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I'm not totally convinced your story with the cup of water was an ego related issue. The workflow of doctors in the hospital is complicated, and different docto

by sxg 10y ago

I'm not totally convinced your story with the cup of water was an ego related issue. The workflow of doctors in the hospital is complicated, and different doctors and nurses have different privileges for different patients, which can make things appear to be ego related. In your scenario, you're a post-operative patient. Your primary doctor is likely the surgeon that performed surgery on you. I'm thinking the doctor that saw you and wouldn't get a cup of water was a consulting-team doctor that was asked by your primary doctor (the surgeon) to see you. Consulting doctors don't "own" their patients (although this differs in different hospitals). This means they can't put in orders (i.e. prescribe meds, give you food, water) for you. They can evaluate you and provide recommendations to the primary doctor, and it's up to the primary doctor to make the final call on the recommendations. If a patient asks a consulting doctor for water, the safest thing for the doctor to do is to defer to the primary doctor or nurse who does "own" the patient. The nurse will know from the orders put in for the patient what kind of diet the patient is on and whether the patient is allowed to have water. Yes, this is a lot of bureaucracy, but there is a reason for it. If your surgeon thought there was a good chance that you'd have to go back in for surgery soon, he'd likely want you to be NPO (no food or water intake) to minimize the risk of aspiration and choking during anesthesia and intubation if you were to undergo surgery again. He might want you NPO if you had just had some sort of GI surgery or were due for a barium swallow study. A lot of patients are NPO in the hospital, and for consulting doctors, it's much easier to defer to your nurse or your primary doctor for even basic needs like food and water.

jacquesm 10y ago
> I'm not totally convinced your story with the cup of water was an ego related issue. Ok. > The workflow of doctors in the hospital is complicated, and different doctors and nurses have different privileges for different patients, which can make things appear to be ego related. In your scenario, you're a post-operative patient. Your primary doctor is likely the surgeon that performed surgery on you. I'm thinking the doctor that saw you and wouldn't get a cup of water was a consulting-team doctor that was asked by your primary doctor (the surgeon) to see you. All that's correct. Even so, I was in some pretty serious discomfort, the guy asked me if he could do something for me, if I could have I would have gotten up myself and instead we spent a couple of extremely uncomfortable minutes waiting for the nurse (busy elsewhere) to perform a 10 second action. That discomfort could have easily been avoided. If there was a more complex situation at play then there was plenty of time to explain that but no such explanation was given, when I asked later about why the doctor didn't get me the water himself (to the nurse that got it for me) her answer was because they're too good for that. So FWIW I think the story is simply as it is at the simplest level without any need to bring in larger scenarios or extra complexity. After 6 hours of surgery without any water and a tube down my throat a bit of water was not too much to ask for to receive right away, my throat was burning and my tongue was parched. To me that's basic humanity, it's nothing to do with bureaucracy or complex reasoning, after all if I could have gotten up I would have gotten some water myself.
- sxg 10y ago
  Obviously I don't know all the details of your story, but I'm still a little skeptical. Yes, there are likely doctors out there that do believe they're too good to get water for patients, but I haven't worked with any like that yet. I have rounded with doctors who have delegated simple tasks like getting water to someone else, but it's always been to either save time or avoid giving water to someone who isn't allowed to get it. You mentioned you had a tube down your throat—that's probably an NG or OG tube, which is often used for feeding solids and liquids. If you had one of those tubes, then there's very likely a reason you couldn't take solids/liquids by mouth. Again, I don't know all the details, but I'd imagine what happened is that your consulting doctor saw you had an NG or OG tube and wasn't sure why. He probably deferred the decision on whether you could have water to your nurse who would know for sure what you were and weren't allowed to have. The nurse probably isn't aware of what the different doctors know and don't know about their patients and interpreted the request to get water as an ego thing. If my interpretation is correct, the doctor is still wrong in not giving you or the nurse an explanation of what's going on, but the issue is more communication related than it is ego related. I don't believe what happened to you is ideal or how medicine should work, but it's how medicine often ends up working with so many different people having tangential and partial responsibilities for patients. Based on my experiences working in the hospital so far, communication issues are massive and frequent causes of problems and conflicts between health care providers and patients as well as between different health care providers. Again, the workflow in the hospital is complicated, and I don't believe any one person really knows what any other person should be doing. Each provider knows the extent and limitations of their own role, but others' roles are a mystery. All of this leads to miscommunication, misunderstandings, and massive/frequent problems like your experience.
  - jacquesm 10y ago
    > which is often used for feeding solids and liquids. No, it was there during the operation, not for feeding. > Again, I don't know all the details, but I'd imagine what happened is that your consulting doctor saw you had an NG or OG tube and wasn't sure why. No, this was definitely not the case. > All of this leads to miscommunication, misunderstandings, and massive/frequent problems like your experience. This may sound funny to you, but ego or miscommunication doesn't matter to me, the end result is what matters. If you can't communicate or have an inflated ego I'd rather not have you as my doctor because either one of those is an ingredient in a recipe for an accident.

