Lab orders should not make us crazy. Yet here we are.
About 3 weeks ago (does time have any actual meaning anymore? I have no concrete way of being sure it hasn't been 2 months since then) Babygirl had her outpatient transfusion. Her hemoglobin hopped up from 5.8 to about 6.8 and gradually worked its way up into the high 7's, significantly better. But then it began a fairly steep decline, to the point where it dropped below 7, making the vascular surgeon uncomfortable with proceeding. Oh, and by the way, has she been cleared for this by her primary physician? Well, no, since you didn't request it, it didn't get scheduled.
So, the race is on.
Friday they let Babygirl know that she has an appointment with GI. On Monday. So I had TODAY only to rearrange my schedule. Again.
Tomorrow, the family doctor is squeezing her in for a pre-op visit at 6:30 AM. Yes, really. And he got her set up for a transfusion tomorrow. I made sure to ask, "Is this a type-and-crossmatch? Last time it was a type-and-screen, and they had to redo the labs and wait an extra two hours to get the transfusion." I was assured that the correct labs had been ordered this time.
We met the new GI doc today (and by "new" I would like to point out that his name isn't on the stationery yet - he's still a write-in LOL). He ordered some blood work, suggested that a hematology consult would be a GREAT idea. He plans on doing upper endoscopy, as he is reasonably certain that she will not be able to tolerate the prep for colonoscopy, given her overall level of nausea. He made sure we had more nausea pills. He also said that if the Protonix wasn't working at twice a day that there was no need to take it more than once a day. He also said that switching to another medication in the same class is not useful.
So we hike the half a mile of corridors from his office to the lab, and register for his lab work (ordered an hour earlier) and the family doc's lab work (ordered this morning). The woman registering us said she saw labs from both doctors, and sent us back.
When the phlebotomist finished, she put a bandaid on Babygirl and turned to leave. "Hey, wait - where's the red bracelet?"
When anyone has labs done specifically to match them with a specific bag of blood, a red bracelet is placed on the patient with a special number to help avoid errors. Babygirl didn't get the bracelet with the first set of blood last time, and had to endure a second stick for the correct lab work to get the transfusion.
The phlebotomist looked me dead in the eye and said, "It wasn't ordered." We had to go out to registration, where the clerk said, "That's not what was ordered."
Well....duck.
I mean, it's not a crisis, exactly. And getting blood work done is no big deal, right? Except that we've already proven that she has TINY veins, and that they aren't in fabulous shape, and is it TOO GODDAM MUCH to ask that she NOT get poked twice for every ducking thing they order??
I generally don't call the on call guy if I can help it. But I called. Twice, because there was no response when they sent a text (turns out the poor guy was just on call 3 days ago and didn't realize he was up again - somebody must be on vacation). He listened to the story, and said he'd call the lab to see what the deal was.
So, some unneeded education in the foolishness that is Electronic Medical Records. Our system, when we order things, offers us the option of NOW/STAT or Future Order. We learned early on that the first option does not actually work, so if you want something STAT you put in a Future Order and write STAT in a little box. Perfectly sensible. But if I put in a Future Order I am essentially ordering something for tomorrow. This is generally immediately visible, so if the patient goes to the lab same day, there is no problem.
Except, apparently, for the type-and-cross. THAT test, ordered this morning, will not be visible until 3 AM. So did didn't actually "exist" yet when we went to the lab. Clear? DUCK, no. But that is where we are.
Our remaining options are to get it done right before the transfusion and wait the extra hours, or stop at the lab on our way home from the doctor's at 7 AM. For the second second stick.
Surgery is still on for Thursday. I think.
DeeDee
PS Not sure if I should call administration, or IT about this one.
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