Thursday, January 28, 2010

Party at the Hamptons

Well, not really the Hamptons (what are those, anyway?). The Hampton Inn, in Conway, AR. Come join.

At work this morning, I became riddled with anxiety over the impending weather. Normally, when I go to Conway hospital to work (it has been a couple of months), I get the kids up, take them to school early to a teacher that accepts money for her service, and get on the interstate. But everyone was talking, "the weather, the weather." I got on the national weather sites, and instead of 30%, 40%, like it has said in the past, it was predicting 100% icy storms with accumulation.

After looking at a few cases, I went into my partner Dr. Woods office. "I need to vent. About the weather." He assured me that there would be no accumulation, I would be fine.

I went to show another partner, one that commutes to Conway frequently, a case.

"I knew I was smart back in August when I put you on the Conway rotation. Thank goodness it's not me, tomorrow. Make sure you have a full tank of gas. Last time there was ice, a truck jackknifed over the interstate and I had to back up and take the old highway. It took me seven hours to get there."

More stressing. I arranged for my caretaker, her two youngest kids, and her granddaughter to spend the night at our house. I booked reservations at a hotel in Conway. I canceled the morning session with their teacher. I decided it may be highly unlikely that I would have trouble with the morning commute, given the recent warm weather, but with 100% chance precipitation and accumulation likely, I needed to be prepared. A lot of the histotechs, nurses, gross room assistants, lab technicians, etc., had completely booked the hotel across the street from the main hospital by noon.

As the day progressed, I looked at cases and tried to generally tie things up since I am on vacation next week. I started thinking about the prospect of a one or two night stay at a hotel, by myself, and got excited. All this was dashed when a bigwig from the lab stopped me in the hallway.

"I need to talk to you about something."

He gave me the names of two patients that I had looked up. Some Big Brother somewhere was wondering why I had gotten into their medical records, since I was not listed as the attending on that case. I sighed heavily.

"This happened to me once before. I got a list of six or seven names, when I hadn't been here but six months. I was told I was being audited, because they couldn't find an anatomic report with my name attached to the patient. It took me all afternoon, but I finally discovered I had read peripheral smears and serum protein electrophoreses on each and every patient, a few weeks before. I was a little angry and defensive, when it was all over. I am a mother! And a doctor! Does anyone really think I have the time to be snooping around in patient files? Or the inclination? Do they think I am stupid, and live under a rock? I followed the stories about Ann Pressley. I realize the consequences of looking around in patient files. Not that I want to - I would never think to do that. It's wrong. I'm the kind of person who worries about her patients, even when I am covering another service and am no longer responsible for them. But I would never stoop to checking up on them electronically, because it doesn't feel right."

The bigwig smiled and laughed, apologetically, but still wanted proof. One of the names I recognized immediately - I was still working on a bone marrow case of his. The other name was familiar, but I couldn't pin it down. I unsuccessfully enlisted the transcriptionists for help. Finally decided to figure it out on my own, and did some detective work. The reason I got into that other patient file, was because it was a common name, and I accidentally clicked on someone else with the same name and age, looking for relevant clinical information. I printed out the anatomic report for proof, with my explanation in a post-it. There, dammit. Don't crucify me. I am not a bad person. And I have more important things to do, than to prove that over and over.

Having vented about all that, I realize the importance of checking up on staff and ensuring patient confidentiality isn't breached. I read a story today, about something in L.A., that was despicable. I am glad someone is looking out for the patient. It just didn't fit into my schedule, today, and I got pissed about it.

Thank god that was over, and I could focus on getting to the hotel, and worrying about childcare. I packed a ridiculous amount of books, clothes, and snacks. I ensured that the hotel had internet access. So funny how in mid-range hotels, like this one, breakfast and internet access are free - a given. Not so much with high range hotels. I think I'm happier here.

There's also a workout room. It's been a few days, since I ran. I'd better go to sleep, so I can get up with my alarm at 5:30.

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