A Rough Ride at the Theodore Roosevelt Cancer Center

Abstract

Nurse Carolyn Harried walked quickly down the narrow halls of the Theodore Roosevelt Cancer Center (TRCC), rushing to complete her rounds of surgical patients. She could hear the rain pounding at the window, adding to her stress from the busy, difficult shift. Her last patient, Mrs. Surgerized, looked pale, but was sleeping quietly following her radical mastectomy. Nurse Harried glanced at the JP drain inserted at the end of surgery, and noticed there was more drainage since the last check. She jotted down the amount, so that she could record it in the computer’s new Intake/Output (I/O) module. Although she had been instructed to use tablet PCs for data entry, she preferred the desktop workstations to the cumbersome tablet setup. She found an open workstation and stared at the blinking Teddy Roosevelt cursor as the log-on process proceeded slowly. The program finally launched, and a couple of screens later she was on the I/O page where she recorded her numbers and printed out the report for Dr. Lerner, the Surgical Fellow on-call for the evening.

Dr. Lerner grabbed a cup of coffee, picked up his patients’ charts, and began his review. He was not happy with the new I/O format and wondered why the attending surgeons had not gotten to evaluate this module prior to rollout. He tried to decipher the I/O data, loaded the patient charts onto a cart, and made quick bedside rounds. He noticed that Mrs. Surgerized appeared pale, so he rechecked her I/O numbers which seemed to indicate that there had not been excessive drainage from the JP tube. He noted that a complete blood cell count (CBC) had been ordered for the morning, and he made a mental note to recheck this patient before tomorrow’s rounds.

Note: All names of people and places have been fictionalized for confidentiality purposes.