Culture Shock — Patient as Icon, Icon as Patient  

Oleh:

Verghese, Abraham

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 359 no. 26 (Dec. 2008), page 2748-2752.
Topik: Culture shock

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Perpustakaan FK Nomor Panggil: N08.K.2008.06 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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On my first day as an attending physician in a new hospital, I found my house staff and students in the team room, a snug bunker filled with glowing monitors. Instead of sitting down to hear about the patients, I suggested we head out to see them. My team came willingly, though they probably felt that everything I would need to get up to speed on our patients — the necessary images, the laboratory results — was right there in the team room. From my perspective, the most crucial element wasn't. For the next few weeks, I ensured that we spent as little time as possible in the bunker. These were excellent residents who cared enormously about patients' welfare. They enjoyed being shown common findings — white nails of liver disease, an accessory nipple, Dupuytren's contracture, parotid enlargement, spider angiomas, café au lait spots, the paradoxical splitting of the second heart sound in left bundle-branch block, signs of pseudobulbar palsy — which today are uncommonly recognized. When I stroked a patient's palm and caused a twitch of the mentalis muscle under the chin — the palmomental reflex — it was as if I were performing magic. Still, the demands of charting in the electronic medical record (EMR), moving patients through the system, and respecting work-hour limits led residents to spend an astonishing amount of time in front of the monitor; the EMR was their portal to consultative teams, the pharmacy, the laboratory, and radiology. It was meant to serve them, but at times the opposite seemed true.

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