Wednesday, March 2, 2011

Tales From Intern Year: PT

At most hospitals, I think it's standard to write a physical therapy (PT) referral before a patient is discharged, just to make sure that when they try to leave their hospital room, they don't fall on their face and break their hip. The challenge is to remember to do this in advance so you don't end up either calling PT and begging them to see your patient ASAP or, worse, having to keep the patient an extra day.

During my intern year ICU rotation, I forgot to write for PT on a patient when I transferred him off the unit. This was a transfer I had to do when I was paged out of morning report and told that I had five minutes to get all his paperwork done because they had an unstable patient they had to get into the unit.... and four minutes into it, my senior resident Annie came by and said, "We're rounding NOW. Let's go!" So I forgot something. Big shock.

Unfortunately, Annie was not willing to let me forget that I had screwed up.

Annie: "Did you write for PT?"
Me: "Oh shit! I forgot! I'll go write for it now."
Annie: "Every time you transfer a patient to the floor, you have to write for PT."
Me: "I know. I just forgot because I was in a hurry. I'll write the order now."

Annie: "Did you put in the order for PT?"
Me: "Yeah, I did it just now."
Annie: "You have to write for PT when you transfer a patient."
Me: "I know. I just totally spaced that one time. I'm sorry. It won't happen again."

Annie: "I don't think your patient can go home today because he hasn't had PT yet."
Me: "I'm really sorry about that."
Annie: "In the future, you need to write for PT on every patient."
Me: "Yes. I know."

I sort of felt like I was in that scene in Office Space, where the guy keeps getting told about that coversheet memo for his TPS report by all his different bosses.

Of course, maybe I would have remembered to write the order if I wasn't running around like an idiot trying to get everything done. Annie and I followed the same exact patients, yet I did all the work, wrote all the notes, and wrote all the orders. I know that stuff was my job, but she could have offered to do a couple of things just so I wouldn't have been in such a crunch. I don't even know what the hell she always did while I was running around all day. She was probably looking up labs or going to a spa or something.


  1. "Yea....I'm going to have to go ahead and ask you to come in to round on your patient's on Saturday"

    At our hospital(s) we have pre-written order forms for ICU transfer, which are usually already marked for things we'd want done on every patient (PT/OT consult, labs before they leave, etc), so there was less of that BS. That much have been frustrating to say the least.

  2. I feel your pain on the questionably-busy-boss syndrome. My boss's boss got "special part-time" status with probably full-time pay, always says she's busy and just dumped her 3rd last-minute grant application on me in less than 4 weeks. She's probably getting her nails done :/

  3. This sounds like precisely the kind of condescending thing my tutor would say to me. Ugh, I feel you!

    (BTW, not sure if I introduced myself - I'm a huge stal-- fan of your blog! :))

  4. Sounds like she's certainly cut out for management =/

  5. Let me guess, they made her chief resident.

  6. Thanks, Sunrise... I like stal-- fans :)

    OMDG: Annie actually wasn't that anal a resident. She was some mixture of anxious, bossy, funny, and slightly incompetent. Not at all chief material. At first I hated her, but we eventually got into a grove together and started to have fun together.

  7. I'm nervous about this stage of school, because knowing me I'd accidentally make a smartass comment.

    Just found your blog the other day and LOVE it!

  8. I had a medic like that when I was an EMT

    Medic: did you change out that empty O2 canister?
    Me: Oh, right, I forgot - *starts to walk out* Doing it now
    Medic (shouting after me): You always need to change those

    I walk back in...
    Medic: did you change the empty O2 canister?
    Me: Yeah, just did it
    Medic: ok, you need to make sure you always do that; it's very important, you can't just slack off...(rambling, I stopped paying attention).

    Now I know it sounds more dire than a PT order, but we carried at least 5 O2 canisters on the ambulance and we were the transfer car (not the 911 car). I agree that it's important. I just forgot and was thankful at first that she reminded me, but it got annoying really fast!