This week I am at the National Commission on Correctional Health Care’s Fall conference, and if you have ever attended, you know the feeling. Within a few hours, the hallways fill with conversations that would make little sense almost anywhere else. Someone describes a medication pass that ran two hours late because of a lockdown. Someone else asks how other…
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It’s 2:30 in the morning. You saw a patient at evening sick call for a cough and fever, and you have reassessed him twice since then. His respiratory rate is a little faster than it was earlier, and his oxygen saturation is a few points lower. He tells you he feels about the same. Nothing is dramatically abnormal, and nothing…
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When I review a medical record, I rarely look at a single note by itself. I read the record from beginning to end, and over time the individual entries begin to tell a story. Sometimes the story is reassuring. Sometimes it shows something that no one recognized while it was happening. Consider a patient who submits a sick call request…
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