Saturday, October 06, 2012

Recently, I read an article bringing attention to our practice of identifying new protocols and practices, as being “Evidence Based”. I don’t remember much of the article, but it did ring true in some respect, with my opinion of this overused, naming of new things.

About five years ago, we were instructed in new, (“Evidence Based”), Intensive-Care Insulin Administration Protocols. At the same time, there were other similar protocols instituted for those patients not in the Critical-Care setting.

Here we are five years later, now knowing that those mechanisms and flow-charts for treating elevated levels of blood glucose, were based on some erroneous ideas, resulting in thousands of hypoglycemic episodes. This was not isolated to just our hospital, but in fact, it was happening nationwide. Unfortunately, singular episodes of severe hypoglycemia, are far more damaging than the opposite. Hypoglycemia can cause death and brain damage, in a very short period of time.

So go ahead and call me obstructionist, if you will, as I cast a very suspicious eye upon our newest “evidence-based”, hot off the griddle, it’s the latest and greatest, Glucose Monitoring and Treatment Protocol. Whoopdy-doo!

Repackaged Miracles

The same old theories
Newly renamed,
And we are the Nurses
Soon to be blamed,
For all of the shortcomings
And lack of adherence,
Yes, these tired old formulas
Have a shiny new appearance.

That’s what I’ve noticed
During the last thirty years,
Repackaged recipes
That drive me to tears,
Sure, some of that knowledge
Is rightfully new,
But they sell it to us, saying
“It’s a miracle, sacré bleu!”

If it was truly a miracle
It wouldn’t need fixing,
No, this is Grandma’s old pudding
With a little remixing,
Reformulated ingredients
That taste just about the same,
Pharmaceuticals and committee’s
Why, they all play this game.

Administrators and mid-managers
Tout this latest new way,
But, I’m telling you Brother
We’re the ones who will pay.


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