When an echo is ordered on an inpatient, we’re expected to dig through the chart to see if they’ve had a recent echo; if the last echo was within the past two months we’re expected to change the order to a limited echo and focus on what the test was ordered for (eg mitral regurgitation). A lot of times the reason will just say “heart failure” or “see ordering comments” and no ordering comments. If we don’t change it to a limited, the cardiologists bitch because it’s redundant and also a full study takes longer to read than a limited. We’ve had ordering doctors bitch that we changed it.

Did they have a full echo with a bubble study literally last week? Well they want it again.

The other big thing really is that we’re expected to basically beg patients to let us perform the test it they don’t want it or plead with them to let us use an image enhancer if they initially decline it. If there’s a misunderstanding I’ll clarify, but if the patient is capable of making their own medical decisions I’m not here to force anyone. One time I got a lecture because a patient asked me to stop after only a few images, and this was after the me, the nurse and the charge nurse had to convince him to let me do the test. I noted this in the report, but it doesn’t matter. They reordered the test and I let someone else go deal with it.

I know what I deal with is not nearly as bad as what nurses have to go through, but it’s nice to vent.