Friday, January 29, 2010
MAR de Debarquement Syndrome
(When you get dizzy discharging the patient from the hospital). Whenever we go to discharge a patient from the hosital we have to fill out this form that shows all the meds they were on while in the hospital and we have to decide if we want the patient to continue them. The problem is that often we are not the ones who put them on the meds to begin with and further, the list has the meds the patients say they were on before they came in to the hosital. I love it how all the older men always say they are on Viagra and need a script before they go home. I have had anabolic steroids on the list and of course the ever present, I wont be able to go to the pain clinic for a while so I need my Oxy and Percs. I tell the residents the only scripts patients get from us are for the meds that we put them on, none other. When the ever present JACHO form nurse asks about the other meds, I write on the form that "other meds are at the discretion of the original prescribing physician and patient can not be discharged until these medications have been reconciled". I know that by doing this I am "ticking off" alot of the long white coat clipboard carrying administrative types, but it sure does get them moving in a frenzy to check on all the patients medications and make sure that they have someone accountable. Everytime they come back to me and ask me to be the one to approve some of these medications, I explain that I am here to fix the trauma, no be responsible for their their pre-existing narcotic dependence or erectile dysfunction and they can find someone else to admit these patients and I will just consult!