Worried

[douglas393]

You are partially correct. Anyone can be a surrogate if so appointed by an adult. The surrogate decision making only occurs if the patient is unable to make decisions due to incapacity. If the patient can make his own decisions there is no need for a surrogate.

If an interested third party, related or not, tried to take me to task and chew my ass, I'd be perfectly within MY right to terminate the discussion. And while the third party might raise a stink, that's as far as it goes. Now. If you wanted to ask why a certain treatment decision was made, and wanted to really understand what was happening, I'm sure I, or any other healthcare professional would be willing to educate you. But to proclaim up front you'd give a piece of your mind to the staff for making what appears (from the limited info given) to be an appropriate treatment decision.... That dog won't hunt.

On a side note. I'm not known for political correctness. That's why I'm not in management.

And Bruce is right. You cannot force a change to your medical records. You have the right to insert an addendum, but not edit other entries.

I am not going to get into a ****ing contest, but I can guarantee you that I am very familiar with the diagnosis and treatment of seizures among other neurological disorders, and often with limited information. My issue with the way the OP was managed is simply if this nurse felt the OP had seizures which is about the only thing in his description of events that seems to be possibly objective, then she did not provide him with appropriate care after making that diagnosis. I then said if that was the case, I would be questioning her as to why she did not do appropriate due dillegence in taking care of my son. It would be no different than if she diagnosed him with cardiac syncope and sent him home.

As for health care surrogates, any compentant adult can chose to have a health care surrogate make decisions for him. Furthermore, if a patient has a health professional to speak to someone about their care, you should do that. Do you have to know, but it is what I would consider appropriate medical care. Furthermore, if a patients choses so they can have a health care surrogate make medical decisions for them regardless of whether they are capable of making the decision. This will often happen if the patient does not understand the medical decision making process.

As far as a patient or interested party chewing you out because they disagree with your way of taking care of the patient, that is their right. You want to terminate the patient doctor relationship because you cannot stand a little heat, that is your option and right. In fact, you can terminate a patient doctor relationship for any reason you want, or for no reason at all. That is your right too. I, however, look at those situations in a different fashion. It takes a lot longer and is a lot harder to have empathy for the fustrated patient, and their family, but this is where a doctor can make the biggest difference in their treatment of a patient.
Lastly, what Dr Bruce was saying was in his statement agreeing with me.

 

[bbchien]

And actually, the healthcare provider, even if he agrees, should not modify the record, but simply add an addendum!

 

[douglas393]

And actually, the healthcare provider, even if he agrees, should not modify the record, but simply add an addendum!

Here is one of those it depends. For the most part I agree. If in an EMR and the final copy has been signed then all you can do is an addendum. If it is a transcribed copy, or hand written note, you can cross out the incorrect entry, and correct it. In practice addendums can be cumbersome and confusing, and so for certain applications, a cross out, or clearly identified revision may be acceptable, for example letters to lawyers or independent medical evaluations, the recipients will often ask for additional information to be put into a initial report and these will be clearly identified as revised and on what date. The medicolegal aspect is that if something is changed it should not look like something is being hidden.

But this is really a thread hijack and we should be helping the OP figure out whether he can fly or is he going to die or something in between.

 

[Morne]

Didn't know Chris about you being a recipient, but he definitely wanted "anyone who needs any parts" to have them when he was done with them. Haha.

It actually made the day much longer. Brain stem injuries are not "brain death" under Colorado law, and you wouldn't believe the hoops the poor donation places have to jump through to decide if they can get someone with a massive brain stem injury pronounced legally dead so they can take organs.

They were great folks but that process wasn't fun.

You have to remove the person from life support for ten minutes and measure their strength. If they're likely to survive more than 60 minutes, they can't be pronounced legally dead in Colorado. Don't know about elsewhere.

And there's loopholes galore... Example, if they're "too strong" but can't maintain their own airway, a Judge will agree they can't survive. Etc etc etc.

He was very much a South Dakota and Northen Colorado farm kid... Just parts for the tractor... If he wasn't using them, anyone else was welcome to them.

Orgon donation is a wonderful thing. My wife sometimes gets called in to help with the transplant team when organs are harvested. It can be in the middle of the night or whenever, which is awfully inconvenient, but the miracles that result would make any benign deity positively beam with pride. Truly it is the very best of humanity.

Besides, she gets called in at other times for lots worse reasons. Heck, she almost never has to go in unless someone is dying. But at least with a donor someone else is getting another shot at life.

Sorry for the drift, I just had to raise my mug to those souls who literally gave their all.

 

[douglas393]

Didn't know Chris about you being a recipient, but he definitely wanted "anyone who needs any parts" to have them when he was done with them. Haha.

It actually made the day much longer. Brain stem injuries are not "brain death" under Colorado law, and you wouldn't believe the hoops the poor donation places have to jump through to decide if they can get someone with a massive brain stem injury pronounced legally dead so they can take organs.

They were great folks but that process wasn't fun.

You have to remove the person from life support for ten minutes and measure their strength. If they're likely to survive more than 60 minutes, they can't be pronounced legally dead in Colorado. Don't know about elsewhere.

And there's loopholes galore... Example, if they're "too strong" but can't maintain their own airway, a Judge will agree they can't survive. Etc etc etc.

He was very much a South Dakota and Northen Colorado farm kid... Just parts for the tractor... If he wasn't using them, anyone else was welcome to them.

Organ donation is probably one of the most generous gifts of the modern era.

The definition of brain death, which is legally defined differs slightly from state to state ,and considerably sometimes from country to country. In the US for the most part the determination of brain death requires documentation of complete lack of activity in both the brain stem, and cerebral/cerebellar hemispheres and diencephalon. How that is determined can differ from state to state, and even from hospital to hospital with in the same state. In England (though it may have changes since I last looked at it years ago)the presence brain stem function did not rule out brain death, all that had to be shown was the lack of activity of the hemispheres, and I believe diencephalon.

 

[Matthew]

I'm curious: I know you need to report visits to medical professionals within the last 3 years, and this will qualify. But, can a nurse make a diagnosis? I may have missed something along the way, but does a nurse saying, "I think you had a seizure" count as a diagnosis? I know the OP still has to explain the loss of consciousness.

 

[bbchien]

I would tend to think with the lack of a reocrd for the sort of encounter, that anything the nurse said is totally unsubstantiated.

 

[LDJones]

I went to Tulane when the drinking age was 18. If half my friends did not fall over in a given week, something was wrong. One of my good friends, would wake up on someone's frontlawn at least once a month not knowing how he got there or where he was.

And he got a job with Northwest Airlines, right?

 

[douglas393]

And he got a job with Northwest Airlines, right?

NO he is a doc now, last time I checked in Arkansas.

 

[Unregistered]

Op here. Nurse wrote "Fell over, hit head on table, jerked a bit, Was given fluids and food. Said he had not ate all day, which was unusual, said he had been rushed all day. No time to eat. Student admitted to a new diet, high protein, low carb. Told him to come back next week. He said he would."


She then wrote another section,

"Called student following week, said he had ate and drink and fell asleep. Awoke feeling much better. Ask him to come in if problem persist."


Dr. Bruce, that going to hurt me?

By the way, that diet is out the window now. I had been on it for about 1-2 weeks prior to the event.

 

[bbchien]

Nope that's going to be fine. But does it really say, "jerked a bit?" That's hard to believe. The record incriminates itself as to competency of the nurse!

 

[Unregistered]

Op here, Yeh, it really does. That nurse was really not that sharpest tool in the shed needless to say =/