Please write down time that you call consultants and ask for them to see a patient as data is actively being colected on this.
If you know what time they arrive to see a patient write that on the chart too.
If you mutually agree on a time to see patient then write that on the chart.
Just a reminder.
John
HI all,
Please be aware that our drug screens do not pick up fentanyl!
Also – be aware that different isomers of fentanyl are in our community and have different metabolism times!!
I am working with the lab re: our drug testing but be aware.
Any patient that is decreased LOA with response to narcan consider observing for several hours.
Hopefully more details /specifics to come.
John
Hi there fellow South Muskoka Docs….!
My Christmas Reindeer filled with almonds has gone missing….( the great SMER nursing present!)
I know it is proabably just someone looking out for my health but I need my reindeer.
NOW!!!!
John
Please order salbutamol news with mg’s not amps…..
Two different strengths floating around.
We also have very, very little in terms of supply overall ( as you will have seen memo today)….
Please consider use MDI’s with aerochamber when ever possible!!
The studies suggest this is probably best practice anyways!
John
Hi all,
Just bringing your attention to the Charcoal issue…
you will see the memo…
Bottom line is pharmacy can’t guarantee that it works like that we are used too and we have limited supply…
Use only when clear potential aid/poison control suggests…
many hospitals in same boat…
John
Hi all,
Just a reminder to fill in time you see patient and disposition times ( many , many of the disposition times in particular are left empty).
It is okay to put your deposition time for patients you are gonna admit as soon as you make that decision too ( whether orders done /mrp contacted/etc or not…).
thanks,
Our health record staff thank you!
John
Hi everyone,
Kate has quit as ER NP in SMMH er and just finished at now.
I am waiting to have an exit interview with her and then I can fill you in more around reasons.
We are without an NP for the time being.
Also- I have learned that the “protected NP funding” that SMMh had is no longer and that the salary provided for an NP was rolled into general budget by the MOH.
Stay tuned…..I have met with Esther and talked to Deb…I am worried about the future….
John
Good evening all,
Just a reminder if you are dealing with an aggressive mental health patient…you could consider loxepin…
We do have it in both er’s.
It is part of the OSMH mental health orderset that I circualted months ago after meeting with memebers of the OSMH mental health team.
Just a reminder….
DR Zacharias ( lead pysch hospitalist) and Dr Rodway -Norman are still planning to come to a talk or do rounds with us soon. ALthough…for many reasons we are now looking at JAN 2017 for this.
I circulated OSMH’s months ago and when I recently wanted it I actually just called OSMH Er and had them fax it to me.
John
Hi all,
Just a reminder that if you can’t get a urine sample from a patient you still may be able to medically clear them.
You can consider a call to the psych hospitalist at Orilla direct to discuss if unsure and bed available there ( or psychiatrist if RVH or Penatang).
Sometimes that urine sample may be needed but if you are unsure you could consider a call to discuss.
John
Hi all,
Question…
Would every doc be okay to fax a copy of the facesheet to DI when we write down a test to be done????
I think it is the best way to go to ensure the rads have the info they need from the chart and our clerical staff or nursing staff then don’t need to put anything in the comments box in terms of history except the indication for a test if not in their main menu.
The rads want this info!!!
It is standrd of care elesewhere.
There have been countless hours used trying to come up with a work around/electronic version/powerchart access for rads/etc….etc…etc…..
DI will take the faxed sheet and marry it with the cerner order. They wil double check the order then and all people then seem to be happy..
Thougths?
I give you one week to comment on this.
thanks
John
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