Sunday, February 25, 2007
STUDIES SHOW…
A majority of Dr’s on our ward tend to prescribe the almighty IS (incentive spirometry) to help aid in the prevention of chest infections post surgery. Hmmm, beings there is not a lot of evidence that this piece of equipment does in fact…work, but also cost the hospital or the patient $$$, I wanted to put in a word or two. It all began when a young, fit patient day 1 post lower abdominal surgery joined our ward and as I was doing my initial Ax, Tx etc. Dr ‘old pro’ joined me and of course took over the show…for a bit…which seemed to fit his schedule, and knowing me…I aim to please and patiently awaited for him to finish! He later ADDED how physio will fit him for IS to help his chest. Nothing like putting words into one’s mouth ‘eh! Just as I was about to chime in some EBP, he was interrupted by another staff member so I attempted to utilize this time to finish my Ax. Good thing I’m a charmer cause he patiently awaited my wrap up, and politely bit his tongue for the next 2 seconds, before he asked the patient…’any questions?’ and scooted on his merry way. Upon his exit, I just couldn’t help but explain to the patient that it is WAY more beneficial to be in an up right position and/or WALK, especially for this patient. Getting up and out of bed will be 10x more effective then an IS. Not so sure if Doc would have agreed, so as you do…retrieve and dust off the ‘ol IS! Guess I’m still a bit shy on the ward because really, NOT so sure I would have corrected DOC as I am a student…and have a funny accent! I did not demean the Dr in any way, I just explained to the patient a better alternative for chest care. Were does teaching a Dr it fit in? I mean, what is a good way of bring things such as this, where we are more knowledgeable in an area, to other practitioners’ attention…politely?
Subscribe to:
Post Comments (Atom)
2 comments:
Tarsi my love,
I've also had the same conversation with my supervisor as we routinely give & teach post-op patients IS which as you've mentioned there is little evidence for its efficacy. I came to the conclusion that for where I have been on prac and the avg age is about 80, the mighty IS is more of a visual cue for pts to do their DB ex's rather than an actual effective Rx, cos lets face it, pts can take big breaths without a little plastic thing but as I said with a lot of my patients their memories aren't as good as they used to be and motivation can be an issue so having the little breathing machine on their heart table is a good reminder and therefore an effective tool. But you're absolutely right, there is no substitute for SOOB and going for a hearty walk!!
You'll be surprised at how little some Dr's know about some things. They go through so much schooling that they know a bit of everything but not a lot of one thing. On one of my pracs an intern actually told us that the reason they prescribe certain machines is because that's what their protocol says to do and they don't actually really know what or how it works.
Post a Comment