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April 06, 2017

The chart.


The ward doctor entered the room with "I hear you have meds that are uncharted".

Um, sorry?

I deciphered this statement at the time as follows: it appeared one of my Zarzio immunity injections hadn't been included in the documented medication list when I arrived at the hospital for my overnight stay the night before, meaning the nurses were unaware of it and weren't going to offer it to me that day without prompt. And when I did prompt - they were very confused.

"It's not on your chart".

"Well, it was self administered. I've been taking it at home and I have one more left".

"But, ... it's not on the chart".

This is one of the occupational hazards of walking the tightrope between 'in' and 'out' patient - managing your own body and being managed by the system.

As I explained this situation to the ward doctor, he looked at me as if to say "skip to the part where you confirm you need this med charted". Once I did, he was off, merrily tapping the touch screen at my bedside. Charting. The med. Apparently.

When I asked him the question I had thought he was there to answer - whether I should self-administer this injection as I had all this week  (ok, I lie, I wasn't brave enough to self stab, but it had been done at home!) - he shook his head a little and said, vaguely, "the nurses will deal with that, we'll ask them".

We? Um, who is 'we'? Are you 'we'? Or am I 'we'? Also relevant - the last words I had heard from the nurse were "we need to ask the doctor".

Then - "Oh no, come on. You make one small change and the whole thing falls over. These systems are very nice, effective, in theory, but you can tell they were designed by someone who has no idea how a hospital actually operates".

This was getting too cute. In fact, the management consultant in me started to take great delight in the irony of this situation. Here we were, solving a patient question by charting a med, discussing how work-based solutions are not targeted to the real need of a user.

"Ok, all done".

And with that, he was gone.

I still had no idea who was giving the injection, whether I needed to bring mine from home, or whether my oncologist was in the loop. I did know that the task of charting a med was possible, albeit with some frustration, from my bedside touch screen. So at least that's something.

The nurse entered shortly thereafter.

"So you need to take dexamethasone right, should I give it to you?".

This was starting to really make me giggle. Out loud. Dexamethasone is a steroid I had been taking, at the start of my chemo course, for two days. It is not Zarzio and I didn't need to take it now. And just so everyone is on the same page, it was certainly not on the chart.

"Nope!," I responded with a big smile. "Dexamethasone hasn't been charted, just the injection. So I'll get my husband to bring it in and you can administer it for me. That way you are across it".

The lingo is everything.

The nurse checked the chart.

"Ah yes. Ok, it's on the chart, for 3pm, we will do it then".

Thanks chart!