Breakfast Note

One of the many nuances of medicine as it's practice today: we write the most retarded notes ever. We devote a huge chunk of our day to documentation. You write a medical note to document not only what you did, but why you did it, and why you did not do something else. This is preposterously time-consuming. It's not for better patient care, it's so that the documentation is "thorough" aka so that if the doctor gets sued years later he can defend what he did at the time. Hopefully. And we have to write notes about everything: admit note, progress note, procedure note, consent for procedure note, discharge summary, transfer summary, consult note, etc, ad nauseum.

Here is an example of how this could ruin anything that might otherwise be simple and enjoyable.


BREAKFAST NOTE
7/11/2010 05:15 AM

The kitchen was entered and food was selected for breakfast. Cereal was not selected based on lack of milk. Rule out toast based on lack of bread. Or functional toaster. Breakfast bar was selected based on quickness with which it can be eaten in the limited amount of time to get ready in the morning. The bar wrapper was opened in the usual fashion. The bar was consumed in approximately 10 bites. There were no complications. The wrapper was disposed of in the usual sterile fashion. Then it was picked back up off the floor and placed in the trash.

The refrigerator was opened. The only bottle of water in the fridge was chosen. One packet of Crystal Light Strawberry flavor was added to the bottle, in the customary 80/20 fashion of counter top spillage. This was shaken, and the damp bottle was placed in the "work" bag in the usual fashion. Sigh. Sigh was made in the usual fashion.

Outcomes: breakfast concluded

Complications: none






...OH BY THE WAY, that note took me 10min to write. It took me ~5min to eat breakfast. Therein lies the rub- what I can do during the day is significantly limited by all the crap notes I have to write about what I did, what I plan to do, what I was thinking, what I plan to NOT do and why.

Ok, additionally, all the electronic medical records that I've had the opportunity to work with are all totally non-intuitive, cumbersome, pieces of shit littered with colorful side tabs. Oh come on, Intern, it can't be THAT bad! Oh can't it?!? Ok, this is what it's like. Imagine one of the top executives at Microsoft got together with Apple's best computer engineer, and they took a promising young computer whiz with them out to lunch at an unlicensed catering van. (...do you see where I'm going with this?) Ok, then they brainstorm about how to come up with the best user interface that will include all the pertinent documentation while at the same time streamline workflow to actually makes the "providers" jobs EASIER! Then, they create a program that does the EXACT OPPOSITE of ALL of those things. Then, they just get together and take a giant shit on your computer. And you sit down, and you try to work with this terrible, terrible program, and you think "this is ruining my life. I have to just click out and close this window." But you CAN'T, you know WHY? Because all the aforementioned people have REPLACED YOUR MOUSE WITH A GIANT DOODIE. All you can do is sit there, simmering in your own bitterness, wondering why you weren't invited out to the catering van, too.

The point is: it took me less time to write all my notes using the old paper system.