Jim Buterol is a fellow respiratory therapist who works at a famous hospital down south. I'm not going to reveal his real name to protect him. He told me that where he works there is a doctor that he refers to as Dr. Q1. Her real name is Dr. Krane, but that's not a real name either. She loves to order breathing treatments Q1 until discharge.
It gets old after a while, he said. While most doctors would at least assess the patient before ordering medicines, this doctor, once she learns a patient has shortness of breath, orders albuterol Q1 automatically.
I told my friend that I think this doctor is smart. He said, "Why?" I said, "Because she knows exactly when patients are going to be short of breath."
He laughed. But it really wasn't funny. It was actually horrible. In many cases this resulted in wasted medicine and resulted in a poor use of the respiratory therapists time.
In many cases, my friend said he would be in the emergency room tending to these patients who were, in many cases, no longer short of breath by the time the second, third, fourth, fifth and sixths treatments were being given. In many cases there were other patients he had to attend to but couldn't because he was in ER taking care of his Q1 treatments.
He said he complained to his bosses, but they said the job of the RT is to do whatever the doctor says. So, he decided, there was no point in further complaining. He said after a while he became burned out and apathetic.
We have similar stuff that goes on here at Shoreline. I talked to my boss this morning, and she said I did twice as many procedures last night as the other night shift worker the night before, and we both had the same number of patients.
I said, "That's because Dr. Q1 was working." She didn't understand what I was talking about, so she ignored me. I was fine with that. I didn't want to explain to her why I said that anyway.
When I gave report I said, "Dr. Q1 worked last night." My coworker understood immediately what I was referring to. It's sort of an inside joke, I guess. It's code language only RTs understand.
I wrote before that I think it's neat when a doctor is smart enough to know a patient will be short-of-breath and exactly when. How the heck does she know a patient is going to be short-of-breath every hour? We may never know.
Funny thing is, she's wrong most of the time. Most of the time, as I noted above, patients are not short of breath when they are ordered. But, who are we, as humble RTs, to argue with a doctor? Are there an Q1 doctors where you work? I have a sneaking suspicion that there are.