2HPPS ...and other nonsense

Everyone on the planet is familiar with at least one other person whose mere presence makes their skin crawl. For me, there are a variety of doctors who fit into this category, but one in particular actually makes me try to come up with a reason to leave the floor so as to avoid any sort of conversation between him and I. We'll call him Dr. I., for Irritating.

Today, as I was doing some bedside patient teaching about a persantine cardiolyte stress test with a middle-aged woman, Dr. I. rushed into the room and said, "Are you taking care of 59B, too?" (I was standing at 59A.) I said, "Yes," and continued with my teaching, basically ignoring his implied request for me to drop everything and follow him to the other side of the curtain. He proceeded to ask me questions about his patient through the curtain as I was obtaining consent for the stress test from bed A. I have gotten pretty good at ignoring him and finishing what I'm doing, so I did just that. When I walked around the curtain, he said, "Have you been checking her blood sugars?" And I said no. He said, "I wrote for you to check her blood sugars. And I ordered Hemoglobin A1C and a fasting blood sugar," I said, "The order says to check her blood sugars if she reports any dizziness. She hasn't been dizzy." (And she's not diabetic.) He says, "Oh." Yeah, Oh. Ugh, I am already annoyed. Then he says, "Well what about her fasting blood sugar? Did they do another one two hours after she ate?" And I said, "That fasting one would be on her morning labwork, right? She had a BMP. It should be on the chart." He says, "Can you go make sure it's on the chart?" I'm like, come on, you are so helpless.... but I think to myself, hey - he's actually just given me a reason to leave the room... I'm on it!! So I walk out and ask the secretary to print the labs for 59B. He comes out to the desk and says (as I am handing him the two pages of lab results), "Did you get my paperwork? Did she have a fasting blood sugar? And did they do the HbgA1C?" And I say, "Yes... it's all there..." MAN, THIS GUY IS ANNOYING. OPEN YOUR FREAKING EYES AND look AT THE PAPER I JUST HANDED YOU.

I shall break briefly to define a few things. A BMP is a basic metabolic panel which, when drawn at 5 a.m., always includes a fasting blood sugar. A HgbA1C, otherwise known as Hemoglobin A1C, is an indicator of where a patient's blood sugars have been over the past three months - it's a way to check for new diabetes and also to check up on how well an known diabetic is managing their disease. Both results in this case were normal.

So then Dr. I. calls me over to him and shows me the orders in the chart. "See? Right here. I ordered a fasting blood sugar and HgbA1C. And a post-prandial blood sugar two hours after she eats. See, it's right here. Did they do test her sugar after she ate?" And I say, no. "But I ordered it, it's right here." I look at what he is pointing at:

2HPPS.

I am guessing that is 2 hour post-prandial sugar, meaning two hours after the meal. I say, "Ahh. That's because we had no idea what you meant by that order." Duh, who WOULD know? Anyway, whatever. He's like, "Post-prandial blood sugar? You don't know what that means?" and I'm like, "NO, I just didn't know what 2-H-P-P-S meant."

"It means two hour post-prandial blood sugar."

(Gritting my teeth...) "Yeah, I got that. We didn't know what that meant. You could probably write it out. So you want us to do a chemstick two hours after she eats, or do you want it drawn by the lab?" He says, "Oh, by the lab, definitely by the lab." Yeah, because the chemstrip machines by which we dose all our insulin-dependent diabetics are completely unreliable. What a moron. So as I am giving report, like literally midsentence, he busts into the report room and says, "Make sure you do that blood sugar today. I wrote it. Make sure it gets done." And I say, "Did you write it out, so the next shift knows what it means?" (Of course I'd already passed it on, but that's not the point.) He says, "I wrote it. I told the secretary. She knows. You make sure it gets done."

So I go out to the chart, and this is what he wrote: 2HPPBS today *underlined.*

Okay, not only are you an idiot for writing it the first time, but you are even more of one for re-writing it when I already told you no one knows what this [unapproved] abbreviation means. But on top of all of that, you threw in an extra letter, which is just retarded - why change something to add confusion to something that was already confusing? AHHHHH!