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Authors: Denise Gelberg
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happen.”
“Well, I know Joyce Hilker is a wreck about this. She’s a great nurse; don’t get me wrong. She trusted the pharmacy’s label on the heparin. And she should have been able to trust it. If the pharmacy had done its job correctly, she would never have administered a near-lethal dose of heparin to her patient. But as it stands, she’s got to live with the knowledge that she nearly killed a baby.”
Sarah thought this would be a good time to get Dr. Smith’s take on the rollout of the system lauded by Joanne Marsh. “To what degree, Doctor, would you say the staff believes in the efficacy of the BCMA system?”
“You want the truth?”
“I do.”
“So far, I’d say the BCMA has been more trouble than help. If the company who sold the system had flooded the hospital with their own people to debug it as we rolled it out, maybe we would have had a better first week. But that didn’t happen. I know that I overrode it when it rejected perfectly appropriate scripts. I can’t speak for the others, but I wouldn’t be surprised if they did the same.”
Bingo. The system had problems. Help was scarce. Maybe most importantly, people hadn’t bought into the BCMA. Hence, Alejandro Avila’s reluctance to believe the scanner’s error message and Albert Cappelli’s override of the system with his handwritten label. Joyce Hilker had followed suit, chalking up the failure to scan as a system failure. Sarah would guess Dr. Smith, Avila, Cappelli and Hilker were not alone in responding to the “foolproof” system by blowing it off. In this particular case, however, had everyone involved not overridden the BCMA, Ariel Arkin would likely be healing nicely from the staph infection that brought her to the ER, and the pediatric fellow sitting next to Sarah would be enjoying his day off.
Sarah could see the guy was beat, but there were still some bases to cover. In the event the baby didn’t survive, there would be a further investigation into how the staff had responded to the error. So she asked the pediatric intensivist to describe his efforts to stabilize the baby. She knew she could get much of what he had to say from the baby’s chart, but she figured she couldn’t be too careful. Dr. Smith complied in painstaking detail. When he was done explaining how he had labored through the night to save the child, she shook his hand and thanked him for his help in the investigation.
For Rick Smith’s part, he hightailed it back to his apartment and the lure of at least another couple of hours of shuteye. As he left the interview, he toyed with the idea of checking on Ariel Arkin, but he knew that if he went up on the floor, he’d get sucked in for hours. Instead, he jogged home and thought about that good-looking attorney. She was a little uptight, but a beautiful woman. No doubt about that. Once in his apartment, he quickly pulled off his sweatshirt and jeans and got back into bed. He thought about how he wouldn’t object to spending a little time alone with that lawyer — and then he was out like a light.
* * *
After Doris headed home, Sarah gave John Mess and Julie Bonner a verbal summary of her findings. She emphasized that it was more complicated than just the careless error of a novice pharmacy tech — the story Joanne Marsh had tried to sell earlier to Mess. Sarah told them they would have her written report in the morning. They were both happy — no, ecstatic — to share news on the baby’s condition. Her vitals were strong and her infection retreating. She was responding to stimuli appropriately for her age.
After a day filled with graphic accounts of so ghastly an event, Sarah was relieved to know there was reason to hope that little Ariel Arkin might recover.
CHAPTER ELEVEN
Sarah worked until the wee hours of the morning on her report. It shouldn’t have made any difference that the injured baby had a powerful father, but knowing the big guns Mark Arkin could aim at
“Well, I know Joyce Hilker is a wreck about this. She’s a great nurse; don’t get me wrong. She trusted the pharmacy’s label on the heparin. And she should have been able to trust it. If the pharmacy had done its job correctly, she would never have administered a near-lethal dose of heparin to her patient. But as it stands, she’s got to live with the knowledge that she nearly killed a baby.”
Sarah thought this would be a good time to get Dr. Smith’s take on the rollout of the system lauded by Joanne Marsh. “To what degree, Doctor, would you say the staff believes in the efficacy of the BCMA system?”
“You want the truth?”
“I do.”
“So far, I’d say the BCMA has been more trouble than help. If the company who sold the system had flooded the hospital with their own people to debug it as we rolled it out, maybe we would have had a better first week. But that didn’t happen. I know that I overrode it when it rejected perfectly appropriate scripts. I can’t speak for the others, but I wouldn’t be surprised if they did the same.”
Bingo. The system had problems. Help was scarce. Maybe most importantly, people hadn’t bought into the BCMA. Hence, Alejandro Avila’s reluctance to believe the scanner’s error message and Albert Cappelli’s override of the system with his handwritten label. Joyce Hilker had followed suit, chalking up the failure to scan as a system failure. Sarah would guess Dr. Smith, Avila, Cappelli and Hilker were not alone in responding to the “foolproof” system by blowing it off. In this particular case, however, had everyone involved not overridden the BCMA, Ariel Arkin would likely be healing nicely from the staph infection that brought her to the ER, and the pediatric fellow sitting next to Sarah would be enjoying his day off.
Sarah could see the guy was beat, but there were still some bases to cover. In the event the baby didn’t survive, there would be a further investigation into how the staff had responded to the error. So she asked the pediatric intensivist to describe his efforts to stabilize the baby. She knew she could get much of what he had to say from the baby’s chart, but she figured she couldn’t be too careful. Dr. Smith complied in painstaking detail. When he was done explaining how he had labored through the night to save the child, she shook his hand and thanked him for his help in the investigation.
For Rick Smith’s part, he hightailed it back to his apartment and the lure of at least another couple of hours of shuteye. As he left the interview, he toyed with the idea of checking on Ariel Arkin, but he knew that if he went up on the floor, he’d get sucked in for hours. Instead, he jogged home and thought about that good-looking attorney. She was a little uptight, but a beautiful woman. No doubt about that. Once in his apartment, he quickly pulled off his sweatshirt and jeans and got back into bed. He thought about how he wouldn’t object to spending a little time alone with that lawyer — and then he was out like a light.
* * *
After Doris headed home, Sarah gave John Mess and Julie Bonner a verbal summary of her findings. She emphasized that it was more complicated than just the careless error of a novice pharmacy tech — the story Joanne Marsh had tried to sell earlier to Mess. Sarah told them they would have her written report in the morning. They were both happy — no, ecstatic — to share news on the baby’s condition. Her vitals were strong and her infection retreating. She was responding to stimuli appropriately for her age.
After a day filled with graphic accounts of so ghastly an event, Sarah was relieved to know there was reason to hope that little Ariel Arkin might recover.
CHAPTER ELEVEN
Sarah worked until the wee hours of the morning on her report. It shouldn’t have made any difference that the injured baby had a powerful father, but knowing the big guns Mark Arkin could aim at
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