Monday, January 09, 2006

From Social Chasers to Chasing Socials

Today was a good day. The foundations for my unexpected joie de vivre were in fact laid last night during a little jaunt to the cinema to catch the brand-new must-see, Brokeback Mountain. This was a rare pleasure on at least three counts: firstly because it afforded me the opportunity of seeing Dear Jake Gyllenhaal as a needy, closetted gayer begging for man-love, which, strangely enough, is much as I've always imagined him in my dreams; secondly, the man in front of me appeared to have the misfortune of suffering from microcephaly which allowed me to slouch down and still see all of the screen; and, finally, because the whole affair had the undeniable air of an organised Butlin's coach trip right in the middle of London town. From the moment of their arrival it was evident that this film had had a particular appeal for the audience of an alternative persuasion. The marks of the beast were everywhere to be seen: a new-wave haircut or a couple of belt-chains here; a leather Lonsdale satchell or a limp-wrist there. Then, once the whole fandango was over and the tears had been dried, almost the entire cinema promptly got up, swiveled on their Gucci heals, and minced off en masse to That Bar for the first New Week's Eve celebration of the year. The Pink Psychiatrist and I also went along...but only to study the social phenomenology, naturally.

It could have all gone horribly wrong; all that studying of social phenomenology left me feeling a touch fatigued this morning, after all. Thankfully, I was saved by the fact that my job consists of little more than 'chasing' and can therefore be almost entirely conducted from the end of the mess telephone with a sausage roll in one hand and a triple espresso in the other. (I am in the process of finding out the patient's bedside telephone numbers so I will never have to enter the ward again.) 'Chasing stuff' is one of those things that has been invented to take up junior doctors time so that they have something to pay us for. A typical chasing scenario might be as follows. Say I'm a registrar or consultant and I want a CT scan. My junior diligently orders the scan but, because of demand, there is a waiting list for it of, say, on average, three days. Yet, on the wardround the very next day I will feel compelled to ask them to 'chase CT', predominantly because otherwise there would be nothing to write in the plan bit for that day. The junior is then compelled to phone the CT department to ask why the CT scan has not yet been done. It has not been done, of course, because there are other people who have been waiting longer. Simple and sensible. However, by the time the junior has actually got through to switch board, then spoken to the whole department before finding the right person to ask, and finally debated the whole situation for a while to no avail, it is quite possible to have wasted a good hour. It appears to be a prerequisite of seniority in medicine that you hold the delusional believe that a test chased is a test done faster. Only the juniors really know that chasing achieves sweet F A and they're not going to tell because then they'd be out of a job! Besides, there is no end to the things or people that can be chased. Chase CXR. Chase bloods! Chase social services!! Chase next of kin!! Chase old notes!!! Chase neurology review!!! Chase your tail round and round and round and round...


Anonymous Anonymous said...

It's all so true! (Chasing, that is - haven't seen Brokeback Mountain)

7:03 pm  
Blogger The Venial Sinner said...

Chase the sun, baby! Oh, and go see Brokeback Mountain - it's very good!

7:57 pm  
Anonymous Anonymous said...

Ta for recommendation of Brokeback Mountain - will pencil in when have finished exam purgatory.

No sun chasing for me until next Tuesday.

9:10 pm  
Blogger vegas said...

I can't be bothered chasing anymore. I just say "I chased, and the test will hopefully be done tomorrow". Then use the same line the next day, and so on, until the test is actually done. Then the fun starts, because you have to start chasing the result of the test. And once you have the result, it is time to chase the "formal report", because it is not Gospel unless it is seen on a computer screen.

It is time for a new style of honest entry in the notes, along the lines of: "Nothing more to add today, the patient is still alive and pain free and waiting for [the test]. My work here is done. To be honest, the nurses are probably going to do more to make the patient feel better than I am so I might as well go home now. Please contact me on my mobile when the results of the test are ready next week. Remember, the only reason I admitted this patient was to get the test done sooner, not because they are particularly unwell."

Perhaps if we stopped hassling the departments trying to chase all this bullshit they would have more time to do more tests?

11:26 pm  
Blogger The Venial Sinner said...

My thought exactly, mate. If anti-neuronal antibodies take three weeks to come back, then they take three weeks to come back. Ain't no point forcing your way on the tube before people have got off thinking it's going to get you there faster. It never does. It gets you there the same time, but more pissed off.

12:45 am  
Anonymous Anonymous said...

I had a consultant breathing down my next to carry out a test faster - which was all very well, and I understood his motivation. However, if the molecules involved would only move at a certain speed, his presence wasn't going to change that. Otherwise we'd have had him written into the SOP.
And yes, you're right, answering the phone to say 'no, it's not ready yet' DOES slow laboratories down.
Well, it used to slow ours down.
Our doctors DO write 'no change, still awaiting results' (or whatever) in the notes - I can see it must be an utter pain in the arse not to be able to be that upfront.

8:43 am  

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