Page 60 - Hospitalists - Risks When You're the Doctor in the House (Part One)

SVMIC Hospitalists - Risks When You’re the Doctor in the House

Communicating with Staff

It is important to build and nurture rapport with nursing staff
in order to avoid a toxic environment in which nursing staff are

hesitant to call on the physician. This can potentially create an
unsafe situation for the patient and simultaneously increase

liability exposure for the physician. The following case illustrates,
among other things, the need to listen to other members of the

team.

C A S E S T U DY

Mr. Miller, a 40-year-old male patient, was hospitalized
following surgery to remove a large atypical thyroglossal

duct cyst from the base of his tongue. The patient, who
was physically active, 6’ 2”, 240 lbs., and presumed to be

otherwise healthy, was admitted so that a feeding tube
could be placed since food could not pass the surgery site

without causing dehiscence and contamination. He was
admitted to the care of a hospitalist, Dr. Kerr, who viewed

his role as basically “babysitting” this patient until he was
able to swallow food again and could be discharged.

After a few days, the patient began exhibiting signs of
abnormal behavior, agitation, nervousness, and “weepy”

emotional outbreaks. All of this was noted in the patient’s

medical record and was brought to Dr. Kerr’s attention by
both the nursing staff and the patient’s family. Although
disputed later, Dr. Kerr said that during his conversation

with the patient’s wife, she told him that Mr. Miller had not

been truthful on his pre-op questionnaire about his alcohol
consumption and that, in actuality, he typically drank two
or more six packs of beer per day. This conversation was

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