Sometimes Even the Doctor is Wrong
I had a good laugh this morning. A doctor was ranting and raving that an order he'd written two weeks ago still hadn't been followed. The order was for a pressure-relieving shoe for a patient with a plantar wound. The doctor was very upset. He was making threats. He demanded something be done by 7 p.m. this evening or he would do something.
The first thing we did was check the chart. It took several tries to identify the order. At least we think it was the order. It was written so illegibly no one could read it. Another order was found about a week later. Someone had signed off on it but never taken it off the chart.
I've seen that particular doctor in the facility at least three times weekly. He sees all of his patients every time. I wonder why he didn't say something the first time he noticed the order hadn't been followed. He rounds once a week with our wound care nurse and sees all of his patients. That would have been a good opportunity. He and I have also talked about the wound a few times. Those were other good opportunities to bring up his concern.
No, he waited until today when he noticed the order still hadn't been followed to take action. Fortunately for us, what he wanted was something we had in stock. Had we known about the order, or had someone been able to translate the original order, that would have been that. If he had said something right away, it could have been taken care of.
Now that all has been said and done, the doctor got what he wanted. To my knowledge, no one has pointed out to him that had he written the order more clearly we could have followed it immediately. Yes, there is some blame on whoever signed off on the order for not calling him. Nor has anyone pointed out the numerous opportunities he had to effectively address the problem during wound rounds. Yes, there is some blame for others but ultimately he was responsible because he wrote the order.
Ironically the patient is refusing to wear the shoe. He says it's uncomfortable and he prefers to wear his flip flops. He acknowledged the purpose of the shoe and why the doctor wanted it. He stated he understood he was supposed to wear it whenever he got out of bed. He just isn't going to wear it. I had to bite back the laugh.