Okay, my job is about 50% patient care and 50% administration these days.
One of my tasks is to review the abnormal labs that come in on our new inmates. The inmates come in at a rate of over 30 a day, so there’s always work to be done. I often have over 100 different patient results to review in a sitting.
As such, I’ve learned to really crank through them. I can identify a potential significant abnormality pretty easily, so I breeze through the insignificant ones rather quickly. I open the chart to the flagged report, scan the report, initial it, date it, then lift that report to see if there’s another to be signed off. Assuming there is and it’s a trivial abnormality, I sign off on that too, until I review all new abnormals in the chart, pull the flag, close the chart, and move it away. The work of a few seconds.
However, many reports (generally culture reports) come back as “preliminary results”. These need to be reviewed, signed, and kept in the chart until the “final results” arrive. At that point the preliminary reports need to be discarded (via shredder, as it is confidential information), rather than clutter up the chart.
In the past, the preliminary results used to reliably cross my desk before the final results did. Lately, they come in bundled together with the final results.
Which caused this recurring scenario:
Open the chart, review and sign the preliminary results, lift it with my left hand, see that the report right under it is the final results, so immediately move the prelim report to the shredder.
I think I did this about 6 times in a row before I noticed my medical assistant staring at me. When I explained what I was doing, she quickly grasped the gist of it. We both do work for the government, after all. However, we did both pause to marvel at the fact that I get paid to review, sign, then immediately destroy reports.
(BTW, I did some quick time and motion studies. It is faster to sign first then shred if necessary, than it is to check to see if the final result is there, then go back and shred the prelim without signing)