD charting and complaining about it, specifically referring to residents. (However, I have read notes by all three of those attendings, and I don't see that they are any more descriptive than the residents.) They claimed that the use of computers in medicine was growing, more time was spent in front of the computer, but the benefit to patient care was minimal. I kept my mouth shut, but I wanted to say that the computer was a good thing for nursing because we no longer have to decipher bad penmanship.

    Copious notes about lab work and results of tests is due to the smart tags in Epic, whereby stuff can be brought into the note. I have seen incorrect assessments entered through copy and paste (probably from the very first assessment when the condition didn't yet exist), but when you get to the part where the residents have to type out things, the assessment is correct. Or, they've filed the note so early in the morning that the lab work is from the previous day, rather than the current day. (In a couple of cases, I've had to point out to the intern to look at the "collected" time, rather than the "update" time for the labs because they were prescribing according to old data.) Many intern and resident notes wouldn't pass muster in a court of law due to inconsistency.

    I do sympathize with internal medicine teams, though. They often have to reconcile contradictory recommendations among consults. I see this especially with consult recs from nephrology and cardiology. No wonder they spend so much time in front of the computer.
  4. by   Ruas61
    Interesting read. He sounds like an interesting gentleman and has had a good run of it.
  5. by   anon456
    Great read! Thanks for sharing!