For years my RT co-workers and I have been trying to change the EKG policy in the ER so that EKGs are only ordered on people who need them, as opposed to every person who walks into the door with CP, stomach pain, back pain, toe pain, etc.
However, our boss doesn't like to rock the boat, and he didn't want to have to go out of his way to try to convince the ER RNs and doctors that they need to be more specific on who they order EKGs on. Or, better yet, it's all about money, and the more EKGs we do, the more money we make.
And our medical director did a review of the EKGs ordered in ER, and the reasons why they were ordered, and he agreed that there were many frivolous reasons for EKGs being ordered, however he was also reluctant to overrule the ER EKG policy where the nurses get to order the EKG on any patients they think one is needed on.
Yet today I went to ER to do an EKG on a 24-year-old female with CP. To me it sounded like she had a little chest cold or something, but considering I was overruled on my attempt to get rid of these frivolous EKGs, I had no choice but to complete the procedure.
Yet this time, as I handed the EKG to Dr. Honk, he said, "I don't think we need to do an EKG on every 24 year old with CP."
"I just do what I'm told," I said. "The nurses order the procedure, and I do the test."
"Well, Ill have to have a talk with them, because I wouldn't have ordered this EKG."
Awesome, I thought. Finally a doctor who's anti-useless therapies. And now that I think of it, he doesn't order breathing treatments on every patient who comes through the ER doors complaining of a common cold either.
Wow. If Dr. Krane, of whom usually works my nights, was working, not only would I be doing the EKG, but I'd be doing a breathing treatment "to ease that chest pressure." And I'd be coming up with a new name for a new 'olin for the bottom of this blog.
I'll have to have this Dr. Honk talk with Dr. Krane and have him knock some sense into her.