Sunday, June 22, 2014

my job: where the impossible is supposed to be possible

So apparently the "bed to med" time has become a big thing.  In other words, you hit the bed, how long does it take us to get you pain medication?  They are measuring this time now.  The goal is 40 minutes.

Steps in the process:

1) Doctor has to see you.  If we are busy, there is a critical, that is delayed.
2) Doctor orders med.
3) Nurse acknowledges order.  Busy with your other patients? Delay.
3) Pharmacist has to approve med.
4) Nurse goes to pyxis to get med.
5) Nurse goes to room and has to start IV.  90% of pain meds are given IV.  Bad veins? Delay. Our ER is full of chronically ill, old people, druggies and drunks who sometimes are a difficult stick.
6) Scan meds into computer.
7) Give med.  Or several meds.

So lets say I have 4 patients.  I may be doing this or something else for 3 others. I might not get to you right away.

This is the problem with standardizing things in medicine.  It doesn't take into account what else is happening.  It assumes the ideal.  It is decided by those who don't do the job.


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