Wednesday, July 13, 2011

*Twiddling thumbs*

No news is good news, right?


My incisions itch. I wore pants today, for a short time; long enough to head to Target to pick up a new water bucket and rug for Max. He's ignoring them both, being resistant to change. Eventually he'll cop to the fact that Old Dog Hips are more easily levered from the floor when the feet below them have something to grab hold of, and that Old Dog Mouths like water from nice, fresh buckets rather than two-year-old, scuzzy things, but for now? he's ignoring both with glacierlike calm.

Two things that shock me today: how swollen Mah Belly actually is and how stupid people can be.

I put on a dress that fit fine the day before surgery and was surprised that it wouldn't zip up past my waist. I figured the belly-swelling was a two-to-three-day thing, at the absolute outside, and that I'd be back to normal by day five (which this is). Sadly, no.

I also figured that, given that we're getting more and more patients with strokes in the CCU, there would be--at some point--a drop-off in the number of people admitted under stroke protocol who later turned out to have such conditions as, say, a torn rotator cuff.

Sadly, no.

Going over the recent chart audit submissions from here at Casa Del Piles of Sleeping Mammals, I was distressed but unsurprised to see that the guy whose job it is to compile all the charts to audit had, as has been his habit, included a bunch of people without strokes and missed a number of folks with them.

A little explanation: chart auditing is one of those things which the Accrediting Agencies require hospitals to do for the accreditation. Because Sunnydale and Holy Kamole are both now stroke centers, it falls on us to audit the charts of people who come in with stroke symptoms to make sure that we're doing things like telling them to quit smoking, getting them head CTs in a reasonable time, and doing NIH scales. I got volunteered for the job of doing chart audits because I don't spend enough time already either taking care of patients or making sure people don't suddenly leap out of bed like so many gazelles, eating utensils in hand, ready to attack other nurses.

For whatever reason, the guy who makes up lists of charts for me to audit has about a fifty percent success rate in actually picking out the folks who have had strokes or strokelike symptoms. Fifty percent. That means that half my time is spent picking through charts, reading notes, and looking desperately for something that says "stroke," only to find that the person I'm reading about had, say, a bad reaction to chemotherapy (not making this up), a case of food poisoning (not making this up), or a fecal impaction (o how I wish I had made that up).

The other half of my time is spent--and I kid you not, it's probably close to 40% of the remaining time I spend on audit-related stuff--looking through the charts of everybody that Sunnydale or Holy Kamole has discharged in the past three days, and usually finding stuff that Chart Guy has missed.

Ten percent of that time is spent actually auditing the charts of stroke patients. Since most of them come to me, it's quick and easy: I can and do do it from memory, mostly.

So, yeah. The TL;DR of the preceeding complaint is that I'll have twenty or so (at last count) charts to transcribe to paper and a couple hundred to slog through on the hunt for missed strokes. I don't know what Chart Guy's problem is, honestly, except that he's probably as overworked and understaffed as the rest of us.

In other news, uh. . . .I got nothin'. Der Alter Jo has damaged her knee in some unique and painful way, so we're both lying up on our respective couches feeling like extras from "Spirit of '76." I finished Bill Bryson's book At Home with the result that I now have a list of six more books that I really ought to read. I'm getting into the first season of "Torchwood" and now want to buy a Roomba vacuum for the sole purpose of naming it Ianto.

Off to turn the a/c down some more, and maybe pour myself a glass of something intoxicating, before I get back into chart audits. Hospital administration would be so much more pleasant--and probably more productive--if we were allowed to tipple at our desks.


Silliyak said...

Perhaps tippling at his desk is Chart Guy's problem

jimbo26 said...

" Scuzzy " ones taste nicer . [ bg ] Wouldn't it be easier to show the chart guy what he's supposed to do ?

messymimi said...

Dog reaction: New bowl? What new bowl? There's no such thing. New ones don't taste right. No new bowls around here.

Cat Reaction: What took you so long? It's been two whole months since you replaced it!

Halie said...

Couldn't agree more re: tippling! Cheers!

Penny Mitchell said...

I can't comment on the nursing stuff, as I have no experience with that. I can comment on the swollen belly.

Even though you're reallyreallyreally not going to like the answer.

My hysto was on 12/20/10. I STILL have days of only having a couple of things I can squeeze into. I know we did not have the same surgery, but...patience, Grasshopper. Patience, and wine, Grasshopper. That Bitch of a Belly is going to be with you for a while, and cramming yourself into the jeans that used to fit is a heinously bad idea. Trust me.

Agnes B said...

I don't quite get how Chart Guy is getting it so very wrong. I have been auditing stroke charts because I also work at a primary stroke center. We get our list of stroke patients a month after the patient has been discharged, the list is generated by how the patient codes out -- so they're all actual strokes (or TIAs).