hospital evaluation

the final day had come... the 2 of the 3 connecting road were opened and the committee had decided to come for the review...

I was post call and had to stay back during the process...a stress for me... 

I was posted to ICU as planned. My official title was physician responsible for ICU. The title was set by the hospital evaluation committee and had to meet the following criteria:

1.Pt in the ICU had to be placed under the service of the physician

2.The physician could only had 2 session of OPD

3.The physician could not intake patient outside the ICU

that was the reason the management stopped me from doing any warded patient care since 4 months ago. As the hospital had tried to cut the cost and my overlap time of work with Lem was greatly reduced, caring patient in the ward had become a stress for me, eventhough those patient under my service were all from nursing home, mostly bed-ridden. My working hours could not let me to come everyday to see my patients. I did grumbled about the situation but I could do nothing - the cut of working hours was minor and I gained some from the Hemodialysis round ( still it was negative in total).

Post call with a heavy body and mind and I still did a solid round in the ICU. I was darn tired and slept in the conference room after 11:00am. The lunch suckes - a cake and bread combo box. The excuse was -  loads of oily lunchbox with rice would make the garbage bin looked bad.

 The committee member came to ICU by 1:30pm and selected a case. I was told he is a oncologist and professor in a medical university. He had asked a few question about the admin of the ICU and proceeded to his rounds .He had stood in front a bed who looked chronicly ill(medical case)...but fortunately for us, he took the wrong chart (the neighbour bed) and started to flip . The case of a patient with traumatic brain injury and liver laceration. The charting was done in totally POMR method and he could only pick some minor fault which I did not chart clearly. After some comments, he had looked at his watch and decided not to "torment" us any further...It was a relief, a lot of the charting was not done in the POMR form ( I had left the ICU for quite sometimes) and some of the admin malpractice would be noticed if he really looked into it...

 The evaluation dragged on till 4 something and the feedback session began. Most of us did ok (cant be flawless...) but one of the floor did a major mess up... When the nursing committee member asked about the nurse how they get their drug after the doctor prescribed it, one of the nurses was so big-headed and told the member that they could key in a temporary prescription to pick up medication- it was violation of the medical practice: prescription could only be written/issued by doctors... Well, a bad mark on our review....Hopefully the committee would taken it as a minor malpractice and would give us a pass. A fail would mean a review again in 3 -6 months time... there was a teaching hospital which did something similiar few years ago and suffered from it...

I did my part but I don't think anyone would really notice it, but the most important part was - I did not make any major mistake.... but the electronic prescription system was screwed up by a nurse and I felt a little drawback...a review of the system was needed and I need to do something about it