It had been a very busy night in the hospital when I got pulled into the lab manager’s office in the morning. Ray was a giant of a man. He was a gentle giant, but he was still pretty imposing. He made me look small, and, as one of my many father figures, I respected/feared the man. So when he asked me to step into his office with that look on his face — the look of an angry dad — my heart kind of sank a little.
Ray rubbed the bridge of his nose with one hand as he held his glasses from his face with the other. A piece of paper sat on his lap. It was a printed email, and I could see that it was from the nursing supervisor who was on that night. “Please tell me,” Ray said with a bit of hesitation, “tell me that you didn’t print off 225 copies of the same lab results to the ICU last night.”
I would have loved to tell him that I didn’t. But I did…
Ten hours earlier, a patient had been brought into the ER for some sort of condition. I forget exactly what was wrong with him, but he spent some time in the ER before they sent him up to the ICU. While in the ER, the patient had a ton of lab work done. There was a complete blood count, a complete metabolic panel, a cardiac panel, some blood banking stuff, urinalysis, and even some testing for a reference lab. Anyway, by the time he was sent to the ICU, all of the patient’s results were in the electronic medical record (EMR).
At around 2am in the morning, as I was running back and forth to the ER, drawing blood and doing a lot of blood work on a lot of patients, the ICU nurse who took charge of the patient called me looking for the patient’s lab results. Apparently, the hard copies of the results didn’t make it onto the patient’s chart. She said she wanted to have the chart complete before the patient’s family doctor came in to visit the patient. I told her that I would send her a copy as soon as I could.
Half an hour later, the nurse called again. She asked if I had sent the results. I told her that I had sent the results, but that they might have printed off in the ER since the patient was still in the ER as far as the EMR could tell. “Maybe you should print them off there yourself?” I suggested. Well, she took the suggestion as a bit of an insult, or something. She told me she was very busy to be printing lab results and asked me to try it again.
I got another call from the nurse at around 3am. The patient’s family doctor was there to see the patient, and the hard copies of the results were not in the chart. She said she was embarrassed, and that I — me, the “lab boy” — was wasting her time. As best as I could, I informed her that we had this wonderful thing called an EMR, where she — or the doctor — could look up the lab results and even print them.
“Rene,” she said with a very stern voice. “I need those lab results printed now, in this patient’s chart, and I don’t want to hear any more excuses.”
“Alright,” I responded. “I’ll make sure you get them.”
There were three printers in the ICU, and I knew the extension names for all of them on the network. I knew them because I had to print off to different printers from time to time, depending on whether or not a printer was down. So I logged into the EMR and ordered 75 copies of the patient’s lab results to each of the three printers. Without giving it a second thought, I clicked on “PRINT”.
Ten minutes later, the nurse called again. “This isn’t funny, Rene,” she said.
“What?” I asked, sheepishly.
“I’ll make sure Ray hears about this in the morning.”
“Oh, you got the lab results! Great. Glad I could help.”
After she slammed down the phone, I went back to all the work that was building up. It was a really busy night, and I would remember it even clearer because of Ray’s meeting with me in the morning…
“Do you think you got your point across?” Ray asked.
“Probably not,” I replied. “She’s pretty dense. She’ll probably keep ordering the lab techs to print results for her out of fear of doing it herself.”
“So, if you didn’t get your point across,” Ray said as he reclined in his chair, a little less angry-looking by now, “why did you do it?”
I thought long and hard before I replied to him. “Because it had to be done, boss.”
After work, I drove over to the local Walmart and bought a ream of paper. It was $3 or so. The following night, knowing that the same nurse was working up in the ICU, I walked up and re-filled the printers with the paper I bought. “I heard there was some concern over the paper running out, so I went and got some more… It’s going to be a long night.”
It had to be done.
René F. Najera, DrPH
I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
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