Hospital Patient Chart Dropped = More Work For Nurses.

If I drop a patient's hospital chart, I would never expect someone else to put it back together.  I dropped it.  I put it back together.  I expect the same if I drop a cup of coffee all over the computers at the nurses station.  I spilled the coffee, I clean it up.   That's just my perspective.  That's why I'm surprised to see some nurses come to the rescue of the poor helpless doctor who dropped the patient's chart.  "I can clean that up for you", they say.  "Just leave it and I will put it back together", say other clerks and nurses.  It's almost as if there is a class in nursing school called How To Put Your Doctor's Dropped Patient Chart Back Together With A Smile While Keeping Your Angry Thoughts To Yourself.  On second thought,  maybe these nurses just figure the doctor will just make things worse.

Is this attitude unique to the nurses?  I've never seen another doctor offer to put together a chart that another doctor or another nurse dropped.  Oh, let me put that back together for you are words I have never heard another physician speak in my ten years of hurried hospitalist life.   To think there are some doctors out there who would not take responsibility for fixing their own patient charts makes me sad to call myself a doctor.  It's not something I understand, but then again, I also clean up all my own sharpies after a procedure and would not expect a nurse to do it for me.

Hospital patient charts can come in all shapes and sizes.  They can open side-to-side or top-to-bottom.  They can be secured with clips or they can be fastened together with ringed binders.  They can be large, small, big or small.   Most of my charts have ringed binders.  Occasionally, I may  open the rings to take out an EKG or an x ray report to review with another physician.   This is a dangerous time for potentially catastrophic chart annihilation.  If the chart is not safely resting in a place far away from the surface edge,   I guarantee it will find its way on to the floor in a million pieces.  Never  leave an open chart unattended.  That's  just asking for trouble.  

I've dropped, bumped, nudged and mishandled hundreds of hospital charts over the years.  Only a small percentage actually make it onto the floor in a scattered and disorganized array of lab results, progress notes, orders and nursing documentation that will never be read again.  I can tell you with confidence, my heart stops at the instant that chart hits the floor.  I think to myself, "Am I about to spend the next ten minutes putting together hundreds of pages of charting that nobody reads anyway?"  At the exact moment that chart hits the floor, I am frozen with anticipation from this gravity confirming event. 

The worst chart mishaps are those where the chart just falls.  I have no explanation why it falls.  Nobody is standing near it.  Nobody is touching it.  It just happens.  Bam!  Down goes the chart.  That's the moment when everyone looks around to see who is to blame and who is expected to put it back together.  In the old school world of hospital hierarchy, there was no question about who owned the task of hospital patient chart organizer.  It was, of course, the job of the nurse.  Today, that expectation lingers with some nurses.   For others, not so much, as this original Happy Hospitalist nursing ecard below helps to explain. Perhaps, someday, when the entire paper hospital chart is replaced by a fully electronic medical record, chart dropping hazards will disappear.  Unfortunately, the job of the nurse will not end there.  It will instead be replaced by helpless doctors  asking nurses to get lab results and xray reports pulled up in the computer.  For reasons that make no sense to me,  some doctors can complete medical school, residency and intensive fellowships requiring years of specialized training,  but they can't type their user ID and password into a computer to find information vital to their patient's care plan.

"Hey doctors.  You dropped the chart.  You put the damn thing back together.  Love, the nurses."

This post is for entertainment purposes only and likely contains humor only understood by those in a healthcare profession.  Read at your own risk.

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