Chits for Rounds

The wards are crowded with patients. The residents' minds are crowded with many things. Sometimes the nurses reshuffle patients' beds after the residents' ward rounds. Hence it becomes difficult to remember which patient has what, and hence they have to resort to memory aids when they present patients to seniors on ward rounds. Our current Registrars carry this information in a written form. Some of them carry it on small chits used for writing prescriptions. Others write it on bigger sheets of paper. I have told them repeatedly not to waste time and energy writing things down which are already on indoor papers. They should refer to the indoor papers while telling us about the patients' details. But they think they know better. Today my Registrar kept looking at a small yellow chit of paper and kept making mistakes like calling a given patient by another patient's name, stating the time of operation differing by the actual time by 12 hours, and not describing the delivery findings or intraoperative findings. I asked her to refer to the indoor papers, but she wouldn't. If a question appeared to be a little difficult, she would turn to the Associate Professor seeking inspiration, support or a ready answer. Finally I confiscated the yellow slip of paper and gave it to the co-Registrar for safe keeping. Then the Registrar started telling me about the patients from her memory, without looking at any record anywhere. I was worried, because I knew she would make even more mistakes without the information on the yellow piece of paper. So I started checking whatever she said against the indoor papers, and started finding disparities between the two. Even after pointing out this fact, she would not touch the indoor papers. It must be some sort of phobia, I thought. After some time, I found a yellow piece of paper in her hand again. So I turned to the co-Registrar and asked her why she had returned the yellow paper I had given to her for safe keeping. Then it turned out that this one was another piece of similar paper, while the first one was still with the co-Registrar. The Registrar had not understood that the ban was not on only the first piece of paper, but was on any piece of paper. I confiscated the second piece of paper too. But her apron pockets seemed full, and yellow chits were seen protruding from the top as well as from the bottom of the pockets where the stitch had become loose. I had to make her surrender all pieces of paper from her pocket before the round could be continued in a more professional manner. I hope she will finally learn not to waste national resources on duplication of records, of which one set will be thrown away after the rounds. I wonder if she writes a new set every day or uses the same old set day after day. That would save national resources to a large extent, and would also explain the disparities between her presentation and the actual facts.