Tuesday, May 27, 2014

A Bow In Respect to a True Veteran

Mid-morning I received a call from my transcriptionist.

"A nurse on 4B has a question about spinal fluid."

Fair enough, I'm covering cytology. I picked up the phone.

"Dr. Shyder."

"I was wondering if you have a Lithium Test for spinal fluid."

"I've honestly never heard of that."

"Oh, Ok." She hung up the phone.

I breathed deeply. This was unresolved. I called the operator to get the nurse.

"What exactly is a Lithium Test for spinal fluid? Are you trying to assess for toxic levels of that drug?"

"No, I'm looking for the pH."

"Oh, you mean a Litmus test? Is there a doctor asking for that? Have them call me and I'll chat with them about it."

"No, this is Nurse's Judgment. I've been working here over 40 years. My patient just had surgery on her head and she is leaking fluid from her neck. I am worried it might be spinal fluid."

"Well, we have a chemistry test for spinal fluid, but I don't think we have a Litmus test. I've never heard of that being done. But I'm only 40. I've been working here for seven years. I do know that sometimes we use that chemistry test in patients with unexplained constant clear liquid rhinorrhea. It helps to determine if it is spinal fluid or not."

"I remember them doing something like that Litmus test back in the 70's. I was just trying to help the patient. Tell you what, I'll call the doctor and tell him what I think the patient needs, he can order the test."

"That sounds like a good plan. Just because I haven't heard of that doesn't mean it wasn't done. Thank you so much for thinking outside of the box for the patient. We will do whatever we can to help."

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