Ankle biter tasks

[The Knife & Gun Club]

Just curious (as a current fellow) what attending life looks like in regards to the little “ankle biter” tasks from nurses/RT/pharmacy that seem to pile up and really jam up work flow in the unit. Would also be very curious if this changes with having an APP or solo coverage.

Things like…

Patient needs “mechanical soft” modification of their diet orders

Restraint orders need to be renewed at 6:55 pm

The duonebs are ordered as inhalation but we need it ordered as via ET tube

RT can’t find the artery for an ABG

Nurse needs a new nurse communication order for post-op dressings

Need to place a new dobhoff tube because patient ripped theirs out.

PT has an order for PT but need an order for therapy communication that it’s ok to be out of bed.

So on and so forth. As a fellow I get maybe 4-5 of these an hour which breaks up the workflow quite a bit. I kind of assumed it was just the nature of working at a big academic center but now doing community rotations I come to find the same is true even at sites with only an attending. I feel like it would be vastly easier to just tell PT/nurse/pharmacy/RT to adjust the computer stuff to whatever they need to do their job and I’ll co-sign it but Aparently that’s against policy at the few systems I’ve worked in.

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[sylvanthus]

Nurses do the majority of this as verbal orders where im at.

 

[CCM-MD]

Mostly done by everyone else.

 

[psychbender]

Yeah, no, we don't deal with that bull****. Speech and nursing tell me their recs or what they need, I say fine, they put the modified order in, and I sign it eventually. Restraint renewals are entered automatically, and I cosign. If RT cannot find the artery, I ask them to phone a friend (and they'll try with doppler), or decide if I really need that gas. If none can find it, I'll grab the USD, place an art line, and they'll run the gas.