Thursday, June 16, 2011

Thanks for the Access

I was already suspicious when the patient listed Ultram and Tramadol as allergies (same thing).

Yet, today was the day that she decided to be seen in the ER for her long standing pelvic pain for which she had already been worked up.  She had the pain for months and months.  Her pain was no different than it had been for the last months even though she routinely took absolutely nothing for it.  She had never called her primary care or GYN for follow up since her last million dollar workup for the exact same thing (without finding) nine months ago. Since she had a generous insurance plan paid for by you and me she obligingly submitted to the usual battery of tests:

Urine test=normal
Lab tests=normal
Pregnancy test= negative
Pelvic exam= some vaginal bleeding although she claimed she "didn't know she was bleeding since she had her period last week"
Pain relief with Toradol=not so much

The next plan was to send her to the Mother Ship for the obligate and gratuitous ultrasound which we do not have available on evenings.  Or weekends.  Or Mondays.

Although it is the SAME facility and we are merely an extension, for some reason we are required to do transfer paperwork.  The nurse do this.  And because we do NOT have electronic charting in this turn of the century (20th century) state-of-the-art health care environment, we have to copy everything.  When we are also caring for other patients, this takes a chunk of time.  Lastly, we have to call the nurse at the other ER for a report on everything we have done; safe Hand-Off.  All this takes a good 15-20 minutes. 

We usually leave the IV in place, just, you know, in case.  The patient left with a boyfriend that apparently had waited in the car for all of the festivities. 

Two hours later a call from the Mother Ship nurse: "Hey, that patient never showed up".

I HATE when they leave with the IV still in and none of their phone numbers work, and their address doesn't exist.  It just creates paper work.  I should have listened to my spider sense, it is rarely wrong.  Damn.