In fact, they seem to rely soley on tests.
And to make it worse, they're usually unneeded tests.
For example, if someone comes in to the E.R. with a broken wrist, why in the hell are we doing an EKG to check this person's heart? And, although I don't know all the workings of the tests for the lab, I still am not quite sure what the blood tests are going to tell them. This is where getting the x-ray to see where it's broken and whether it can be set in the E.R. or not should be sufficient.
As I have pointed out recently, more and more, the nurses have been allowed to order x-rays. 1st, it is actually illegal for anyone except a physician to order an x-ray. How they're getting around this is pretty complicated, so I don't want to go into it right now.
2. R.N.s order x-rays on anything that hurts... which is not necessarily the way to go about ordering x-rays. Originally, the agreement was that our R.N.s could order extremity (hands, wrists, feet and ankles) and that was it... but now they're ordering abdomen x-rays, skull and face, and extending into other modalities including ultrasound and C.T.s (cat scan), and probably even Nuclear Medicine! That doesn't sound like extremity work to me!
3. The R.N.s usually fuck up the order anyway. When some dork punches a wall because his gf just dumped him, it's a 99% chance that he breaks his hand, not his wrist...specifically, the 5th metacarpal bone, in what we term a "boxer's fracture." But nope, they order a wrist. Another example is that they would order a knee, tib./fib., and ankle x-rays. That's 3 exams! The knee and ankle joints are just as easily seen on a regular tib./fib. x-rays, so those other 2 exams are actually redundant. Why charge a patient for 3 exams when 1 exam is perfectly sufficient?
I should give them some credit, however... see, my subject line is a rant about doctors... at least the nurses are talking to the patients and asking them where it hurts or whatnot... the doctors don't even seem to be doing that anymore!
My biggest rant is that I wish all the doctors would at least do everything the same way.
When someone comes in on a backboard (say, if they were in a car accident), some doctors take them off, and some leave them on.
I prefer that the patient be kept on the backboard until the cervical spine has been x-rayed and cleared. I get better laterals when the patient is still on the board.
But if the patient is taken off of the board, I am still not allowed to move that patient, so I have to try to take my lateral with the patient lying right on the mattress. Trust me... icky poo poo films.
Tonight was definately C-spine night... lots of people falling, bike accidents and car accidents.
Some of them off of the backboard, some of them on... all depending on what doctor it was.
Do I type too much?
Should I stop babbling and get to something more important?
I wish I was an alcoholic, because I'd be real drunk about now.
Actually, a drink does sound good... maybe I should get one just to help me relax from tonight's stupidity!