Here's the scenario: A patient is being transfered by ambulance from a smaller facility for appendicitis. Reason for transfer given is no on call surgeon at small facility. Pt is a 20 something young woman. Pt arrives at around midnight, you call the accepting surgeon who gives you minimal orders for IVF, pain and nausea meds, and when asked he informs you that he will do the surgery at 8AM. He has not seen the patient at this point, nor viewed the radiology CD from the small hospital.
You go and inform the patient and her mother. Both are upset, why did they just ride 30 minutes in ambulance for nothing, what if appendix ruptures, they ought to go home and wait, this is ridiculous. Pt wants cigarette, had pain meds previously and is comfortable, getting drowsy. Mom is rather irate, says that ER nurse from other facility said her daughter would be going straight to surgery.
I thought she had a very good point and called back surgeon and presented her point and he also saw her point, ended up coming in and doing the surgery right away. I was just staying to help with the admit but heard the outcome was good.
It just so happens that I used to work at the smaller hospital and as I recall appys were done right away there. When I worked Med/Surg there I never remember sitting on an appendicitis case all night like this surgeon wanted to do.
The surgeon is over from the other side of the mountains filling in ad locum for a month for a buddy of his (he used to work here) He says that where he's working now they routinely wait till morning for these types of cases.
