Day 76: Handover Chaos Before Rounds

Dialogue

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1. 1

   A 다들 잠깐 모여 봐요. 어제 교수님 회진 때 스테이션에 아무도 없었던 거, 병동에 소문 다 났죠?

   Dadeul jamkkan moyeo bwayo. Eoje gyosunim hoejin ttae Seuteisyeone amudo eopseotdeon geo, byeongdonge somun da natjyo?

   Everyone, gather round for a minute. The whole ward has heard by now that nobody was at the station when the professor came on rounds yesterday, right?

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2. 2

   C 네... 그때 저희 다 인수인계 중이었어요. 일곱 시에 시작했는데 사십 분 넘게 걸렸거든요.

   Ne... geuttae jeohui da insuingye jungieosseoyo. Ilgop sie sijakaenneunde sasip bun neomge geollyeotgeodeunyo.

   Yes... We were all in handover then. It started at seven and took over forty minutes.

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3. 3

   A 그래서 오늘은 제대로 정하자고요. 일곱 시 반 회진 전에 인수인계까지 다 끝내자면 지금 방식으로는 도저히 안 돼요.

   Geuraeseo oneureun jedaero jeonghajagoyo. Ilgop si ban hoejin jeone insuingyekkaji da kkeunnaejamyeon jigeum bangsigeuroneun dojeohi an dwaeyo.

   So today we're settling this properly. If we want handover finished before rounds at seven-thirty, there's no way we can do it the way we do now.

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4. 4

   C 제 생각엔 인수인계를 십오 분으로 줄여야 해요. 전산에 다 적혀 있는 걸 굳이 입으로 한 번 더 읽을 필요가 있나 싶어요.

   Je saenggagen insuingyereul sibo buneuro juryeoya haeyo. Jeonsane da jeokyeo inneun geol guji ibeuro han beon deo ilgeul piryoga inna sipeoyo.

   I think we should cut handover to fifteen minutes. I'm not sure we need to read aloud everything that's already in the system.

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5. 5

   B 그게 바로 실수가 생기는 방식이에요. 지난달에 금식 환자한테 식판 들어간 거 기억 안 나세요? 전산에는 적혀 있었는데 말로 안 넘겨서 착오가 생겼잖아요.

   Geuge baro silsuga saenggineun bangsigieyo. Jinandare geumsik hwanjahante sikpan deureogan geo gieok an naseyo? Jeonsaneneun jeokyeo isseonneunde mallo an neomgyeoseo chagoga saenggyeotjanayo.

   That's exactly how mistakes happen. Don't you remember last month, when a meal tray went to a patient who was nil by mouth? It was in the system, but nobody said it at handover, so the mix-up happened.

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6. 6

   C 그건 한 번 있었던 일이잖아요. 매일 사십 분씩 붙잡혀 있다가 투약에 차질이 생기는 것도 실수예요.

   Geugeon han beon isseotdeon irijanayo. Maeil sasip bunssik butjapyeo itdaga tuyage chajiri saenggineun geotdo silsuyeyo.

   That happened once. Being stuck for forty minutes every day and throwing off the medication schedule is a mistake too.

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7. 7

   B 인수인계를 대충 넘길 바에야 차라리 회진을 늦추는 게 낫죠. 환자 안전이 먼저잖아요.

   Insuingyereul daechung neomgil baeya charari hoejineul neutchuneun ge natjyo. Hwanja anjeoni meonjeojanayo.

   Rather than rush through handover, we'd be better off pushing rounds back. Patient safety comes first.

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8. 8

   A 회진 시간은 제가 정할 수 있는 게 아니에요. 교수님 외래가 여덟 시 반부터라서요.

   Hoejin siganeun jega jeonghal su inneun ge anieyo. Gyosunim oeraega yeodeol si banbuteoraseoyo.

   The time of rounds isn't mine to decide. The professor's outpatient clinic starts at eight-thirty.

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9. 9

   B 그럼 적어도 위험한 환자들은 꼭 말로 넘겨야 해요. 수술 직후 환자, 금식 환자, 낙상 위험 환자요.

   Geureom jeogeodo wiheomhan hwanjadeureun kkok mallo neomgyeoya haeyo. Susul jikhu hwanja, geumsik hwanja, naksang wiheom hwanjayo.

   Then at the very least, the high-risk patients have to be handed over verbally. Patients straight out of surgery, patients who are nil by mouth, patients at risk of falls.

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10. 10

    C 그건 저도 동의해요. 그럼 안정된 환자는 전산 요약만 확인하고, 위험한 환자만 병상 옆에서 직접 넘기면 어때요?

    Geugeon jeodo donguihaeyo. Geureom anjeongdoen hwanjaneun jeonsan yoyangman hwaginhago, wiheomhan hwanjaman byeongsang yeopeseo jikjeop neomgimyeon eottaeyo?

    I agree with that. Then how about we just check the system summary for stable patients, and do the high-risk ones in person at the bedside?

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11. 11

    A 병상 옆에서요? 환자 앞에서 넘기면 환자분이 틀린 걸 바로잡아 주실 수도 있겠네요.

    Byeongsang yeopeseoyo? Hwanja apeseo neomgimyeon hwanjabuni teullin geol barojaba jusil sudo itgenneyo.

