Ever have one of those days

[cbrchick]

Originally Posted by tommymac

Well seems the latest "blunder" got broadcast to the staff today as well. Funny how this ones pegged on me buts not realy tha tmuch of my fault. this is one where we cna play the what if game, and either way the problem wasnt caught at the time of the initial accident and I didnt see the guy at that time.

Seems its being used to get a point across which I can kinda see (BUT IS AT MY EXPENSE) but I can also throw it back with the whole if x y and z were done earlier (kind alike if woody had gone straight to the police this never would have happened) it may have been caught much earlier.

its prety much a no win if I tried to fight it so it may just be better taking me lumps and tomorrow being another day on this one

Tom

What happened....?

[GSXRGirl]

I had one yesterday .

[tommymac]

Originally Posted by cbrchick

What happened....?

A little over a month ago a guy injured his foot. Was initially evaluated and told to follow up in afew days. I see him 6 days later. He still has some pain but its improving. I tell him to come back if it doesnt improve or gets worse. And I filed his chart away.

Now as we both know most patients dont follow up like theyre instructed and being a construction worker is worse since theyre the big tough guys. So here we are 4 weeks later. This guy is still hobbling around, so his foreman sends him to the clinic ot be re evaluated. they x-ray the foot and he has a fracture (9 I want to say its a jones, but am not sure but was told its unstable and intraarticular)

So now the logic here is had I not filed it away we would have continued to call him and have him follow up and this would have been caught sooner. Regardless this guy wuould have been walking on this fracture for over a week anyway. I could argue he should have been x-rayed initially and none of this would have happened either but may be better off just letting it go.

Now its used as an example for everyone to be more on point with some of the follow ups (at least I am not mentioned directly but its not a reach to figure out whoi made said blunder)

So for now I just want to get thru todays shift here, then its 2 nights in the ER and a few off days from the sites which may be best for now.

Tom

[cbrchick]

Originally Posted by tommymac

A little over a month ago a guy injured his foot. Was initially evaluated and told to follow up in afew days. I see him 6 days later. He still has some pain but its improving. I tell him to come back if it doesnt improve or gets worse. And I filed his chart away.

Now as we both know most patients dont follow up like theyre instructed and being a construction worker is worse since theyre the big tough guys. So here we are 4 weeks later. This guy is still hobbling around, so his foreman sends him to the clinic ot be re evaluated. they x-ray the foot and he has a fracture (9 I want to say its a jones, but am not sure but was told its unstable and intraarticular)

So now the logic here is had I not filed it away we would have continued to call him and have him follow up and this would have been caught sooner. Regardless this guy wuould have been walking on this fracture for over a week anyway. I could argue he should have been x-rayed initially and none of this would have happened either but may be better off just letting it go.

Now its used as an example for everyone to be more on point with some of the follow ups (at least I am not mentioned directly but its not a reach to figure out whoi made said blunder)

So for now I just want to get thru todays shift here, then its 2 nights in the ER and a few off days from the sites which may be best for now.

Tom

Ah... kinda crappy.

Even if you sent him for an xray, would he have gone? If you're still uncomfortable after 4 weeks, common sense would say you should see someone, not continue to grin and bear it. People aren't all that bright. It's a shame when we have to always "CYA" for pt's stupidity.

People don't want to take responsibility for their own health. They have to be "told" what to do to take care of themselves... Even when they continue to drink, smoke, do drugs, play without equipment, drive drunk, dont check their sugars, eat better.... etc...

[tommymac]

Originally Posted by cbrchick

Ah... kinda crappy.

Even if you sent him for an xray, would he have gone? If you're still uncomfortable after 4 weeks, common sense would say you should see someone, not continue to grin and bear it. People aren't all that bright. It's a shame when we have to always "CYA" for pt's stupidity.

People don't want to take responsibility for their own health. They have to be "told" what to do to take care of themselves... Even when they continue to drink, smoke, do drugs, play without equipment, drive drunk, dont check their sugars, eat better.... etc...

On these jobsites we send them for x-rays so the def get done, as fo rfollow up after that its anyones guess but so long as we do our job for them were good. It seems that i twas an odd presentation since we were just discussing the case.

Working these construction sites have been quite intresting in that I see a lot of different types of people (and no bloody smelly vagina ) Most of these guys dont want to/cant afford to miss work so were not always worried about malingering, but we do get some who milk the light duty thing abit.

The site I am at in westchester is in a nicer more upscale area so mos tof the people are prety well educated and do follow through on the most part. the site in the bronx is a mix as far as education, they have laborers there who cant read english so it gets challenging. The thing is all these guys are union guys so they have benefits so thats easier on us too.

Tom