Red tapes

I was cornered by a middle-aged lady this afternoon. As it turned out, she was the niece of one of my patients, Mrs H. Her aunt was admitted with right leg swelling.

She first came to the outpatient DVT clinic towards the end of last week. Under normal circumstances a Doppler scan would be carried out by the DVT Specialist Nurse there and then. But due to some unforseen technical problem she was asked to return today for the scan.

Mrs H however had to be admitted over the weekend due to intractable pain in her right leg. Common sense would dictate that she stays in till today, have her Doppler, and then take things from there, depending on the scan results.

Not really if you're a patient of our hospital.

Mrs H and her niece were informed by the DVT Nurse that since she's now an in-patient, she can't have her Doppler scan. Never mind the fact that she already has a scan appointment for today. The appointment is only valid if you are an outpatient! The nurse went one step further by explaining it would be wrong for her to do the scan! Doppler scan for in-patient can only be done by a radiologist!

The niece asked me to explain the situation. She said she couldn't understand why such ridiculous decisions were made. I duly replied, "Neither can I"

Red tapes! Bureaucracy! That's the reason, if you ask me.

DVT Specialist Nurses are higly trained to perform Doppler. Yet they are only allowed to do a scan on out-patients. Is it technically different to scan an in-patient? Why does an in-patient need to be scanned by a doctor?

The consequences of these decisions are:
1. Mrs H has to be kept in for a few days, while awaiting her In-patient Doppler scan.
2. It costs approx £300 per day per medical bed. Say 3 days she has to stay in, that would be a cool £900.
3. A precious medical bed taken up by a non-essential case, one which can easily be managed outwith hospital. This will potentially preclude more urgent case to be admitted.
4. It's well known that hospitals are not the cleanest place of all. The longer one stays in, the higher chance of him/her picking up a nasty airborne infection. Mrs H clearly did not need to be admitted.

Poor policy-making? I bet.