As I entered the patient's room, I introduced myself and asked if her name was "Sarah." She said "yes," nodding in my direction with a welcoming smile. Prior to entering the patient's room, I had diligently reviewed the chart. She was 93 and had been hospitalized after slipping and falling in her home, where she lived alone. Her husband had passed away few months ago.
Since the patient had complained of left hip pain, x-rays were ordered. They showed normal degenerative changes without evidence of a hip fracture. Her pain was being managed conservatively with physical therapy and pain medications. My job was to assess/evaluate for any other injuries. It seemed straightforward enough. As it turned out, it was not.
As a proceeded with the history intake, things were not making sense any longer. The patient, who was hard of hearing, stated that she had fallen as she was walking toward her mailbox. She then proceeded to tell me how relieved she was that her hip surgery went so well yesterday. She was hardly in any pain and was participating in physical therapy, so that she can return home to her husband.
"Good to hear! What surgery, may I ask?" I inquired. "I broke my right hip, honey, and had surgery yesterday to correct that," she responded calmly.
The patient's chart clearly stated that she had injured her left hip and there were no hip fractures, let alone surgeries. I was convinced that the patient was confused about the events that had occurred recently. She was, after all, 93 years old, staying in an unfamiliar environment, and possibly in pain from the fall. Confusion is likely in her case.
On physical exam, however, I noticed a well-healing incision over her right hip. Her left hip was nontender. My own physical examination supported my patient's story that she did in fact fracture her right hip and had surgery for this recently.
After spending 20 minutes with "Sarah," I realized that I had just interviewed the wrong patient. Embarrassing. Looking back at it now, it is somewhat comical. But I do not intend to repeat this again. I made two mistakes that day: I did not check the patient's wristband for her name (they are there for a reason) and I was guilty of ageism. I assumed the patient was the confused one when it was actually me. Lesson learned.