by sxg 10y ago

jacquesm 10y ago

> I'm not totally convinced your story with the cup of water was an ego related issue. Ok. > The workflow of doctors in the hospital is complicated, and different doctors and nurses have different privileges for different patients, which can make things appear to be ego related. In your scenario, you're a post-operative patient. Your primary doctor is likely the surgeon that performed surgery on you. I'm thinking the doctor that saw you and wouldn't get a cup of water was a consulting-team doctor that was asked by your primary doctor (the surgeon) to see you. All that's correct. Even so, I was in some pretty serious discomfort, the guy asked me if he could do something for me, if I could have I would have gotten up myself and instead we spent a couple of extremely uncomfortable minutes waiting for the nurse (busy elsewhere) to perform a 10 second action. That discomfort could have easily been avoided. If there was a more complex situation at play then there was plenty of time to explain that but no such explanation was given, when I asked later about why the doctor didn't get me the water himself (to the nurse that got it for me) her answer was because they're too good for that. So FWIW I think the story is simply as it is at the simplest level without any need to bring in larger scenarios or extra complexity. After 6 hours of surgery without any water and a tube down my throat a bit of water was not too much to ask for to receive right away, my throat was burning and my tongue was parched. To me that's basic humanity, it's nothing to do with bureaucracy or complex reasoning, after all if I could have gotten up I would have gotten some water myself.

sxg 10y ago
Obviously I don't know all the details of your story, but I'm still a little skeptical. Yes, there are likely doctors out there that do believe they're too good to get water for patients, but I haven't worked with any like that yet. I have rounded with doctors who have delegated simple tasks like getting water to someone else, but it's always been to either save time or avoid giving water to someone who isn't allowed to get it. You mentioned you had a tube down your throat—that's probably an NG or OG tube, which is often used for feeding solids and liquids. If you had one of those tubes, then there's very likely a reason you couldn't take solids/liquids by mouth. Again, I don't know all the details, but I'd imagine what happened is that your consulting doctor saw you had an NG or OG tube and wasn't sure why. He probably deferred the decision on whether you could have water to your nurse who would know for sure what you were and weren't allowed to have. The nurse probably isn't aware of what the different doctors know and don't know about their patients and interpreted the request to get water as an ego thing. If my interpretation is correct, the doctor is still wrong in not giving you or the nurse an explanation of what's going on, but the issue is more communication related than it is ego related. I don't believe what happened to you is ideal or how medicine should work, but it's how medicine often ends up working with so many different people having tangential and partial responsibilities for patients. Based on my experiences working in the hospital so far, communication issues are massive and frequent causes of problems and conflicts between health care providers and patients as well as between different health care providers. Again, the workflow in the hospital is complicated, and I don't believe any one person really knows what any other person should be doing. Each provider knows the extent and limitations of their own role, but others' roles are a mystery. All of this leads to miscommunication, misunderstandings, and massive/frequent problems like your experience.
- jacquesm 10y ago
  > which is often used for feeding solids and liquids. No, it was there during the operation, not for feeding. > Again, I don't know all the details, but I'd imagine what happened is that your consulting doctor saw you had an NG or OG tube and wasn't sure why. No, this was definitely not the case. > All of this leads to miscommunication, misunderstandings, and massive/frequent problems like your experience. This may sound funny to you, but ego or miscommunication doesn't matter to me, the end result is what matters. If you can't communicate or have an inflated ego I'd rather not have you as my doctor because either one of those is an ingredient in a recipe for an accident.