Wednesday, July 27, 2011

Tales From Intern Year: How to call a consult, Part 2

My experience attempting to get one of my ICU patients chemo:

"Oncology consult."
"Hi, I'm the intern on Black Medicine and I'm calling about the onc patient you're following, Mr. Murphy. We got his meta-port in and we'd like him to get chemo today."
"Oh, okay. In that case, just call the chemo pharmacy and tell them to start the patient's chemo."
"That's all I have to do?"
"Yes."
"Nothing else?"
"Yeah."
"Okay, great."



"Operator."
"Hi, can you please transfer me to the chemo pharmacy?"
"Huh?"
"Uh... the chemo pharmacy."
"I can transfer you to the inpatient pharmacy."
"Uh... fine."



"Inpatient pharmacy."
"Hi, can you please transfer me to the chemo pharmacy?"
"You mean you don't want to talk to us?"
"Uh..."
"Okay, I'll transfer you."



"Chemo pharmacy."
"Hi, this is Dr. Fizzy from Black Medicine and I'm calling because we want to start chemo today on Mr. Murphy. I called onc and they told me to call you and let you know you could start."
"All right. We need to have the chemo orders faxed over here."
"What? Onc told me I just have to call you and that's all."
"No, we need those orders faxed over. What time do they plan to start?"
"I don't know."
"We need to know what time they have to start."
"Why?"
"Because the medications need to be coordinated with the chemo nurse's arrival."
"Chemo nurse?"
"Yes, you have to contact a chemo nurse. A regular nurse can't administer the chemo."
"Oncology told me I just have to call you and that's it."
"No, we can't send the medications without the orders faxed and a chemo nurse."
"Okay, I'll call back. Just give me your number so I don't have to go through two operators again."



"Oncology consult."
"Hi, I was just talking to you earlier about Mr. Murphy. Now the chemo pharmacy is telling me they need a special nurse and they need to know what time you're going to start.
"Why do they need to know that?"
"Because they have to coordinate it with the chemo nurse."
"Well, we won't know when we're going to start until--"
"Look, can I please give you the phone number for the chemo pharmacy? I can't go back and forth like this. I need to go find a chemo nurse somehow."
"Okay, fine."


Ten phone calls later, the chemo was finally arranged. Then:

"Dr. Fizzy, Mr. Murphy's meta-port is clotted off. We can't use it."

5 comments:

  1. Didn't you love being an intern?

    ReplyDelete
  2. *snicker* My mom's a chemo pharmacy tech. This is every day for her.

    ReplyDelete
  3. And people wonder why healthcare professionals are grouchy.

    ReplyDelete
  4. I have never heard of an intern or even an internist having to coordinate chemotherapy. During internship the oncology consult service always specified the timing of chemotherapy delivery. Is this not the norm?

    ReplyDelete
  5. Haha sounds par for the course.
    I love how someone gives you instructions and then when those don't work they sound SURPRISED.

    ReplyDelete