Apparently I'm falling down on the job...

...because the Focus On Patient Care hasn't been what it could be lately.

Patient Care, people! That's what it's all about! Unless, of course, you work for La Schwank Hospital, in which case it's about Customer Service. But I'll get to that in a minute.

So. Boys and girls, let's go over this one more time:

Attendings:

If you have a resident to admit and discharge patients, please make sure that resident knows that he or she is to admit and discharge patients. That way I won't have four patients waiting in their rooms, twiddling their thumbs, while I wait for orders. And call six residents in round-robin fashion, looking for somebody, anybody, to write diet and activity orders.

If I have a patient who's just been admitted to the unit with bleeding from hinty-bazillion places, and I call you because the orders say to call you when the patient arrives (bleeding from hinty-bazillion places, oh, and now there's some weird swelling going on, too), please don't lecture me about "turfing". Not only do I not know what "turfing" is (it seems to have something to do with the perceived size of your genitalia relative to how many calls you get in a day), I don't care. Take it up with the other attending, who's been working this case with you for weeks.

I know you have a rule that I'm not supposed to call you before seven in the morning. Occasionally, I break rules. Like the other day, when your patient had a massive stroke and had to be moved to the ICU and placed on a vent. Sure, I called you at 0655 (and no, I do not kid), but was that really a reason to scream and holler for a minute and a half? I would've called your resident, but you don't have one.

Finally, if you're an attending I've never seen before in my life, from a service I've never seen in nearly five years of working at La Schwank, please don't be offended if I ask your name. Especially please don't be offended if I ask your name after you've walked up to me and started spouting off verbal orders without preliminaries. You may be considered God wherever it is you came from, but here you're just another damn thing I have to deal with.

Residents:

Don't put that vacuum container filled with strangely-colored body fluids down on the desk and tell me to "take care of this" without telling me where it came from, who it came from, and what the bloody hell I'm supposed to do with it. If you omit those minor details, that Evac bottle will sit on the corner of the desk until you're out of surgery. At least label the damn thing with the patient's name so I can divine your intentions from your badly written, detail-free note.

Do not--and this I am saying for the last time, before I come hunt you down--put an unstamped, un-labelled loose order sheet on the desk. Ever. There are charts for a reason, there are stampers and labellers for a reason, and you have a pen in your hand. If I don't know who those orders are for, none of them will get done.

Stay the fuck away from my pencil case. Next time I see you riffling through my stuff looking for something like a penlight, you're gonna lose digits. "MD" does not mean "My Domain."

While I'm at it, where were you raised, that you think using *my cellphone* without permission is acceptable? If you and your pencil-case-riffling colleague don't stop this, Patient Care will suffer because I'll be out back, shoving your bodies into the incinerator.

PAs, NPs, and other and sundry people:

I'm calling you at the office because you submitted the wrong damn set of order sheets to the PACU. That means that your patients have meds ordered that we don't have, and you're referring to protocols that we don't follow. Don't snark at me because I called you to inform you of this fact. Just get me the correct order sheets and I'll figure it out on my own.

Read the allergy list prior to prescribing meds to which the patient is allergic. Please. This is only the forty-millionth time I've pointed this out to you.

Please know the protocols for the hospital at which you've been practicing for ten years. Thank you.

Customer Service People:

I know the patient's daughter called you, angry because I wouldn't order a food tray for the patient. Hear me out: the patient cannot swallow and is a silent aspirator. Do not make my job harder by sending a food tray up to make the daughter happy.

The time to come in, cheerfully dropping off a basket of fruit and a newspaper, is *not* when I'm involved in an unpleasant and potentially embarrassing bedside procedure. Knock first.

Things like isolation rules cannot be relaxed just because somebody's stepfather twice-removed gave a load of dough to the hospital eight years ago. No matter how important the patient, they cannot bring their own furniture to the hospital. Don't tell them they can.

I've been too nice lately. It's time to get out the whip and Bettie Page-style nursing outfit and start cracking down on folks.