Walking a fine line…

For the weak hearted who donot like any talk about hospitals and ill patients, this might not be a post you want to read.

I was doing my first set of nights at a hospital that was very sparsely staffed.Like most hospitals. What was terrifying was that I didn’t have a senior I could turn to for help, incase the need arrived.I would have had to call a consultant in the middle of the night if anything went wrong.Not some thing anyone wants to do.

This would have been my second or third night.I knew I had done well so far.That night had been busy. I had already seen 13 patients or so.I remember.Some days/nights you just do.

An old man was brought in by his son.Must have been around 6 in the morning.I was already counting minutes to 8 am, when I would be relieved.I was really tired.This man looked sick and his son very worried.He needed attention right away.

When I was done with the patient, high on my differential diagnosis was neutropenic sepsis*. I had taken the bloods myself.I always use a glove as a tourniquet. Not the ideal. But when patients are difficult to bleed the glove works wonders. He wasn’t easy at all. He was so dehydrated, I just couldn’t find a vein.

I wrote all my notes. Wrote the drug chart. Made sure plenty of fluids were prescribed. The blood results were back in less than an hour’s time. The patient was neutropenic alright.I was very pleased with myself.Who doesn’t like being right. Especially at that hour.

Assured I had everything under control, I told the son he could go to sleep and that he should come around later. By then we would know all our plans for his father.The son refused to budge as according to him his father looked really ill.I agreed.The father was very ill.

When the consultant came around 7:30 am, I asked him to see this really ill patient first.When we got to the bed side, my patient looked a lot whiter and more sick than what I had left him 15 minutes ago.Some thing was drastically wrong.

I looked around.Horror of horrors.The place I had tied the glove as a tourniquet was red.I must have left it on.Someone has just taken it off.He wasn’t getting any fluids.No drips in the arm.Why wasn’t his medication being given to him?I didn’t know what was going on.I was ready to scream.I was losing my patient right before me.This couldn’t be happening. I had him.And I had him right.He could not die on me. Not after all that. I was panic stricken. I had done everything by the book.So I left that glove.Couldn’t be more than an hour.That cannot kill him. But what was killing him then?


I had forgotten to sign the drug card.

None I mean NONE of his medications were given to him.He was slipping away, right before my eyes. C’mmon nurses.So you have your instructions.But you have some common sense too don’t you.This wasn’t the time to pass a buck and principally I was to blame.

Drug card signed, orders checked I proceeded onto to present my other patients to the consultant.After the rounds I checked on my old man again.He was sleeping. The son was just leaving.He began to thank me.I just had to cut him short, the guilt was too much to bear.

Of course sleep did not come easy that day. Knowing the nature of this man’s emergency how could I forget to sign his drug chart.At lunch time I checked on my old man again.He looked less dehydrated.So the drips were running fine.I went back to my room and slept for the coming night. At night my man looked a lot better. The colour in his cheeks was returning and I knew he would live.

When he felt much better I walked upto him to let him know that the worst was over and that he had to work on getting his strength back.

He turned out to be a very jovial old man. Just before I could take his leave, he thanked me for giving him a new life.I looked at him wondering if he knew how very close I was to taking it away.

I often think of some of the patients I have met.They help me find strenght and motivation to do better in my life. They also humble me into remembering that we are all walking a very fine line….

* That is best explanation of the condition that I could find on the net.In short it is a medical emergency where in if the patient does not recieve immediate antibiotic therapy and plenty of fluids, there is rapid deterioration which can lead to shock and even death.

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29 Comments

Filed under Life

29 responses to “Walking a fine line…

  1. Hey Educatedunemployed (why do you have that name), ๐Ÿ™‚ I know how it feels when you screw up and it is horrible if the patient may die because of that. Thats what happens I guess when you are soooo overworked, though no excuse for mistakes. Well good that he didn’t die and got better. Wow and you are so smart, heck I would never think someone has neutropenic sepsis without knowing their labs!

    You said you are not in residecny, how come?

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  2. yes, its a very fine line indeed….. each of us in this profession has faced something like this at least once (and probably more than once)… yeah, its downright scary… but I guess God has a way of looking after his own…. and that includes doctors as well as patients :)… so look on the bright side,a jolt like this makes us more careful in future…

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  3. Yeah nurses are to blame. They should have called you and let you know the issue. I don’t know much about these thing but glad that things turned out to be better at the end.

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  4. Sinusoidally:
    I am educated and I am unemployed.:D The story of not being in residency yet is long sad and horrible.May be some day I shall write a post about it.
    About diagnosing NS, I remember strongly suspecting it and even writing out the drug card according to protocol.I think I was waiting for the bloods to be back so I could confirm my diagnosis and start the correct treatment.

