“Um, maybe you need a time-out.”
—Cindy Lou Who in “How the Grinch Stole Christmas”
Procedures are safer now. That’s what I am told. I, being a scientist of modest repute, want to see the proof. There are metrics, and they say we are all, indeed, safer. I believe. I am sure that there were some problems that all of our new safety measures fixed. Much as buying a new car fixes the air filter problem you are having with your current automobile.
One new component of any procedure now is this thing known as the “time out.” You know what I’m talking about. It’s that time where we all cluster around the patient and agree that they are the patient and we are the doctors. No, no. We all cluster around the patient and chant incantations and shake rattles and burn incense. No, no, no. We identify the patient. “You, patient.” We confirm they are indeed them. We do this by asking if the correct name is on their wrist band. They say yes. Invariably.
(Whoever set this up has never attended a concert or party where drinking age is established by the same system and ALL the people who shouldn’t have wrist bands are able through subterfuge to obtain them).
We confirm that we are doing a procedure on them and that is where the needle goes. Right there. In that left knee or right wrist or spine or right upper quadrant. Sometimes you have to mark it. And we confirm that we are in a procedure room and the X-ray works and the patient has no allergies and it is June or whatever.
And then, because it is a hospital for God’s sake, we have to enter a minimum of 45 lines of text in the EMR, initial three times on paper documents, and electronically sign. And then, we’re out of room time and the administrator is yelling that the schedule is behind and we won’t have a nurse to recover the patient now and CT can’t do the post-procedure exam for an hour and the patient’s family is upset with the delay.
Am I the only one who has noticed that this is the same thing we use on our kids when they do something stupid?
“OK, you can’t put beans in your sister’s nose. You need a time out. Go take a time out in that corner.” This gives new meaning to the whole concept.
“Go over there and correctly identify your sister’s right nostril and annotate on it with an indelible marker. Then count the beans. Then, and only then, you can insert them. And sign here.”
Sorry, I’ve got to take a time out.
Mahalo.Back To Top
Phillips CD. Whoa, whoa. Let’s be safe.. Appl Radiol. 2016;45(5):48.
Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.