Alternate title: Why I hate transfers from band-aid stations.
There are a lot of small surrounding hospitals that are part of our larger system. We receive their emergent or urgent transfers as we have the capability, but the major problem is that a lot of these facilities hire very new, inexperienced physicians to staff their ER. I suspect a lot of them hire residents and pass them off as full-fledged physicians.
ER physician: "Uh, I have a patient that we need to get to your hospital right away."
Me: "What is the problem with the patient?"
ER doc: "They have a creatinine of 9."
Me: "Well, that sounds legitimate. Do they have a history of kidney problems?"
ER: "Oh, uh. Let me ask." *puts down phone* "Yeah, she is on dialysis."
(Side note: creatinine means nothing if you are on dialysis)
Me: "Did they miss their appointment or something?"
ER: "Uh, let me ask." *puts down phone* "Uh, they are supposed to get dialysis tomorrow morning."
Me: "What's her potassium?"
ER: "Her potassium? Um, let me..."
Me: "Just send the patient over."
Nurse: "Why did you take that patient?"
Me: "Because she'd be better off dying en route here than sitting under that moron's care a minute longer."
#firstdonoidiocy
2 comments:
I worked at one of those band-aid EDs. We were a little tiny hospital. We didn't have a neurologist, a pulmonologist, or any other useful speciality that I can think of. 2/3 of the surgeons who were the main group to serve us refused to come because we didn't have a PA to assist their sorry asses. We had a part time radiologist. Mostly we took care of run of the mill shit and we had a drug recovery house next door. I did the best I could. I used to work at a university hospital where there was a sidewalk consult down every hall. And I was an arrogant ass about it. Until it was all me all the time.
I'm not doubting there are good physicians that work at these, but when you call someone with a transfer you should have all the basic information I am going to need to assess whether or not they need to come to us. If you have to look up a few arcane things, then I understand, but this was not an unstable patient, they had dialysis scheduled for the morning and clearly did not need to be transferred. I took them away from his care out of respect for their safety, not because I thought they needed advanced care. One of my partners works at these little ERs, but the difference is, when he calls me, I know it's legitimate (no his name is not Todd Akin).
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