It’s hard to teach an old dog (me) new tricks.
It’s hard to teach an old dog (me) new tricks, or to remember old ones.
The other night I was working the swing shift, and admitted a patient who I thought may have adrenal insufficiency. Being the good internist that I think I am, I decided to order a cortrosyn stimulation test. Being the creature of a habit that I am, I wrote “cortrosyn stim test at time o and in one hour” in the orders, not specifying the amount of cortrosyn. There poor ward clerk was mystified. “What do you mean, cortrosyn stim test–is that a radiology procedure?”
Spoiled creature that I am, used to simply typing in “cortrosyn stim test” in the computerized order entry system at the other hospital where I work–and having it spit out the protocol with out me looking up how much and at what times to give the cortrosyn and measure the cortisol levels. All this got me thinking–do order sets make us stupid? At my other hospital, where we have a complete electronic health record, we rely heavily on order sets and protocols. This is all to improve care, but I think I have gotten overly reliant on them.
I had to go look up the dosing nomogram for the cortrosyn stim test. I had a difficult time getting good results in my computerized search, and ended up asking a colleague, who, ironically enough,was ordering the same test and writing it in the orders. I wrote out the whole protocol and turned it in to the ward clerk.
Sad as it is, it is probably a good think for me to have to slow down and write out orders. It makes me think a little harder, and that’s a good thing.
Tags: EHR, order sets
