Motivation

things are pretty low today for no good reason. i'm off sick with some vague gastro symptoms. (somatosization? depression? lazy bastard?) would normally feel a bit guilty for going off sick (despite the fact that i've taken maybe 1 day off every 2 years for sick leave) but anyway. they'll manage at work.

had a good week off. got some studying done (though not as much as i'd hoped), caught up with lots of friends (you forget how many people are around you when you never get to see them) and managed to chill out.

then back at work yesterday and it was the same old crap. running around asking people to do tests, schedule them correctly, admin, etc

oh yeah. the most ridiculous thing yesterday was trying to send a patient home (for god's sake)

1. one of our dialysis patients is admitted in the early hours to a liver ward (Ward 1) as it's the only place with beds
2. night doctor for our team goes over to see her, thinks she's fine, and makes the plan that she's got a very mild chest infection, she can have her dialysis in the morning and go home with some antibiotics if all is ok.
3. i go over to see her first thing. she is fine, no temperature, clinically well, bloodwork is all fine. i agree with my colleague's plan that she should go to the dialysis unit, have her dialysis and then go home.
4. dialysis goes fine. i see her again afterwards. she is very well and keen to go home
5. at 5pm i do her paperwork and say to the dialysis team that she can go home with her meds. they tell me that she has to go back to Ward 1 to be discharged.
6. i trudge round to Ward 1. staff there tell me that she has been moved to another ward (Ward 2) because they needed the bed and she was off the ward the whole day. i say i've done all her paperwork can you not just discharge her anyway. they say no, they've already moved her to Ward 2.
7. i go down to ward 2. they say they don't know who the patient is as she hasn't arrived yet. she is still on dialysis. i explain that i think she will be coming soon as she's finished dialysis but she can go home.
   
8. ward 2 staff phone up dialysis team and say why can't she be discharged from there. they reply because she is officially admitted onto Ward 1 they can't discharge her from the dialysis unit.
9. ward 2 then tell me that patient will have to be admitted formally before they can be discharged (ie. be assessed by a nurse, blood pressure taken etc)
   
10. i say this is a bit mad because she can BLOODY WELL GO HOME.
11. ward 2 say she can't go unless she's been admitted and then discharged.
12. i leave paperwork with ward 2 staff and decide if the only person who can go home without being admitted/discharged is me, then i am going home

thought i would get out pretty early (5.30 ish) but ended up leaving at 6.15pm. 45 mins of nothing. if she had been ill or needed my medical "expertise" in any way i would have absolutely NO PROBLEM with staying behind 45 mins, 1 hour, 3 hours or whatever. this, however, was once again a waste of my time.

i hope she got home at a reasonable hour.

[i am listening to Somebody that i used to know by Elliott Smith]