Sunday, 12 June 2011

Tips for Junior Doctors part 1: Make sure you have the right patient.

Highly advisable: being efficient and seeing the patients in one room in one go.
Not-so-advisable: getting your patients mixed up.

Friday afternoon, cardio ward. Short-stay room. I have 2 grey-ish-but-not-yet-fossilised males, both returned from a coronary angiogram that morning. There also are slight differences:

Patient A has a wife who has been hanging around the room the entire day, boasting about how annoyingly rich she is. (Seriously, I don't care that you made a bid on a ridiculously famous estate in South-Africa, I care even less that you can compare the most expensive shopping streets in the country; and I'm not as flattered as you think by the fact that you're impressed with my medical school. The main reason I went there as opposed to my colleagues is that I had the guts to go there.). Patient A also had the worst outcome and needed a CABG.

Patient B is younger than patient A, and probably was a good man, your average Joe. His outcome was fine, and he was good to go ahead and get the planned valve surgery.

One of them had an angioseal, the other didn't; both had palpable masses over their femoral arteries.

I mixed them up, went ahead and told patient B that he had several options for his surgery. Then I phoned the cardiologist because I could not feel a femoral pulse, asked him if it was fine to let the patient go home. All this time, I thought I was talking about patient A.

Until at some point mrs A pointed out that that was not her husband.

Trust me, no matter how human such a mess-up is; the patients are not impressed. It's hard to get your stories straight afterwards.

In hindsight, I should not have ignored the fact that I thought that it was odd that such a high class citizen as 'mr A' pulled down both his pj bottoms and his underwear the minute I told him I needed to check the place where they stuck in the catheter.

2 comments:

  1. We've all been there...it's a horrible feeling. I have caught myself trying to sneak a look at patient's wrist bands so that I can remember who I'm talking to. Sigh.

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  2. Darn patients, most of the time I remember them as room numbers, unless they are memorable for some reason, like being nice or having an interesting story.

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