Doctors checklist

Just had a few days admission, and whilst the majority of the staff were exceptional (best nursing team i think ive ever come across) there were a fe doctors who drove me up the wall, and their behavious was getting weirder and weirder to the point where I couldnt work out if they were giving me salbulatmol simply to explain the fact that I had a high heart rate! Anyway, had a chat with Philomela and it got me thinking, AUK should make instant feedback forms for docs, so we can tick a few boxes to let them know what they are being surreal about and then hopefully they can improve!! I find it a giggle, wanted to know any other suggestions!!

- Giving me medications and then complaining to ME that i'm experiencing the side effects

-waking me up to discuss whether i need somthing to help me sleep

-suggesting that it is possible for me to be anxious and over aware of my breathing while im asleep

-doing crazy and random stuff with my steroid doses that make me wonder if you are actually trying to kill me

-repeatedly giving me incorrect doses or drugs that interact with each other and refusing to accept that they DO interact (i am more than happy for them to say there is an interaction, we know this and accept it is worth the risk at this time - thats fine - i just want to feel reassured that its been considered, ive been ODed before and its nasty)

-telling ME off that you've been asked to come look at me because my HR and resps are high - i'm very sorry, i dont want you to come and disturb me either if im honest

-giving me nebs when im not wheezy and asking me to try to manage without them when i am

-asking me why i have not gone home yet when YOUR collegues messed up my discharge!

-telling me that under no circumstances can someone sit in my (private) room during protected mealtimes, coz they are protected mealtimes, but doctors are still ok to come and talk to me during meals!?!

any more ideas guys?? Me and the nurses did have a laugh hen a doc this admission insisted i needed a neb when i was lying down, chattging and comfortably watching TV, and then came to check on me coz my HR went up (also - blimey hen you can breathe you get a fuller dose of salb - my heart goes mad when im getting the full dose in my lungs)!! Started coming up with the list after the third ICU review in a night!! By the end i was at the point where they came in and i just said ""look, if you're from ICU, i'm soooo sorry, i'm really really fine, i dont know how to get them to stop calling you - apparently im too young to get the parameters for scoring changed"" lol!

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Since we were discussing it:

-Telling patient that they shouldn't have followed (and I use the term loosely because I tend to also interpret them rather loosely) official guidelines or advice from other doctors/nurses including their own freaking colleagues about getting help, but totally failing to provide any kind of useful alternative plan

-Getting at patient over issues you have with colleagues' advice/treatment decisions they made when you weren't there

-Crediting patient with a medical degree and psychic powers - apparently we should be able to predict ABG values, which I suppose would be useful as it would remove the need for anyone digging around!

-Giving lots of nebs, then commenting on how shaky patient is and asking if they're anxious

-Morbid preoccupation with patient's own alleged (but denied) morbid preoccupations with dying (and failing to realise that if patient usually calls 111 or goes to a walk-in if they think they're dying instead of calling an ambulance this would be a bit more worrying)

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Being left for hours and hours until you crash and end up in HDU and then being told that you should have attended earlier d'oh!!!

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I definately think it would be really helpful if there was a standard, fairly basic and straightforward ticklist that consultants/resp nurses could do for their patients to make emergency situations easier. I know some do write letters etc, but a standard form would be universally recognisable. In my case, Ive been very impressed at how comprehensive the handovers have been from my lovely cons to the med team on admission and juniors in resp team, also very definately clarifying what she means such as......

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Chest is clear, no wheeze, but its always clear. Air entry is not good, moderate/poor but not good, etc. Plus similar regarding sats being stable but HR affected by effort in maintaining sats etc. This has been helpful but not fool proof as not everyone seems to read the notes!

I also find different approaches within teams difficult. My cons wanted a 2nd opinion from the other top one which was ok by me tho I wouldnt have pushed for it, but when he came (6pm Fri eve, fgs!) he wanted to make sweeping.....

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Changes to what was in place for over the weekend, which I politely but firmly refused. They have different approaches - he is very much anti-steroid as far as possible and thinks the 4x100mg hydro I will have had for 10 days by Mon is way over the top. My cons has also been pushing to get my reg pred dose down, so the fact shes had me on this hydro suggests she thinks I need it! Both approaches may well work, but I think consistency is essential in order to get a good result.

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Reading my notes from my 6wk admission I saw even more extreme differences, such as the newly qualified, rather up himself cons declaring that he did not believe my asthma was severe, let alone brittle, yet mine and the other cons consider me so at risk that they will not consider allowing me home yet, nor even one nights sleeping tablet as there is too much risk of me just stopping breathing in my sleep. I can possibly understand this between hospitals, but within one team??

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Sorry, this reply is probably far longer, detailed and serious than you intended in this particular thread, but having spent more time in hospital than at home since June, its something Ive had time to think about and now have strong views on!