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Old 03-14-2008, 02:51 AM   #11
ERCougar
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Originally Posted by MikeWaters View Post
100k is the number I have heard.

We are always trying to implement new procedures. Problems include bad handwriting, medications that sound or are spelled similarly, and many other things.

For example, I had a friend who told me once he ordered 4mg Magnesium Sulfate to be given IV. The nurse called him back said "We don't have 4mg of morphine, I've checked". And he almost shat a brick.

In case you don't know, 4mg of morphine IV would probably kill a horse.

Even if it looked like he wrote for morphine, the nurse should have known not administer that much.
And just to further beat the dead horse--
Now that I think about it, your example's even more flawed. If he's ordering magnesium over the phone, he's talking to a nurse in L&D or postpartum, both of whom are VERY familiar with magnesium, and would in no way confuse this with morphine (particularly to the extent of calling the pharmacy to see if it is available). Magnesium is a drug with very specific, limited indications--none of which would be confused with morphine.

More likely scenario--your friend read the ubiquitous hospital document telling us all to write out morphine sulfate instead of MS, lest it be confused with magnesium sulfate, a mistake that I guarantee has never happened. He then made up an entertaining anecdote for his friends to bring up at cocktail parties (or message boards).

Sorry...this stuff just bugs me. The better study would be to see how many errors JCAHO (the regulatory agency overseeing hospitals) is causing by the ridiculous hoops they're making us jump through--particularly in the emergency department, where timely therapy is just a little important. It'd be different if any of them had spent a second in a hospital (besides their little regulatory visits)--the morphine/magnesium example is a perfect one in demonstrating their clinical ignorance.

Last edited by ERCougar; 03-14-2008 at 02:54 AM.
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Old 03-14-2008, 03:57 AM   #12
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Originally Posted by SoonerCoug View Post
It depends on the definition of medical mistake.
I could buy into this, except the 60 Minutes article (we'll see what the show is like), leaves the impression that all 100,000 are on the order of this Quaid tragedy.

I'm guessing errors of that magnitude are less common than that number. Sheer hunch, of course.
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Old 03-14-2008, 04:45 AM   #13
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And add to your list, mistakes made that are covered up, and the patied is lied to about the mistake.

This brings to mind another serious mistake. A doctor orders something like triple the recommended highest dose of lithium over the weekend (because he is inexperienced). Patient becomes very ill and had to receive dialysis. That patient could have died.

The deadly "mistake" that is most common in psychiatry is saying someone is safe and then that person commits suicide. The reason I have quotation marks is that it is very hard to predict. You use all the information you can, then make a defendable best guess.

ERCougar is really what I consider the worst of medicine. He sees the procedures in place to insure safety as nothing but impediments, and has the gall to suggest that the safety procedures kill people. I know enough about him now. Don't need to know anymore.
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Old 03-14-2008, 04:47 AM   #14
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Apparently Dennis Quaid is going to be on 60 Minutes talking about his twin infants' horrible ordeal at a hospital that administered the wrong medicine to them.

In the process he says 100,000 Americans die in hospitals each year from medical mistakes.

Is it me, or does this sound a little high?

http://www.cbsnews.com/stories/2008/...n3936412.shtml
I don't know, but who's for some tort reform and caps on damages? Yeehaw!!
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Old 03-14-2008, 04:47 AM   #15
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Even if it looked like he wrote for morphine, the nurse should have known not administer that much.
How much are nurses trained to question the doctors?
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Old 03-14-2008, 04:50 AM   #16
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How much are nurses trained to question the doctors?
That's a complex thing. Some nurses are competent, some are not. Some nurses will call docs about the smallest things, driving them crazy. Some will never call, and you wish they had. Some docs are assholes and yell at nurses everytime they get called. Nurses know not to call these docs. Some nurses are truly jerks and will call doctors just to make their lives worse. These nurses usually have ironclad job security and know that the doc can't have them fired.

A good nurse is worth his/her weight in gold. Bad nurses are absolute hell for the doctor and the patient.
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Old 03-14-2008, 04:53 AM   #17
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That's a complex thing. Some nurses are competent, some are not. Some nurses will call docs about the smallest things, driving them crazy. Some will never call, and you wish they had. Some docs are assholes and yell at nurses everytime they get called. Nurses know not to call these docs. Some nurses are truly jerks and will call doctors just to make their lives worse. These nurses usually have ironclad job security and know that the doc can't have them fired.

A good nurse is worth his/her weight in gold. Bad nurses are absolute hell for the doctor and the patient.
So they are expected to disagree or at least double-check with doctors when something seems wrong?
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Old 03-14-2008, 04:58 AM   #18
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So they are expected to disagree or at least double-check with doctors when something seems wrong?
Of course. If they feel something would be harmful to the patient, they should ask for an explanation and clarification.

When you are a young doc in training, the nurses sometimes know a lot more than you about treating something. And they can actually teach the docs a thing or two.

So in the case of the magnesium/morphine, the patient was ok because the nurse did check. However she checked for the wrong reason.
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Old 03-14-2008, 04:59 AM   #19
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Thanks for answering. I do understand that different factors may make certain situations less than optimal in this area.
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Old 03-14-2008, 05:01 AM   #20
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Something as simple as doctors in the hospital not washing their hands leads to deaths. Nosocomial infections.
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