"Brazil" Award for unbelievable bureaucratic idiocy 1989 nomination, medical division: Here at SF General Hospital we have a form for everything. (Reminds me of the opening monologue from Fiddler on the Roof; "Here in Anatevke, we have a tradition for everything." Same basic idea.) We got a form for xrays, a form for antibiotics, even a form for asking for advice from other departments. If you don't fill out your form, some mindless data-shuffler will beep you in the middle of something important and refuse the service in question, no matter how urgent or medically indicated. This I have long-ago learned to accept. Last nite on call in the Cardiac Intensive Care Unit, however, I saw the form to blow the mind of even this jaded bureauphobe. Sitting innocently among the slips for Blood Gas Analysis and Microbiolgy was one quietly labeled: CARDIOPULMONARY RESUSCITIATION With all the subsequent boxes for patient's name, number, birthdate, indication for procedure, doctor's name, number, liscense, authorizing signature, etc.... I couldn't believe it! I showed the form around to the rest of the Housestaff, CCU nurses, and assorted crew and no one could imagine what the crazed adminstration had in mind with this thing. The imagination boggles: "Code Blue! Code Blue! Room 5! I repeat Code Blue, Room 5! Smith, you're running the code. Johnson and Schwartz, get me IV access, now! Daniels and Wu, I want him intubated STAT. Lopez, man the paddles! Cosgrove, go fill out the CardioPulmonary Resuscitation Form on the double and run it down to the front desk and remember to use Black Ink this time you moron!" ---a few minutes pass--- "I think we have a pulse. Mary, gimme another amp of Epi. John, what did the gas come back at? Damn! Cosgrove, answer my pager will you? ...What! You're telling me to stop the Code? The signature's on the wrong line! The patient's birthdate doesn't check? Cosgrove, you imbecile, you screwed up again! Sorry folks, that's it. We gotta stop. The Cardiopulmonary Resucitation Authorization Committee has disapproved out request for Code orders. They'll have our butts in a sling if we bring this guy back without an OK. Pack it up. Nice try team. Cosgrove, I'll deal with you later..." ---End of Fantasy--- The only thing that stops me from actually worrying about the above scenario is that it would take the imagined committee so long to process any form that not only would the patient be long home but the relevant interns and residents would probably have moved on to other, less crazy, hospitals. A system protected from its malignant officiousness only by its terminal sloth. Back to work now, the pager beeps for me... robin "have tourniquet, will travel" colgrove
(From the "Rest" of RHF)