A reader sent me this little tidbit they experienced a couple years ago. How do I know that hospitalist medicine has arrived? Read on:
Hi Happy. I love your site. I want to share with you a story that warrants mentioning. A few years ago I was working the hospitalist night call at Big Name Hospital Central when I got a call from a surgeon who had just finished an OR case for a complicated bowel perforation requiring extensive resection. He called to request a central line, by me, to continue routine fluid and nutrition management in this post operative patient. I thought that was a bit unusual, but whatever. I do central lines. Why not me?
Having already passed through the claws of an anesthesiologist and a surgeon, I was appalled when the patient arrived on the floor, after surgery, with 20 mcg/kg/min of dopamine running through a peripheral IV just to keep their blood pressure above palpable. Shocking would be an understatement. I got the line in, because, well, they needed a line. And I do lines. And I take care of patients. This kind of crap has to end some day. Keep fighting the fight Happy.
One of my biggest pet peeves as a hospitalist is my constant witness to under resuscitation of conditions where time is of the essence. I can understand under resuscitation due to ignorance. That can be fixed by education. Unfortunately, my experience says laziness, not ignorance is the road block to appropriate care. And there is no cure for laziness.
Hospitalists do more than just medical management for the clownfish doctors. This story is beyond shocking. The hospitalist did what they had to to make sure that patient got the care they needed. They placed the central line and they succeeded in resuscitating a dying patient. It looks to me like the only doctor worthy of carrying the doctor badge that day was the hospitalist. I commend you Dr Hospitalist. All you other doctors should be ashamed of yourselves.
What if that was your daughter, mother, wife or sister? Would you provide the same substandard level of care to them too? I'm appalled to the core of my existence that this kind of medical care still happens today. If you're going to take care of patients, take care of them. If you're not, get out of the way so someone else can. Hospitalists save lives, because that's what we do. What is a hospitalist? This is a hospitalist. What is an internist? This is an internist.
For other posts about central lines visit here:
- I place central lines in anticoagulated patients all the time.
- How much does a central line pay (RVU)?
- How to bill for unsuccessful procedures, like that central line you couldn't get.
- Vein light technology. Maybe the surgeon should stick to nursing.
- Needle stick anxiety: It happens to all of us.
