Saturday, November 15, 2008
way too early d/c
During my ~second week of this last placement, I came across an incident where the Dr. d/c the patient with no follow up physio when we think she shouldn't be. The patient can only ambulate around 10m before fatiguing when she was previously fit. Her chest was still wheezing on auscultation and just simply doesn't look well enough to go home just yet. Before we could get to the Dr about this matter, the pt was d/c already. I think the dr/interns should have communicated with us first about the patient and the suitability for d/c before they make decisions. Around 2 days later, the patient apparently went to ED with SOB. This has not happened before to me, I think with this ward I was on, there was a tendency for dr to dc patients when they 'think' they are well enough and won't bother asking the other members of the team. It was still early for me to pick this matter up so I think I would have made it clear if patients were not ready for d/c if this was to happen again (maybe by writing in the notes? and approach the dr directly) This incident came pretty quickly and if we didn't read the notes, we wouldn't know the patient was being d/c.
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1 comment:
at one of my placements on a surgical ward my supervisor advised that if from a physio point of view i did not believe the patient was ready for d/c i should always write as my final entry "not ready for d/c from physio P.O.V" to both advise the d/c doctor and cover yourself and yes if you feel really strongly about it approach the doctor with your concerns.
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