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Tuesday, May 20, 2008

The difference between a WANT and a NEED

I was called the other night to ER to do a tx and EKG on three patients at the same time. Plus I was also paged to the patient floors too. So, upon entering the ER and starting all the treatments at the same time basically, I asked the nurse if the EKGs are needed or wanted.


Dog gone it, that's not at all what I meant. But thank you for getting all worked up and screaming at me. Now we all feel stupid don't we. Well, I don't, because I just take things in stride.

My point in asking her that question was not to tick her off, but because there is a difference between a need and a want. If a patient NEEDS an EKG, then I would do it right now. If the doctor simply WANTS the EKG just to be on the safe side, then I can move on to other priority therapies before I do the EKGs.

This brings us to another RT Cave rule #98:
RT Cave Rule #98: "Not all procedures doctor's order are really needed. Some are needed. But others are ordered just as a precaution, and thus are wanted. Thus, some are wanted. In order to prioritize, we RTs need to know the difference between a need and a want."
Pre-op EKGs are wants. EKGs done just to prevent a lawsuit are wants. If that guy is having toe pain, then the EKG is a want.

If, on the other hand, the patient is having crushing chest pain, the EKG is needed right now. Another way of looking at it: If the EKG falls within the guidelines of ACLS it is needed, if not is is a want and can be prioritized.

And that, my friends, is the thought of the day.


Djanvk said...

Totally true, don't you just love the Doc's who don't fully trust in their own judgment to diagnose a patient that they will order everything they can think of just to make sure.

Freadom said...

Then they expect us to do it all "right now." Not possible and not necessary.