    At the bedside? If we do it in front of the patient, the patient might even correct us when we get something wrong.

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12. 12

    B 맞아요. 저번에 어떤 할머니는 '나 어제부터 물 마셔도 된다고 했어요' 하시면서 저보다 정확하게 기억하시더라고요.

    Majayo. Jeobeone eotteon halmeonineun 'na eojebuteo mul masyeodo doendago haesseoyo' hasimyeonseo jeoboda jeonghwakage gieokasideoragoyo.

    That's right. The other day an elderly lady told me, 'They said I could drink water from yesterday,' and she remembered it better than I did.

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13. 13

    C 근데 그러려면 밤 근무자가 여섯 시 반까지 검사 결과를 다 정리해 둬야 해요. 안 그래도 힘든 밤 근무에 일만 더 얹는 거 아니에요?

    Geunde geureoryeomyeon bam geunmujaga yeoseot si bankkaji geomsa gyeolgwareul da jeongnihae dwoya haeyo. An geuraedo himdeun bam geunmue ilman deo eonneun geo anieyo?

    But for that to work, the night shift would have to have all the test results sorted by six-thirty. Isn't that just piling more work onto a shift that's hard enough already?

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14. 14

    A 그 말은 일리가 있어요. 뭘 새로 하자면 누군가의 일이 느는 건 피할 수 없으니까요.

    Geu mareun illiga isseoyo. Mwol saero hajamyeon nugungaui iri neuneun geon pihal su eopseunikkayo.

    That's a fair point. Whenever you set out to change something, somebody's workload goes up. There's no avoiding it.

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15. 15

    B 그럼 새벽 채혈을 삼십 분 당기는 건 어때요? 다섯 시에 채혈하면 여섯 시 반에는 결과가 거의 다 나와요.

    Geureom saebyeok chaehyeoreul samsip bun danggineun geon eottaeyo? Daseot sie chaehyeolhamyeon yeoseot si baneneun gyeolgwaga geoui da nawayo.

    Then how about moving the early-morning blood draws half an hour earlier? If we draw at five, nearly all the results are back by six-thirty.

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16. 16

    C 다섯 시요? 환자분들 주무시는데 깨우면 민원 들어와요.

    Daseot siyo? Hwanjabundeul jumusineunde kkaeumyeon minwon deureowayo.

    Five? If we wake patients while they're asleep, we'll get complaints.

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17. 17

    B 어차피 다섯 시 반에는 깨우잖아요. 삼십 분 차이로 민원이 들어오면 제가 직접 설명드릴게요.

    Eochapi daseot si baneneun kkaeujanayo. Samsip bun chairo minwoni deureoomyeon jega jikjeop seolmyeongdeurilgeyo.

    We wake them at five-thirty anyway. If half an hour gets us a complaint, I'll explain it to them myself.

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18. 18

    A 좋아요, 정리해 볼게요. 채혈은 다섯 시, 위험 환자는 병상 옆 인수인계, 나머지는 전산 체크리스트로 확인.

    Joayo, jeongnihae bolgeyo. Chaehyeoreun daseot si, wiheom hwanjaneun byeongsang yeop insuingye, nameojineun jeonsan chekeuriseuteuro hwagin.

    Good, let me sum up. Blood draws at five, bedside handover for high-risk patients, and a system checklist for the rest.

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19. 19

    C 체크리스트는 제가 만들게요. 줄이자고 한 사람이 저니까, 빠지는 게 없게 빈틈없이 만들어야지요.

    Chekeuriseuteuneun jega mandeulgeyo. Jurijago han sarami jeonikka, ppajineun ge eopge binteumeopsi mandeureoyajiyo.

    I'll make the checklist. I'm the one who wanted to cut things, so it's on me to make it airtight so nothing gets left out.

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20. 20

    B 그럼 저는 위험 환자 기준을 정리할게요. 누가 봐도 헷갈리지 않게요.

    Geureom jeoneun wiheom hwanja gijuneul jeongnihalgeyo. Nuga bwado hetgalliji ankeyo.

    Then I'll write up the criteria for high-risk patients. So nobody can get confused.

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21. 21

    C 그리고 수선생님, 월요일만이라도 회진을 십오 분 늦춰 달라고 교수님께 한번 말씀드려 주시면 안 될까요?

    Geurigo suseonsaengnim, woryoilmanirado hoejineul sibo bun neutchwo dallago gyosunimkke hanbeon malsseumdeuryeo jusimyeon an doelkkayo?

    And Chief, could you maybe ask the professor to push rounds back fifteen minutes, just on Mondays?

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22. 22

    A 말씀은 드려 볼게요. 설득이 쉽지는 않겠지만요. 새 방식은 이 주 동안 시범으로 해 보죠. 시행착오야 있겠지만, 환자 안전 문제가 한 건이라도 생기면 바로 원래대로 돌아가요.

    Malsseumeun deuryeo bolgeyo. Seoldeugi swipjineun anketjimanyo. Sae bangsigeun i ju dongan sibeomeuro hae bojyo. Sihaengchagoya itgetjiman, hwanja anjeon munjega han geonirado saenggimyeon baro wollaedaero doragayo.

    I'll ask. The professor won't be easy to persuade, though. Let's trial the new system for two weeks. There'll be some trial and error, but if even one patient-safety problem comes up, we go straight back to the old way.

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