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Views And Reviews

Doing things for no reason in the hospital

BMJ 2019; 364 doi: (Published 26 February 2019) Cite this as: BMJ 2019;364:l841

Read the full version of this article on BMJ Opinion

  1. Abraar Karan, internal medicine resident
  1. Brigham and Women’s Hospital, Harvard Medical School, USA
  1. abk655{at}
  2. @AbraarKaran

Many of the things we do as doctors continue simply because “that’s the way we’ve always done it,” says Abraar Karan

“Anyone who tells you that you can get any rest in the hospital is full of sh*t.” Not the way I usually start my morning rounds, but the patient had a point. Between having his vital signs checked every four hours (the tight squeeze of the blood pressure cuff, the unapologetic beep of the thermometer), a tangle of wires restricting any reasonable movement (one was his oxygenation probe, the other his cardiac telemetry), and the incessant commotion of the night team admitting a new patient behind his curtains, I couldn’t blame him.

That day on rounds, our team discussed whether he needed to have his vital signs checked overnight—they had been relatively stable for a few days. Similarly, his oxygenation levels had never really been a concern. He did initially need telemetry, but his heart rate …

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