Tuesday, May 08, 2007

KC's Levicy Posts: Some Reactions (Post 2)

This post is a continuation of “KC’s Levicy Post: Some Reactions (Post 1).” If you haven’t already done so, I urge you to read that post, which includes links to KC’s posts. All of the posts deal with important matters about which sensible people are very careful.

Before getting into Post 2, I want to respond here to part of a comment made on the thread of Post 1.

Anon @ 10:26 pm said in part:

No one goes back and charts on someone who has been discharged. This case was done in the ED when Crystal left on her own two legs at 1:30PM. Glad you have someone from DUMC on the case.
I think Anon@ 10:26 pm is referring to a comment I made in Post 1 about updating charts.

Folks, if a medication was administered to a patient at Noon; the patient was discharged at 1 PM with no recording on the patient’s chart of the noontime med administration; and the failure to record the administration is discovered at 2 PM; what hospital then doesn’t update the patient’s chart to show the med was administered at Noon?

We should all stay out of that hospital.

Now to Post 2 ---

I ended Post 1 with:
Of course, there’s a very good chance (almost a certainty) an HCP asked about a patient’s care even a few days afterwards by police or attorneys will already have had contact with an attorney representing his/her employing institution.
Many of you who are Health Care Providers know it often seems major hospitals such as DUMC have more attorneys on call than physicians and other med staff.

You also know how quickly, often for reasons not entirely clear to you, a hospital staff attorney or one retained by the hospital/service provider is asking questions and reviewing the chart for a particular patient.

No sane HCP wants an attorney looking over her/his shoulder during service delivery.

But when an investigator or attorney is looking at what a HCP did and asking questions, the sane HCP welcomes an attorney at her/his side.

The most competent HCPs I’ve known who became involved in investigative or adversarial proceedings have wanted an attorney “there” working with the HCP, but not because the HCP wanted to CYA.

In my experience, competent HCPs have wanted an attorney “there” in order to be sure they could accurately provide data and not be intimidated or become confused when recounting service delivery, etc.

Many health care centers such as DUMC stress to their HCPs what I’ve heard called “the attorney to attorney” rule.

Yes, you guessed it: a patient shows up with an attorney or an attorney for the patient writes a HCP a letter asking important and legitimate questions: in both instances, it’s time to invoke “the attorney to attorney” rule.

At least it is if you’re a sane HCP.

(Post 3 tomorrow)


Anonymous said...

I personally always charted my medicine immediately after delivery to the patient. Decrease medication errors a lot.

Anonymous said...

I have been a HCP prefessional for 27 years. If a medications, procedure, ore relevant documentation is not docutment when the serive was provided, you make an addendum to your notes. You document the time you are presently writing and then document when the serive was renedered. If charts are pulled from medical records, you always have a supervisor present.
I have never met a nurse who did not learn on the first day of nursing school "If it is not documented, it was not done".
Sounds to me that Ms. Levicy was an over zealous feminist whose subjective opinions were more important than objective infomation. I feel like Albert Einstein compared to her!

sceptical said...

From the Special Prosecutor's report (p. 20):

"The Determination to Dismiss the Charges

* No medical evidence confirmed her (Crystal's) stories. The SANE based her opinion that the exam was consistent with what the accusing witness was reporting largely on the accusing witness's demeanor and complaints of pain rather than on objective evidence."