Stupid Doctor Orders: Yes! They happen

I attended a conference once. I was there with an older therapist named Doug. This was way back when I was a green therapist. So, it was quite a few years ago. The instructor was asking us questions. She said, "Can you name anything good doctors do?" 

Doug raised his hand. "Doug! The teacher said.

Doug said, "Doctors orders." 

So there was a discussion. Then the instructor said, "Name something bad that doctors do." 

Doug raised his hand. "Yes, Doug!" The instructor said.

Doug said, "Doctor's orders." 

A rush of laughter made its way through the room. So funny and so true. Lots of great doctors' orders. And lots of stupid doctors' orders. I think most of us know what a good doctor's order is. I thought it would be neat to list some examples of stupid doctors' orders here. The following are stupid orders sent to me by readers like you. 

1. You have a patient coming in by ambulance. Over the speaker, the ambulance driver reports the patient is in respiratory distress. The doctor looks at me and says, "As soon as they get here, start a continuous breathing treatment and BiPAP." Yep. Even before looking at the patient. 

2.  You have an 88-year-old patient. The patient is completely out to lunch and is totally incapable of using an inhaler. Still, without looking at the patient, the doctor orders BID Symbicort. 

3.  You have a patient on a ventilator. The doctor orders an ABG. The results show respiratory acidosis. The doctor orders for you to increase the rate from 14 to 18. You explain to the doctor that the patient is breathing over the vent at a rate of 20. But, he still insists on increasing the rate. An hour after the ventilator change, the rate is still 20. And the doctor orders a repeat ABG. And, lo and behold, the doctor is perplexed why the CO2 did not come down. 

4. Stupid is giving 6-8 puffs of inhaler to COVID patients in ER. Why the hell are we doing this? Albuterol is for asthma, not COVID. I have never had any covid patient say they can breathe easier after using an inhaler. What a waste of time? The only time COVID patients benefit from albuterol if when they have a diagnosis of asthma. Stupid is that we actually had a shortage of inhalers because of this. And it was absolutely avoidable.