Emergency room visit part 4:
Sheri sat with Bob and tried to have light conversation as she tried to evaluate the situation. She looked for any sign that someone coming into the room would quickly know how cognitively impaired he is, but there was none. There was one of those boards that should have had his name and so forth on it that still blank, may be it could have been there when they had time. When a nurse came in she asked Bob if he was feeling better to which "Al" replied, "yes.", (of course he is... he has no recollection of the event or where he is). So as the nurse was walking out she said " well we are waiting on the chest ex-ray and then the doctor will be in. She was a very friendly gal so Sheri said, "can I ask you a question?" She replied "sure!" "does it say anywhere in his file that he has advanced Alzheimer's and highly cognitively impaired" The nurse replied " I don't know let me look". The nurse went to the computer clicked into many screens scrolled way..... down and said "yep it is in here." Sheri paused a minute and said "Oh good...because that is really important for everyone working with him to know right away."
Heavy sigh...
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This is awful. I had no idea. However, I do hear from others that care from docs and nurses not familiar with the patient (any patient) is being compromised more and more as they don't read the patient's history. Awful mistakes like procedures on the wrong person, are becoming more common place. Add to it a patient with limited cognition-a true recipe for disaster exists!
ReplyDeleteI truly think part of it must be the demands on caregivers that may result in less time to familiarize themselves with patient history.
I really love your idea for the coloured dots! It's easy, relatively inexpensive, and a quick read. However the multicolor approach (for advancing cognitive issues) may be difficult for all to keep up with and change as needed.
What if there was a "universal" assessment tool (like three questions asked of their caregivers, and doctor signs off) and if the patient "qualifies" they get a dot that goes on all records. The dot means criteria in care must be met: ie: patient must not be counted on for decision making, patient must not ever be alone, etc.
I think simple assessment and simple criteria are key. Maybe acronyms.
Its just my two cents.