Thursday, May 13, 2010

The Infectious Disease Doctor

The First Sign of Infection

I gave a presentation yesterday to a group of caregivers for mentally and intellectually challenged children and adults. The presentation was our Family Centered Patient Advocacy Training recognizing that these caregivers, who almost all were social workers, are often the support and / or advocate for the entire family. When they bring a client to the hospital, their skills are perfect for the patient’s needs but what about helping the hospital staff understand their needs and the patient’s safety?

When we discussed the part about infection, I explained that if there is any sign of infection or possible infection, that they need to insist on seeing an infectious disease doctor. Pharmacists, I explained specialize in medication and many doctors have their specialty but an infectious disease doctor specializes in infections.

A nurse in the audience, who was obviously in the business a long time commented. “Infectious disease doctors are always called in if there is an infection” she told us. She explained that it is the policy of hospitals to do that. I reminded her that if policies and procedures were always followed, I wouldn’t be there talking about errors and how to help prevent them. She continued expressing her concern that I may be poisoning the audience (my words not her) with what I was teaching.

Just earlier, a young woman asked how she can find out who the doctor in charge is when her family member was hospitalized. “I kept asking who was in charge and the group of doctors said they are all in charge working together”. I explained that this was probably the resident physicians protecting the attending physician from allowing you to get to him or her. There is an unspoken rule in healthcare that the residents should handle the problems and questions.

Thankfully, a woman with me, who is part of our Patient Safety Advisory Council, just saw last week the
movie about Lewis Blackman who died because of just that reason. Lewis’ mother tried to get the attending physician to look at her son who was declining fast but instead, the new, young doctors, with less experience allowed Lewis to slip away until it was too late. I told the group about the movie and assured her that there is always someone in charge. If one person won’t take responsibility, keep going until you end up in the CEO’s office.

Back to the nurse; I let her know that some hospital staff, maybe the residents trying to protect the valuable time of the infectious disease doctor, may try to handle the problem themselves. With all good intentions, the residents may unknowingly be causing more harm by not getting the “experts” in fast. She was not satisfied and explained further, “Almost always the infectious disease doctor is called in”.

“That almost” I told her, “is why I am here”.

A woman on the other side of the room added to the conversation. Her father went in to the hospital last November for hernia repair, got an infection with all the symptoms, but it took a week to call in the infectious disease doctor. Her father died a short time later.

I rest my case.

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