Kid with Dyspnea and More Miscommunication

PIctures:

• Kid with dyspnea and malaria that improved
• Kids all better!
• Grouping and Crossmatching for testing donor for blood transfusion
• Nurse Francis

Shoot. I made the mistake of writing HIV test on one of the person's chart, and the doctor got really angry at me because apparently I'm supposed to write "Counseling by so and so." Apparently if anyone else finds out without the patient's status without his consent, then the hospital gets sued.

I didn't even know they do suing here. Anyhow, the doctor got really angry at me (oh great, in addition to me pissing him off before for asking why he's prescribing steroids for someone with pneumonia, now I make him even more pissed off).

But seriously, how am i supposed to know that you're not supposed to write on the chart? How am I supposed to know the chart isn't confidential? How am I supposed to know the nursing students aren't considered part of the healthcare team so they aren't supposed to know about the HIV test?

I suppose I should have asked beforehand how to do it properly before ordering it.  It's just so confusing b/c the doctor never gave clear guidelines how he wants things done. For example, he would tell me to write plan etc. on the chart, but then as with the HIV test, he wanted me to consult him first. I suppose the "bigger/more scary" tests I should still consult him first before writing on the chart. I suppose it's hard to remember to tell everyone that goes through the hospital about every policy...but still, I don't like the way he blames me for everything.

Well, this is a good lesson to better be safe and ask about things than assume things and be sorry.

What really bothers me is when I tried to explain, he just left the room without listening to my explanation. He is really annoying me. He does that a lot these days. He just leaves while I'm still talking.  It's really quite immature. I'm gonna blame it on miscommunication/language barrier to make me feel better.

I also think he's putting his pride before patient care a couple of times.  We discussed about this one kid having cough for a while (came in with malaria, difficulty breathing), and was really really dyspneic with stridor.  But now he's all happy and playful and plump. But he still has a cough, and so we talked a bit yesterday, and said that if he still had a fever, we would go get a TB test tomorrow. but today I saw kid, still very low grade fever, but his cough improved, and I talked to the lady in charge of TB for kids - apparently they just put them on imperic tb treatment, since kids can't do a sputum test. And talking to her, she thought he didn't need a test....

so then today when I was going over the status of the kids in c-ward, I mentioned he has low grade fever with improved cough, good breath sounds, and I thought maybe the fever was due to teething. I also mentioned talking to sputum lady. But his response was, "Didn't we talk about this yesterday? Why do you want to change things now?"  My thought: It's a new day! With new condition and information!  Is it that bad to confirm that there will be no change in the plan?? :( Well, the plan was to put him on TB treatment, but turns out there is no TB treatment available now at the hospital for kids, so he's actually going to come back later when the treatment is available.  I suppose it all worked out.

I need to get better at listening to my conscience/gut/God/Holy Spirit/divine/something. So many times I would get a feeling to do something, and then I'm afraid I'm wrong, or I'm lazy, or whatever....but then later I'm right or I find I should have done it.