One of the key responsibilities of doctors and nurses is reassessing their patients.
When a physician or nurse sees a patient for the first time in a hospital or facility setting, the standard of care requires a thorough assessment. For attending physicians and bedside nurses, this will be a thorough head-to-toe assessment. For consulting specialists, it may be a focused assessment on relevant body parts or systems.
Patient assessment isn’t a once and done procedure. It’s an ongoing process of establishing and documenting a baseline that can be referenced during reassessments to determine whether the patient is progressing, getting worse, or staying about the same.
A reassessment is what it sounds like. It’s repeating the assessment and comparing it to the baseline. Without reassessment, it’s impossible to know how a patient is responding to treatment, if a medication is working or causing side effects, or if there are new findings that need worked up and treated.
Hospitalists are physicians who practice hospital or facility-based medicine. They don’t see patients in a private office setting, but rather typically handle the attending physician role for patients admitted to a hospital, skilled nursing facility, or rehabilitation center.
In my experience, many hospitalists are stretched thin. They’re responsible for rounding and seeing dozens of patients in multiple hospitals, nursing homes, and rehab centers. In the many medical malpractice cases we’ve handled against hospitalists, we’ve seen a pattern of inattention. Some hospitalists don’t take the time to perform a reassessment or don’t compare bad findings to the patient’s baseline assessment. This leads to a delayed diagnosis and serious patient injuries that should’ve been avoided.
This is consistent with patient and family complaints about how hospitalists basically run in and out of the room without performing a hands-on assessment, asking the patient any questions, or providing any feedback about the medical plan.
Good medicine and the standard of care aren’t a race. They require time and careful thought. And when a hospitalist physician is too rushed to pay attention, that’s where the safety net of professional nursing can be so valuable.
The nursing staff typically sees hospitalized patients more frequently than doctors, physician assistants (PA), or nurse practitioners (NP). The standard of care requires registered nurses to reassess patient responses to medications and medical treatments, and to report abnormal findings to the doctor (or in some cases the PA or NP working with the doctor).
In addition to reporting findings, nurses have the professional responsibility of being a patient advocate. This means pressing for the physician or medical attention that a patient needs. Good nurses won’t get blown off by a hospitalist, physician, or resident when there are legitimate concerns for a patient’s wellbeing and safety. They should firmly advocate for the care their patients need and, if necessary, take it up the supervisory chain of command to get action.
Albert Einstein is credited with saying the definition of insanity is doing the same thing over and over again and expecting a different result.
If you’re in one of those insane situations where you think things are in a rut or moving in the wrong direction, you may need to be an advocate for yourself or your loved one. Ask the doctor specific open-ended questions that can’t be answered with a yes or no, but instead require thought and an explanation. Do your own assessment and reassessments, recording them in a journal, and share your findings.
If the physician won’t communicate with you, speak to the nurse and express your concerns. You might request some nursing advocacy for evaluation by another physician.
If you’ve been seriously injured because of poor medical care in Texas, then contact a top-rated, experienced Texas medical malpractice lawyer for a free consultation about your potential case.