    Lazy Leo:
    That is exactly what my therapist said to me.:P

    Greensatya:
    In the profession that I am in, passing the buck doesn’t help.Taking responsibility does.Yes I am glad too, he lived while he was in hospital.

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  5. can I send in my bill then? for online therapy?

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  6. man.. this is a real thin line to walk on.. Good I became an engg ๐Ÿ™‚

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  7. LazyLeo:
    I’ll pass on the online therapy.I’ve taken to alcohol these days..:P

    Anuj:
    Wow, well done Engg! Wait till we ask you to make some machines.:D

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  8. i can only imagine how it must’ve felt. I’m glad everything turned out fine.

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  9. ohmigosh! i can totally understand why this is an incident u remember so well…yes, u made a mistake but it is so weird that no one bothered to cross check whether he got his medications..so ur not the only guilty party there…it must be so scary to be so responsible for someone’s life or death..i can only imagine..

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  10. tssk tssk….what’s the world coming to?…mere jaise friends ke rehte bigadti jaa rahi hai…(heh..heh…u’ll probably say….that’s precisely why u’re going bewri)

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  11. Biju:
    I am glad too.I don’t think I would have ever been able to forgive myself had he died on me.

    Lil Missy:
    It was that time of the morning when shifts change for nurses.So between all that sometimes patients get neglected.I suspect the nurse who took off the glove which I had left behind was the morning shift girl.It is scary,and thrilling at the same time.

    LazyLeo:
    You got that right.Now don’t ask me what..:P

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  12. of course i won’t ask what….it’s so bloody obvious…duh!

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  13. Eh, what’s up doc. ๐Ÿ˜€ I have a soft corner for docs but scared of them to the depths of the earth at the same time.

    This post reminds me of all the sitcoms ever made on the docs. And blood.. what could be worse than that :S

    You guys do a great job. But stay away from me please, especially if you have those syringes and those monstrous equipment.

    Glad to see that guy make it through. ๐Ÿ™‚

    Like

  14. Thatโ€™s a wonderful and inspiring story. After watching the increasing batch of medical drama/comedies on TV (House, Greyโ€™s Anatomy, Scrubs, etc.) I appreciate what you have experienced all the more. Blessings to you!

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  15. Gangadhar

    really loved this post,EU..
    Dats why i respect your profession..

    Like

  16. SCARY! Why didn’t anyone check? Err they don’t? Sheesh..

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  17. San

    Oh that was a rather scary incident.

    I know this is harsh and I’m really just voicing my opinion here, yes the nurses could have questioned you etc but the fact remains the responsibility of this patient is ultimately down to you. We can all pass the buck etc, but if I was that ill patients child then I wouldn’t want excuses I’d just want answers not excuses ๐Ÿ˜ฆ

    I hope it doesn’t happen again.

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  18. John:
    I can name quite a few human things that are way worse than blood.But then you wont like me very much.And no sir we don’t walk around with syringes in our hands.So feel free to pop back here.

    Nick:
    I have to tell you this, the sitcoms these days are very good, but they are quite removed from reality.There is a lot more drama in them than there is in real life.But that is only my opinion.

    Gangadhar:
    Thanks about the post.I love my profession too.

    Rohit:
    It wasn’t even 15 minutes between my writing my orders and the consultant coming on rounds.Though I would agree the antibiotics should have started, he became the victim of changing shifts.Only good thing is, he didn’t die on me.I would have never stopped blaming myself.

    San:
    Scary of course.I couldn’t get over it for weeks.And no nothing is harsh about what you said.I agree,it is answers and results we want not excuses.There aren’t any when you walk the fine line.

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  19. the only way i could and would respond to this is a post. and i dont intentd to do it as a comment on your post.

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  20. G:
    Thanks for your post.Thank-you.

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  21. Apy

    That was a scary incident… scared the hell outta me while reading.. but good to hear that no harm done and a lesson learnt..an experience i wd say..

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  22. Apy:
    True, I would write it down to experience too.But scary nonetheless.

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  23. A fine line indeed. Jus remember that you saved this man and thats all that counts!

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  24. Grey Shades:
    Some times the journey is as important as the destination.I wont deny I am happy there wasn’t too much damage done.It was a definite learning lesson.

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  25. Anonymous

    thts a very interesting post..one can relate this to any mistake done in their proffession….i believe in learn frm mistakes..n accept it if ur responsible for something…i apprecite the way u have learnt frm it..keep ur good wrk doc!!

    P.S posting as anonymous as i am nt a first time blog reader :)n yet to create a id

    Like

  26. fainted n

    For the weak hearted who donot like any talk about hospitals and ill patients, this might not be a post you want to read.

    /faints
    /leaves

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  27. Anon:
    Tad bit too late my response but I just noticed your comment. I hope by now you have created your id.Thanks for your wishes.

    N:
    :(.. I would really like for you to stay around.

    Like

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