1. This is my big one. If a child has a G-Tube, perhaps ASK if they eat orally. Let’s face it, this is a more productive question than half the stuff you ask. “Does he eat or drink orally?” is a GREAT introductory question to the infamous “Is he still eating and drinking ok?” Because NOTHING Pisses off a mom of a child who doesn’t eat orally like asking how he’s eating. He’s NOT EATING. Because he doesn’t eat. And maybe when you ask if he’s eating and drinking OK, you mean to include tube feedings, but I can’t assume that, because I can’t assume you’ve looked at his chart and know that he is tube-only. If I just answer, “yes,” I know that I’ll inevitably have a whole horde of confused residents, med students, and God only knows who else, because it’ll inevitably get written somewhere that he’s eating just fine. And THAT will be the one note that anyone bothers to read in his chart.
2. If his chart is too voluminous to read through before you come talk to us, perhaps you need to come up with a better system than making the parents answer the same questions over and over and over and over and over and over. After telling 30 people that he doesn’t eat orally, I’m kind of over that conversation. After explaining to 30 people that he vomits a few times a day and it’s OK, I’m likewise pretty much finished. I’m similarly tired of explaining to 10 people every day how his poops have been for the last day or so, or discussing how he tolerates his feeds, or how he got that bump on his face, or that he fell down and busted his lip. Maybe one person can come in and ask questions and I can record the answers into a digital recorder that we can post inside the door to our room. Anyone who enters can just listen. Maybe the first person to ask us questions each day just jots the answers down in a special place on his chart, a place where EVERYONE looks before talking to us.
3. If there are more than one of you going around and seeing patients, travel together. Honestly. There’s no excuse for a resident and a med student to come see him within 10 minutes of each other.