Wednesday, September 5, 2012

Worst Admission EVER

Ugggh. You can always tell when Dr.Septic Workups and Dilaudid for everyone has been on for a few days, because there will always be shit-tons of holds in the ER.  Because he single-handedly fills up the entire hospital by admitting everyone.  His behavior is so notoriously ridiculous that I've seen it lead to multiple hospitalists having public meltdowns, including one of my favorites, an awesome Vietnamese doctor, who once famously exclaimed to him at the nurses station, "I cannot take this many patients! You fuck me over!"
If a patient still requests more pain medicine after the insane amounts of Dilaudid he usually prescribes, he will admit them for "intractable _____ pain" and order some ridiculous regimen like 3 of Dilaudid Q 2 hours until the hospitalist sees it and changes it to something reasonable because, I don't know, maybe they like their patients breathing.  Which often leads to huge confrontations and AMA signing, own IV pulling dramz when the abrupt Dila-da cutoff is discovered by the patient, but hey, at least that's one more hold that can get a bed?
Anyways, this is all standard procedure at this point, deliver us lest we receive a complaint from a drug seeker.  I guess I get it.  Why bother fighting when you can admit people for whatever they want and make them happy?  However, that still leaves me without an explanation for his most recent insane admitting diagnosis: "acute alcohol intoxication",  The BAC in question? 0.12.  In a 23 year old.  With no other medical history.  Who, with homeboy's crazy long dispo times, was most likely under the legal limit by the time his bed request was put in.  Awesome.  Way to reduce they unnecessary medical costs you're always bitching about, guy. A good friend of mine was taking care of this one, so we had a field day with it.
"0.12, huh? Dude, I guarantee that my BAC was higher than that last weekend.  And I'm pretty sure you bought me one of those drinks.  Obviously, I needed to get admitted to the hospital and I just went home and ate macaroni and cheese.  Why did you not call me an ambulance? You're a shitty friend."
"Right? We should always come up here after we drink.  We've been playing with fire all this time when we were out eating pancakes and stuff."
Seriously, though.  If we're going to start doing this we need to have a whole new wing that's open only for this purpose on weekends and holidays.  Bring on the life saving banana bags!


  1. 0.12??? Wow. Judgment fail...scary in an ER doc. Love the Vietnamese doc, BTW...

  2. I would recommend paging Vietnamese doc or whomever is admitting before the admit is in full force upstairs and being like "look, this dude doesn't need admission, would you be interested in me holding him here a bit so you can d/c him from the ER?"

    It would save the poor dude some time (no need for admission H&P, etc), and with a line as funny as that, he deserves some payback. It's not like any insurance company in the whole world is going to pay him a dime to admit or take care of that patient.

  3. yeah, it's also super fun when we get those patients upstairs in med-surg and do their admission paperwork and discharge paperwork within about 5 hours of each other.

  4. So who is this doc it sounds like the bulgarian? The only other one I know who loved dilaudid that much.....well we got him exciled

    -ER Doc

    1. YUP, that's the winner! And also omegerd I may or may not be about to transfer to that other hospital that you maybe sometimes work at sometimes so F yes hooray. Miss you.

  5. send to my email from my old blog if you have it. i only work at the one place with the billboard now. i didnt think you lived this far north. would love to have you

    er doc