off drip

i had a patient who was intubated and had a history of self extubation the day before... yesterday i put down "off drip" in the management sheet... as a consequence, the whole angiocath was removed, together with the sedative infusion... naturally the patient became very agitated and re-self-extubated again... he had a grade three larynx plus history of repeated intubation so i had to invite the anaesthetist to re-reintubate him on 2 consecutive days...

i learnt a lesson... and i'll never write off drip again... we thought black and white is clearer than verbal communications but it's not always true... haha... perhaps we should all make verbal orders only and perhaps the nurses should follow our ward rounds and take notes of all the management orders...

it's partly my fault because i didn't put it down clearly... but i did a little survey and 6 out of 6 doctors consider off drip means the plain drip only... plus the nurse can always page me to confirm... i thought that's their strength...

no offense... but i think sensible if not smart nurses are really really essential for up-to-standard if not outstanding patient care...to be honest i see the patients for only few mintues a day while you take care of them for hours... some nurses are very good and pick up the real important bits... some others just beep us and inform us of all the abnormal readings and thought they did a good job...