Thursday, June 28, 2012

Why every hospital needs EMR

EMR = Electronic Medical Records

When I was an intern in the ER, one day I came back from lunch and my attending gave me this really dirty look and said, "You know, you wrote to give D5 that diabetic guy with the blood sugar of 500." (i.e. I wrote to give sugar water to a diabetic with really high blood sugar)

"I did???"

He shook his head at me, clearly baffled by my stupidity. "I guess you didn't do it on purpose, but I just wanted to let you know you made that mistake."

I couldn't imagine why I would have written to give him D5, even by mistake. I hadn't ordered that all year. The only thing I could think of was that maybe I had meant to order something else and I checked the wrong box, but I knew I couldn't have actually WRITTEN it.

Finally, I got the order sheet to look at what I wrote. Under NS, I had written 0.5L and they had mistaken my 0.5 to say D5. OK, I guess that's not ridiculous, but why would I have written D5L? What does that even mean???

Regardless, the patient almost got sugar water pumped into his veins.


  1. What was even more awesome is that the attending thought, and probably will forever think you're an idiot, and there's most likely nothing you can do to change that. I hope that wasn't the case though.

    1. You're right. I think even after I explained what I had meant to write, he still blamed me somehow.

  2. EMRs don't always help. I recently ordered a maternal vitamin for an 80 year old man thanks to clicking the wrong button on our EMR. The pharmacist was very amused.

    (Admittedly, this could have been avoided by double-checking my order....except that it's not always easy to do when there are people screaming at you to do other things.)

  3. I agree. Things would be much easier if it was in legible type; AND then one doesn't have to lug around massive files AND medical records can't just "disappear" when a doctor gets taken to court.

    As for Solitary's experience, that's where Electronic Gatekeeping (EGK) comes in - it's programmed to have exclusion/inclusion criteria. In our hospital we use it for labs, but I'm sure a similar program can be written for the drugs.

  4. Yes, as an RN, I love the EMR. For all the years, I had to decipher the hieroglyphics the MD's left me!! Now, it makes it sooo much easier when I am talking to the patient on the phone and ask them how the MD's advice is working out or they even tried it, etc. I also like it when I see the patient 2-3years later and remind them that I helped them through their last pregnancy, or whatever.

    Working with a teaching hospital, I have always been a go-to- nurse for the residents and interns. . . "ok, you might want to get your gloves on and "catch" the baby now. . . "lather up that perineum with a little bit of this goo. . . " "Let's give her some mag before she has a seizure. . .

    But back to the EMR. . . love, love, love it.


  5. a combo of "Anything that can possibly go wrong, does." (eventually) and "failure in communication" from the time of the "Tower of Babel".

  6. "Does this say 'Donkey food'?"..."Uhh...maybe Dialaudid?"
    Sometimes deciphering doctors orders is amusing....despite the fact that it slows us all down.