Archives for February 21, 2005

Daily Weights, and other senseless acts of hospitalization

InstaPundit’s spouse is in the hospital, apparently for evaluation and treatment of arrhythmic heart disease. The hoped-for ablation couldn’t happen, so now they plan placement of a pacer / AICD. I presume that’s why she’s still an inpatient, but don’t know for sure.

This morning he asked, reasonably, why it’s necessary to wake up patients all night long. Yes, vitals can be important, but his objection was to a 5AM “daily weight”. Shrinkette has given a well-written, objective rationale, along with personal experience doing the weighing. Also, Alwyn is on the job from Code:theWebSocket with the nurses’ outlook.

I’m going to point out the other side: orders like this (occasionally) are done ‘just because’. Heart failure is the most common reason to obtain daily weights, as the tale of the scale is very sensitive to fliud retention, and it’s simple and predective enough it’s taught to patients as an at-home screen to adjust diuretics.

However, sometimes patients get admitted to the Cardiac Unit and get Standard Orders, and it’s easy to check a box for daily weights whether that data point is really useful or not. (Data is what you make of it, and I’m not saying this is the case here, I’m just explaining a contrary view). Docs don’t actually DO these weigh-ins, so we don’t know exactly when it’s done, but when rounding on patients docs are going to want the numbers so they can act on them. Rounds will be early, as there’s an office full of patients to be seen today. (Please note, this is from my past experiences as a med student / intern / resident. I’m now happily only in the ED, and none of this impacts me, except for checking the boxes on the ‘standard orders’).

So, it might be necessary, and it might not. Wouldn’t hurt to ask the doc on rounds if that’s really something she needs.

InstaPundits’ latest: he helped his wife scrub her chest with betadine to get ready for her pacemaker insertion. Wow, what a vivid image of a couple sharing their mortality, hope, faith and trust.

Here’s for all the best for his wife and his family.